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It’s one of life’s ironies: when your body is at its peak ability to have a baby is often not when you are actually ready to build a family. Breaking it down for us, Dr. Shruti Malik of our Fair Oaks, VA, location talked to Business Insider to answer the question: how long does it take to get pregnant?

How long does it take to get pregnant?

Malik tells would-be parents not to worry if they don’t conceive immediately. For most fertile couples, it takes on average 5 to 7 months to conceive.

On average, a couple who is having unprotected sex and has no history of infertility, and the woman is younger than 35, has a 15 to 20 percent chance of successfully conceiving each month and the timing needs to be just right. “I have a lot of patients who spent a good portion of their adolescence trying to prevent pregnancy, and then later find out that it’s more difficult than one would necessarily presume,” says Dr. Malik.

When to see a specialist?

While there may be a 15 to 20 percent chance of conception each month at a woman’s peak fertility, this rate declines throughout her 30s and 40s. If a woman is younger than 35 and hasn’t become pregnant within 12 months, both partners should have their fertility evaluated.

Since maternal age is such a vital indicator of fertility as egg quality diminishes and the likelihood for miscarriage and chromosomally abnormal eggs increases with age, the recommended window for trying to conceive without assistance decreases after the age of 35. For a woman 35 to 39, if she hasn’t conceived within 6 months, the couple should be evaluated. And finally, for women 40 and over, the window reduces to 3 months.

“If she has not conceived in that window, there is a higher likelihood that there may be other factors that are contributing to that couple’s difficulty in conceiving. And at that point in time, it warrants seeing a physician or fertility specialist,” Malik explained.

Schedule an Appointment

How long does it take to get pregnant? Talk to a specialist at Shady Grove Fertility. Call 1-877-971-7755. 

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Headlines around the world have cautioned pregnant women and couples trying to become pregnant about the effects of the Zika virus. One of the most alarming results of the spread of Zika virus has been the impact on babies born to mothers with Zika. These children are in danger of fetal birth defects including microcephaly. The Centers for Disease Control and Prevention (CDC) describes microcephaly as, “a birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly.” At Shady Grove Fertility we are committed to providing the most accurate and up to date information about the Zika virus and pregnancy, as well as educating our patients on the simple prevention steps men and women who are trying to conceive should take this summer.

How and where is Zika virus spreading?

Zika virus can only be transmitted via direct mosquito bite or sexually transmitted by a partner who has been infected. Currently, mosquito breeds carrying the virus are clustered in the Caribbean, Central and South America, as well as parts of Africa and Pacific Islands.

The CDC has a comprehensive list of countries around the world that should be currently avoided. If your partner has been to any of these areas recently the CDC advises intercourse with condoms. Pregnant women who have partners who have recently traveled to infected regions should consult with their physicians before intercourse.

Zika Virus and Pregnancy: What We Know Now

On Friday, May 20, the New York Times shared the CDC’s latest update about the Zika virus in the U.S. and abroad. Of the 279 pregnant women the agency is now monitoring, just over half are in the 50 states and District of Columbia with the remaining 122 in Puerto Rico and other territories. Notably, the Times reports, “in most cases, it was difficult to determine how the women became infected because they had lived in or had traveled to areas where mosquitoes carrying the virus were biting.” Currently there is no evidence that Zika-carrying mosquitoes are in the continental U.S. or territories.

Protect Yourself from Zika: Be Vigilant This Summer

The CDC website offers comprehensive news about Zika virus with the following safety tips to avoid mosquito bites:

  1. Wear long sleeve shirts and pants.
  2. Stay in places with air conditioning and screens on all windows to prevent mosquitoes from entering.
  3. Apply sunscreen BEFORE insect repellant.
  4. Look for EPA-approved insect repellants that contain one of these ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Products with EPA approval are okay for use by pregnant and breastfeeding women. Follow instructions on the package and reapply as indicated.
  5. Use indoor and outdoor insect spray.
  6. In areas outside the home that are frequently in use during the summer, keep them scrubbed, clean, and dry. Mosquitos lay their eggs in moist, dark places like under patio furniture and swarm near water like in bird baths.
  7. Inside the home empty, turnover, and scrub every item such as flower pots and vases that water is in.

