The Bethesda Fertility Center is the only center in the region with a long history of offering ovarian reserve screening. Our research has contributed extensively to published national literature in this field, helping to establish industry standards for this important screening tool.
Ovarian Reserve Screening (Egg Count)
This is the best indicator of a woman’s reproductive potential. As a woman ages, so do her ovaries and eggs. The reproductive potential of the aging ovary begins to decline after a woman reaches age 30, and the rate of decline is unique to each woman.
What tests are used for ovarian reserve screening?
Tests for ovarian reserve include an ultrasound and/or blood work.
Who needs ovarian reserve screening?
While age is the most common factor for a diminished ovarian reserve, unexplained infertility is a significant risk factor as well. About 33 percent of women with a prior diagnosis of unexplained infertility have a diminished ovarian reserve.
Semen analysis is a primary tool for diagnosing urological and infertility issues.
When and where should a man have a semen analysis?
A semen analysis should be done very early in the evaluation of a couple seeking fertility treatment. The Bethesda Fertility Center is home to one of the region’s leading reproductive labs led by a board-certified physician, Dr. Warikoo.
HSG or SIS Procedures
Hysterosalpingography (HSG) — This procedure looks at the uterine cavity and the openness of the fallopian tubes. The procedure lasts about 10 minutes and is performed in the hospital’s Radiology unit. The physician injects contrast dye into the uterine cavity via a catheter inserted through the cervix. If the fallopian tubes are open, the contrast dye will fill the tubes and enter the abdomen.
Saline Infusion Sonohysterogram (SIS) — SIS is an ultrasound test performed in the office where a catheter is inserted through the cervix, and saline (fluid) is injected to distend the uterine cavity. This helps the physician detect the possible presence of polyps (overgrowth of the uterine lining or endometrium) or fibroids (overgrowth of the uterine muscle), both of which may interfere with pregnancy.
Intrauterine Insemination (IUI)
Intrauterine or artificial insemination involves placing a highly-concentrated sperm sample into the uterus during ovulation. Depending on the infertility cause, IUI can be coordinated with your normal cycle or done in conjunction with ovulation induction medications. Each cycle is carefully monitored through office visits, ultrasounds and blood work. The cost is relatively low for IUI, and it is usually the first step in treatment.
The IUI is performed by threading a very thin, flexible catheter through the cervix and injecting washed sperm directly into the uterus. The procedure is similar to a Pap smear exam and can be done in the comfort of our center.
Ovulation induction (OI) can prompt the ovaries to release an egg using oral medications and/or injectable hormones. Because the course of treatment depends on the woman’s history, we perform a full workup to identify potential underlying conditions such as ovarian cysts or hormonal dysfunction (i.e., thyroid conditions). We also evaluate male infertility as part of a comprehensive approach to infertility diagnosis and treatment.
Women needing OI typically fall under two categories:
- Those who ovulate irregularly or not at all
- Those who ovulate regularly and have normal menstrual cycles.
Recurrent Pregnancy Loss
Miscarriages before 20 weeks of gestation happen in 15 to 25 percent of all pregnancies, and it is estimated that 25 percent of women will experience at least one pregnancy loss during their life. Miscarriage rates increase with as women age.
Recurrent pregnancy loss is defined by three or more miscarriages. Less than 5 percent of women will experience two consecutive pregnancy losses, and only 1 percent will experience three or more.
Can I still carry to term after recurrent miscarriages?
Recurrent pregnancy loss is emotionally stressful to patients, especially when a definitive cause cannot be found, which is true for a large percentage of cases. In the absence of an apparent cause, the prognosis is usually good with a live birth rate above 50 percent even after six consecutive pregnancy losses.