Zika Virus and Pregnancy: Trying to Conceive

The CDC specifically addresses what cautionary measures men and women who are trying to conceive should take. In addition to the above list to prevent mosquito bites, the CDC also provides guidance for sexual intercourse with a partner who may have come in contact with the virus, and a timeline for trying to conceive after exposure. For healthcare providers, CDC has provided specific guidance for patients who have been exposed to the virus.

Suggested time frame to wait before trying to get pregnant:
Possible exposure via recent travel or sex without a condom with a man infected with Zika

  Women Men
     With Zika symptoms Wait at least 8 weeks after symptoms startWait at least 6 months after symptoms start
     No Zika symptomsWait at least 8 weeks after exposureWait at least 8 weeks after exposure
Talk with your healthcare provider


People living in areas with Zika

  Women Men
     With Zika symptomsWait at least 8 weeks after symptoms startWait at least 6 months after symptoms start
     No Zika symptomsTalk with doctor or healthcare providerTalk with doctor or healthcare provider

For men and women who are trying to conceive this summer and experiencing infertility, it is important to speak with a fertility specialist. From the CDC:

“Decisions about pregnancy planning are personal and complex, and the circumstances for women and their partners will vary. Women and their partners should discuss pregnancy planning with a trusted doctor or healthcare provider. As part of counseling with healthcare providers, some women and their partners living in areas with active Zika virus transmission might decide to delay pregnancy.”

Schedule an Appointment

If you are concerned about Zika virus and pregnancy and experiencing infertility, please call Shady Grove Fertility’s new patient center at 1-877-971-7755.

Editors Note: This post was originally published in May 2016. For the most up-to-date information on Zika, please read Zika Virus: Getting Pregnant Amid Concerns.

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If you’re contemplating single motherhood, there are many important things to consider in making your decision. Perhaps you are among a population of women who made a promise to themselves that they would still pursue motherhood if they were not married by a certain age. Or maybe you’ve been married and divorced without a child and you still want to be a mother. Perhaps you’ve always pictured yourself as a parent—but not necessarily as a wife—so single motherhood just makes sense to you. Or, quite possibly, the decision involves mourning the dream of the “traditional” path to motherhood: love, marriage, and then a child. Regardless of which path led you to this decision point, we recommend answering the following questions honestly about yourself before you move forward.

Considerations before Choosing to Become a Single Mother

There are many questions to consider in choosing to become a single parent:

  1. Do I have financial, emotional, and social resources to be a parent?
  2. Do I have realistic expectations about motherhood?
  3. Would my family and friends support my decision to be a single mother?
  4. How would I handle any health issues that arise during pregnancy or with my child?
  5. Do I have a good work-life balance? Do I travel frequently in my current position? Should I consider moving to another position? How will I manage all of the demands on my time?
  6. If something happened to me, who would be my child’s guardian?

These questions are not unique to single women, as many married couples ask themselves similar questions, although they are more poignant for a woman choosing to parent on her own.

Single women are also often posed with questions or judgments that their coupled counterparts do not receive. For example, many are asked, “Why do you want to become a parent?” The answers are similar to other women: “I always wanted to be a mother.”

Once you’ve made the decision to move forward the next step is to meet with a physician.

Step One: Meeting with a Physician

The first step for mothers by choice is to schedule a consult with a physician. During this appointment, your physician will review your medical history and order a basic infertility work-up. The work-up consists of day 3 bloodwork and an ultrasound to assess your ovarian reserve, as well as a hysterosalpingogram (HSG) to make sure your Fallopian tubes are not blocked. Many women wonder why they need this basic testing—the answer is because your physician will use the results of these simple tests to suggest the best method for conception—a basic form of treatment such as intrauterine insemination (IUI) or a more advanced option such as vitro fertilization (IVF). If your physician finds that your Fallopian tubes are blocked, then lower tech treatment options would not be beneficial to achieving the ultimate goal. Once you complete this testing, you will meet with your physician to review the results.

Following, you will have a chance to meet with a psychologist or social worker with expertise in infertility—a requirement for anyone who is using third-party reproduction. Time spent with your mental health professional will be helpful to work through the mental and emotional aspects of utilizing donor sperm. Once you’ve completed this step in the process, the next step is to select the sperm donor.

Step Two: Choosing a Sperm Donor

Many women planning to have a baby on their own don’t necessarily have any fertility problems, rather they just need sperm to conceive, which is usually obtained from an anonymous sperm donor database. Shady Grove Fertility is very selective in choosing which cryobank to refer patients. For each of the sperm banks we recommend, all sperm donors go through a rigorous course of screening, as required by the U.S. Food and Drug Administration (FDA)—physicals, family medical history screenings, genetic screening, psychological testing, and a semen analysis, to name a few. This is to protect the recipient, ensuring that she will have access to the healthiest possible sperm.

Common Questions about Using a Sperm Donor:

Does the sperm donor remain anonymous?
A recipient will select her sperm donor using the cryobank’s website. Sperm donors are anonymous, but they usually provide a childhood picture. The database provides personal demographics (i.e., hair color, height, race, etc.), as well as essays written by the donor. Some cryobanks even offer voice recordings of interviews with the donor and information on what celebrity the donor looks like. In some cases, recipients can view if previous pregnancies have resulted from that donor’s sperm.

In the case of a known donor (i.e., a friend or family member), the recipient will still need to have an infertility work-up, as well as social work consultations. In addition, the FDA requires a quarantine of the sperm sample for 6 months in order for the cryobank to:

  • test the donor sperm for sexually transmitted diseases
  • freeze the sperm
  • transport the sperm to Shady Grove Fertility

What are the logistics involved after a recipient selects the sperm donor?
After the recipient selects the donor, the cryobank sends the frozen sperm sample directly to Shady Grove Fertility, where we will thaw and analyze it in our andrology lab. From there, the patient will undergo an IUI or IVF cycle using the donated sperm. Additional frozen sperm specimens will be kept at the cryobank for future use.

Step Three: Starting Treatment Once You’ve Selected a Donor

Depending on the results of the basic fertility work-up, most women start with IUI. If several IUI cycles do not result in a pregnancy or if your physician discovers infertility during the initial work-up, then he or she may discuss more advanced forms of treatment like in vitro fertilization (IVF). IVF treatment is commonly used to overcome fertility problems centered around the Fallopian tubes and age-related infertility among other causes of infertility. Thankfully, IVF treatment has some of the highest success rates in terms of both pregnancies and live births.

Where to Find Support Before, During, and After Treatment

Choice Moms is a worldwide organization that gives women the resources and connections they need to decide whether single parenthood is the right path and, if so, what method to motherhood to choose, how to find support in their choice, and how to stay balanced in the lifestyle.

Shady Grove Fertility also offers support groups specially designed to help single women. These small group sessions focus on the fears, challenges, and overall support by others who are in the same situation. Attend Shady Grove Fertility’s monthly support group for single women.

Becoming a single mother is rarely an easy decision to make, but knowing that you have a strong support system in place and the resources you need to achieve your goals will help you on your journey.

If you are considering becoming a single mother by, please schedule an appointment or call our New Patient Center 877-971-7755.

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By Michelle Hester, LCSW-C
Licensed Clinical Social Worker

An increasing number of lesbian couples are using reproductive technology to become parents.  Not having suffered the heartache of infertility, many come to this process hopeful and thankful that there is a technology to help them achieve their dream of parenthood. For others, the reality of needing to use medical intervention to achieve this end is frustrating.

The social landscape for lesbian couples has, of course, changed dramatically in the last decade.  The recent Supreme Court decision legalizing same sex marriage helped to dramatically expand legal rights and protections. However, bureaucratic and logistical hurdles remain.

Deciding Who Will Carry the Pregnancy

For some couples, it is clear who will try to become pregnant. The decision is usually based on age, medical history, and the depth of the desire to become pregnant and give birth. Sometimes the plan is for each to have a child, often with the older partner going first. Some women may choose to carry their partner’s egg so that they both have involvement.

The “other mother” has a challenging role with no established road map. For example, the couple will need to figure out how to answer the intrusive question of “who is the ‘real’ mother?” For some this can be a painful question, which can tie into a sense of loss or of being marginalized. Like the heterosexual father, this other mother may indeed feel a bit sidelined in the first part of parenthood when there is a focus on pregnancy, childbirth, and nursing.  Couples will want to think about the many ways in which they can establish meaningful, mutually supportive roles. In addition they will want to think about how to handle the inevitable questions about their family make up. These are questions that children will also have to answer and they will look to their parents’ example.

Choosing a Sperm Donor

Some couples begin with the idea of using a known donor. If the relationship that both prospective mothers have with the intended donor is based on trust and good communication, this arrangement can have benefits for all involved, including the child. Many people worry that one or more of the parties—and this would ultimately include the child—will in time want a new arrangement, which is not welcomed by the others.

For many, using an anonymous sperm donor seems simpler, and in this stage of the process it can be. From the vantage point of future offspring, the picture might look different. Couples often report that accessing the sperm bank for the first time is a surreal experience, leaving them with the initial impression that they can order a child to specification. This, of course, is not a possibility for any prospective parent. In choosing a donor, couples find it useful to identify what is most important to them, whether that be physical attributes, values, health history, or interests.  Interestingly, people often find the donor’s voice clip useful.

One of the many decisions that couples will need to make is whether they want to choose a donor who says that he is open to contact after a child reaches age 18. This is not a guarantee, but a statement of intention. In the end, the most important variable in choosing a donor is that the parents have a positive regard for the donor because this gets communicated to children in many ways. Couples sometimes feel that if they are a loving, supportive family a child will not be interested in the donor. In fact, many people are interested in their genetic origins notwithstanding a nurturing family. Being a loving, supportive parent may include helping a child pursue his or her interest in their origin.

Seeking Support during Treatment

Getting information from the clinic and from insurance companies about costs and coverage is usually time-consuming and often frustrating. Because the cost is considerable, couples sometimes need to alter their original plan. Coming to a consensus about what the plan should be can be difficult.

Consulting with a mental health practitioner experienced in the field of reproductive technology is another aspect of getting prepared. Same sex couples may initially wonder whether they are being singled out or feel that because they have thought about their plan at length, counseling should not be a requirement. However, counseling is the standard of care for all patients using gamete (egg or sperm) donations. The counselor will have certain topics to discuss, but the most worthwhile meetings for clients are when they bring up their particular concerns as well.

Developing realistic expectations for how long the process will take is also important. Even under the best circumstances, it can take a long time to get pregnant. It’s important to think about what will help you in getting through a stressful time. For some women that will mean simplifying their life and for others it will mean planning distractions.

Support systems are important in every family’s life. Inevitably these systems shift with the arrival of a child. For those who have had problematic relationships with their families of origin, the prospect of a child can be an opportunity to rework that relationship. Indeed, all new parents need to rework their relationships with their families.

Couples will want to think about how they will manage information about donors, treatment, pregnancy, and delivery to achieve the goals of protecting themselves and a prospective child while taking into account the particular ways that their families operate. For example, there is a broad range of ways that couples can handle the information about the donor with family and friends. On the one hand, people may share all information about the donor because they think that family and friends will be interested and that this is a good way to include them in the process. On the other hand, some may limit what they say to a simple statement that they are happy with the information about the donor. They do this because they want to be sure that they are the first people to give their child that information.

Being part of a supportive community is also very helpful for new families. Many communities have LGBT organizations that particularly address the needs of families. They may have support groups for prospective parents and sponsor functions for families. Later on, being part of these organizations may provide opportunities for children to be with families built like theirs.

Becoming Parents

Families built so intentionally have many strengths; this is supported by research that shows that on the whole children do well. Parenting is always challenging and rewarding with each kind of family having its own set of particular issues. Families with same sex parents are squarely in the broad and expanding spectrum of the modern American family.

Michelle Hester has 30 years of experience working with couples, individuals, and groups in a variety of settings. She has specialized in adoption services, both before and after placement, with interest in infertility, adoption, and early adjustment issues for new parents. She is a Licensed Clinical Social Worker in Maryland and the District of Columbia. She sees patients in Shady Grove Fertility’s D.C. and Maryland offices.

If you would like to learn more about Shady Grove Fertility’s support services for lesbian couples or to schedule an appointment, please speak with one of our New Patient Liaisons at 877-971-7755.

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By Erica M. Hanson, LICSW
Licensed Clinical Social Worker

There are many ways that women decide to be a single mother by choice. A portion of these women made a promise to themselves that they would become a single parent if they were not married by a certain age. Others have been married and divorced without children and still want to be mothers. Some women always pictured themselves as a parent—but not necessarily as a wife—so single motherhood makes sense to them. For others, the decision involves mourning the dream of the “traditional” path to motherhood: love, marriage, and then a child.

Some women feel like they are racing against their biological clock and choose to date often and take any opportunity to meet a potential spouse. They soon realize that instead of getting to know their date, they are sizing him up as a potential father for their unborn child. This is the time they step back and make the decision to become a single mother by choice, realizing that there is no timeline to have a relationship but there is a timeline for their fertility.

What to Consider Before Becoming a Single Mother by Choice

There are many questions to consider before becoming a single parent:

  1. Do I have financial, emotional, and social resources to be a parent?
  2. Do I have realistic expectations about motherhood?
  3. Would my family and friends support my decision to be a single mother by choice?
  4. How would I handle any health issues that arise during pregnancy or with my child?
  5. Do I have a good work-life balance? Do I travel frequently in my current position? Should I consider moving to another position?
  6. Will my family and friends support my decision to be a single mother by choice?
  7. If something happened to me, who would be my child’s guardian?

These questions are not unique to single women, as many married couples ask themselves similar questions, although they are more poignant for a woman choosing to parent on her own. Single women are often posed with questions or judgments that their coupled counterparts do not receive. For example, many are asked, “Why do you want to become a parent?”

The answers are similar to other women: “I always wanted to be a mother.”

Single women are also sometimes asked tougher questions like, “Isn’t it selfish of you to want a child?” Reproduction is a human need and single women are not unlike others who want to parent, passing on their knowledge and experiences to their children.

Tips for Single Mothers by Choice

Some single mothers by choice pressure themselves to be perfect parents and to do everything on their own. This is an unrealistic expectation and may set a woman up for frustration and failure. Married or single, everyone needs help raising their children from a family member, friend, or neighbor. It is critical for single women to create a support network.  Here are more tips for single parents:

  1. You don’t have to be superwoman and do it all on your own because you choose to be a single mother by choice.
    Everyone needs help during pregnancy, labor, and as a new mother. Identify who can help you make the transition to motherhood.
  2. Stop pressuring yourself to be perfect and ask for help when you need it.
    Asking for help does not make you weak or incapable. If you do have difficulty asking for help, try to identify what is getting in the way. For some, asking for help can seem intimidating or humbling, but it can lead to new and rewarding relationships with a neighbor or an acquaintance.
  3. Make emergency and contingency plans for unexpected situations.
    Expect the unexpected and identify those who can help you and/or your child when you need it.
  4. Take care of yourself.
    Schedule short breaks throughout the day and do things for yourself that are restorative.
  5. Join a single mothers by choice group.
    Receive support and share resources with others who are in the same situation.
  1. Start a co-op in your neighborhood.
    This is a fabulous way to share shopping and babysitting with others.

Becoming a single mother by choice is not always an easy decision to make, but knowing that you have a strong support system in place will help you on your journey.

Erica M. Hanson, LICSW, has experience working with couples, families, and children in hospital, clinical, homecare, hospice, and agency settings. Her special interests include adoption, grief and loss, and infertility. She is a Licensed Clinical Social Worker in the District of Columbia, Maryland, and Virginia. She sees patients in Shady Grove Fertility’s Fair Oaks, VA, office and has an office in D.C.

If you would like to learn more about Shady Grove Fertility’s support services for single mothers or to schedule an appointment, please speak with one of our New Patient Liaisons at 877-971-7755.

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Medical contribution by Naveed Khan, M.D.,
of Shady Grove Fertility’s Leesburg, VA, office

Dr. Naveed Khan

When you meet with a fertility specialist for your initial consult, he or she will outline for you a diagnostic plan—or infertility work-up—tailored specifically for you, which will help determine the cause of your infertility. The physician will base the testing schedule on the information provided by your medical history and physical examination. This plan will focus on answering many important questions, including the following:

  • Are you ovulating?
  • Are your fallopian tubes normal?
  • Is your uterus receptive to implantation?
  • Are the sperm normal in number and function?

The diagnostic tests that comprise the standard infertility work-up answer these questions and help determine the cause of your infertility. While we commonly recommend a set of routine prescreening tests at Shady Grove Fertility, there are some tests that do not always make sense at such an early stage, and we would caution patients from moving in that direction unnecessarily.

Infertility Work-Up: Routine Tests

SGF uses the following standard infertility work-up to evaluate the potential fertility of the female and male partner:

Female

Day 3 Bloodwork

A clinician will perform bloodwork on day 3 of your menstrual cycle to test levels of the following:

  • E2 (estrogen): the main female reproductive hormone secreted from the ovary
  • FSH (follicle-stimulating hormone): releases from the brain and stimulates the ovary to mature an egg. High FSH levels can indicate to your physician that the hypothalamus and pituitary glands are working harder than normal due to a decrease in ovarian reserve (egg supply). FSH levels can vary from cycle to cycle.
  • AMH (anti-Müllerian hormone): AMH is the most accurate predictor of a woman’s egg supply. This test can be more accurate than FSH because there is no fluctuation from month to month and the test is not dependent on a woman’s menstrual cycle, which means women can have the test at any point.
  • LH (luteinizing hormone): a hormone that is integral to the final maturation and release of a mature follicle.

Internal Baseline Ultrasound

Embryos implant in the uterus, which makes it necessary to perform tests to determine if a woman’s uterine cavity is normal. A sonographer or physician will perform an ultrasound of the ovaries between days 2 through 4 of your cycle. We use this test to determine the antral follicle count (AFC), which represents the number of eggs available for pregnancy that month.
HSG

The HSG, or hysterosalpingogram, is an x-ray of the uterus and fallopian tubes to help determine their condition. Physicians rely on this test to see if a patient’s fallopian tubes are open, to assess whether the uterus has normal shape, and to ensure that the cavity is not affected by fibroids, polyps, or scar tissue.

Male

Semen Analysis

Andrologists perform a semen analysis to evaluate the sperm’s potential to fertilize the egg. The test results will tell your physician the number of sperm in your semen (your sperm count), whether they are normal (morphology), and how well they swim (motility).

Infectious Disease Testing

Through a simple blood test, a clinician will perform infectious disease testing for both the male and female partner.

  • Male screening includes: HIV; Hepatitis B surface antigen; Hepatitis C antibody; RPR (serology)
  • Female screening includes: Hepatitis B surface antigen; Hepatitis C antibody; HIV; RPR (serology); Rubella titer (one time only); blood group; and RH (one time only). Negative infectious disease results must be documented every 12 months.

Genetic Screening

SGF is an advocate for genetic screening when planning for pregnancy, offering testing for over 100 different diseases and syndromes. While we strongly recommend this screening due to benefits for patients and their future children, patients do have the choice to opt out of testing. For patients who are interested, their physician will review their family history at the initial consultation and select the appropriate testing. Patients are provided with a testing kit and will then arrange to return to our center for both partners to be tested during day 3 bloodwork or at specially-scheduled appointment. The testing kit can be run from DNA obtained through either blood or saliva. Once the sample is obtained, the kit is sent out to the genetic testing laboratory, with results arriving to the patient and physician within 2 to 3 weeks.

Infertility Work-Up: Non-routine Tests

The American Society for Reproductive Medicine (ASRM) recommends consulting with your physician to discuss the risks and benefits for any of the tests described below before making a decision. Your personal diagnosis may necessitate one or more of these tests. This article represents a respected clinical viewpoint, but there can be exceptions.

Laparoscopy for Evaluating Unexplained Infertility

Unless there are suspicions of pelvic conditions based on clinical history, an abnormal pelvic exam, or abnormalities identified through less invasive testing, SGF physicians generally find a routine diagnostic laparoscopy (a surgery that uses a thin, lighted tube inserted into the belly to look at female pelvic organs) unnecessary for patients undergoing an infertility work-up.

Advanced Sperm Function Testing

ASRM found that advanced sperm function testing in the initial work-up—such as sperm penetration or hemizona assays—to generally be unnecessary, as variability exists in these tests with very little correlation between results and outcomes. They are also not cost-effective and can lead to more expensive treatments.

Postcoital Test (PCT)

The postcoital test (PCT) is not easily reproduced and its prediction of pregnancy is “no better than chance,” according to ASRM. Utilizing this test often leads to more tests and treatments, but it does not yield any difference in pregnancy rates.

Blood Clotting Evaluation

Performing thrombophilia tests is of no benefit to patients who do not have any history of bleeding or abnormal clotting, or in the absence of family history. We do not recommend this test as part of the routine infertility work-up.

Immunological Testing

As mentioned above, an infertility evaluation investigates factors affecting ovulation, the fallopian tubes, and sperm, based on clinical history. While immunological factors may influence early embryo implantation, routine immunological testing of couples with infertility is expensive and does not predict pregnancy outcomes.

Prescribe Testosterone or Testosterone Products to Male Partner

Testosterone therapy is widely used for sexual dysfunction, but researchers have found it decreases sperm production, sperm count, and causes infertility. These therapies are not always reversible, even after removing the additional testosterone, so we strongly advise against it if a man is attempting to conceive with his partner.

FSH Level Screening in Women in their 40s

Menstrual cycles for women over 40 are less predictable due to the normal menopausal transition. During this time, FSH levels can vary from woman to woman and from day to day in the same woman. The FSH level will not predict when a woman will transition to menopause or diagnose that it has begun. If there are no other causes of irregular or abnormal bleeding, fertility treatment for women over 40 will not change based on the FSH level.

Endometrial Biopsy

The endometrium is the tissue lining the uterus. This tissue responds to the production of ovarian hormones and allows implantation of the placenta during pregnancy. During menstruation, the upper layers of the endometrium are shed. An endometrial biopsy (removing a sample of this tissue), will not predict the likelihood of pregnancy in general and it is not associated with improved live birth rates in assisted reproductive technology (ART) cycles. Physicians at SGF do not utilize biopsy in the routine evaluation of infertility.

Prolactin Testing in Women with Regular Menstrual Cycles

Prolactin levels are routinely checked during the infertility work-up by many centers. According to ASRM, though, there is no reason to expect that a woman would exhibit significant, elevated prolactin levels when she has normal menstrual cycles and no discharge from her breasts. Therefore, testing prolactin levels in a woman with a normal menstrual cycle provides no benefits and would not impact clinical planning.

Infertility Work-Up: The Bottom Line

When it comes to testing your fertility in the initial work-up, your Shady Grove Fertility physician has your best interests at heart. Day 3 bloodwork, the ultrasound, the HSG, and the semen analysis all provide your physician with important data regarding your reproductive health. Do your hormone levels show a decreased egg supply? Are your fallopian tubes blocked? Does your uterine cavity have a normal shape? Does the male partner have sperm? These are all valid questions that can we can answer from the work-up to help put you on a treatment path that will ultimately lead to parenthood.

If you would like to learn more about the infertility work-up or are ready to schedule an appointment, please speak with one of our New Patient Liaisons at 877-971-7755.

2026 Shady Grove Fertility

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