New Hope Reproduction Medicine Virginia Beach VA

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Reference Testing & Treatment

Sono-Hysterosonogram (Sono-HSG)

It is a valuable technique for evaluating unexplained vaginal bleeding that may be the result of uterine abnormalities such as:

Polyps / fibroids / endometrial atrophy / endometrial adhesions (or scarring) / malignant lesions/masses / congenital defects.

ALSO: used to investigate uterine abnormalities in women who experience infertility or multiple miscarriages.

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PRIMARY: used to examine women who have difficulty becoming pregnant by allowing the physicians to evaluate the shape and structure of the uterus, the openness of the fallopian tubes, and any scarring within the peritoneal cavity.

INVESTIGATE: repeated miscarriages that result from congenital abnormalities of the uterus and to determine the presence and severity of these abnormalities, including: mullerian anomalies/adhesions/uterine fibroids

EVALUATE: the openness of the fallopian tubes, and to monitor the effects of tubal surgery, including: blockage of the fallopian tubes due to infection or scarring /tubal ligation / the closure of the fallopian tubes in a sterilization procedure and a sterilization reversal / the re-opening of the fallopian tubes following a sterilization or disease-related blockage.

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Post Coital Test

The post-coital test may be done if you are not able to become pregnant and:

  • You are ovulating, your fallopian tubes are not blocked, and your partner's sperm are normal. A problem with your cervical mucus may be causing infertility.
  • Immune system problems, such as sperm antibodies, may be a cause of infertility.
  • Your male partner does not want to be tested.
  • Have sex about 2 to 12 hours before your visit. Do not use lubricants during sex. Do not douche or take a tub bath after sex, but you may take a shower.

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Endometrial Biopsy

To see whether the lining of her uterus can support a pregnancy.

To find the cause of abnormal uterine bleeding, to check for overgrowth of the lining (endometrial hyperplasia), to check for infection (endometritis) or to check for cancer.

See whether the lining of the uterus is going through the normal menstrual cycle changes.

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Semen Analysis - Normal Parameters

What does the test result mean?

The typical volume of semen collected is around one-half to one teaspoonful (2-6 milliliters) of fluid.

  • Less semen would indicate fewer total sperm, which may affect fertility. More semen indicates too much fluid, which may dilute the concentration of sperm.
  • The semen should initially be thick and then liquefy within 10 to 30 minutes. If this does not occur, then it may impede sperm movement.

Sperm concentration (also called sperm density) is measured in millions of sperm per milliliter (mL) of semen. Normal is 20 million or more sperm per mL, with a total of 80 million or more sperm in one ejaculation. Fewer sperm and/or a lower sperm concentration may impair fertility.

Motility is the percentage of moving sperm in a sample and an evaluation of their rate and direction of travel.
  • At least 50% should be motile one hour after ejaculation, and they should be moving forward in a straight line with good speed. The progression of the sperm is rated on a basis from zero (no motion) to 4, with 3-4 representing good motility.

  • If less than half of the sperm are motile, a stain is used to identify the percentage of dead sperm. This is called a sperm viability test.

Morphology analysis is the study of the size, shape, and appearance of the sperm cells. The analysis evaluates the structure of 400 sperm, and any defects are noted.
  • The more abnormal sperm that are present, the lower the likelihood of fertility.
  • Abnormal forms may include defective heads, middles, tails, and immature forms.

Semen pH should be between 7.2 and 7.8, fructose at 150-600 mg/dL, and there should be less than 2000 white blood cells per mL.

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Natural Cycle Monitoring

Intrauterine Insemination

Recommended: couples with no known cause of infertility who have been trying to have a baby for at least a year. OR may be used sooner in older woman.
  • Under normal circumstances, IUI uses sperm from your male partner.
  • Although "sperm washing and intra uterine insemination" may help couple conceive when the sperm counts and quality are suboptimal, studies suggest that IUI will not be effective in cases where the sperm counts and quality are very poor.
  • Before proceeding with this process, sperm tests need to show reasonable sperm function.
  • If you do not have a partner, or if your partner has very poor quality sperm, then therapeutic donor insemination using screened sperm samples from anonymous donors or use of IVFW/ICSI using your partners sperm would be considered.
  • Approximate pregnancy rates per cycle of NC/IUI performed for the correct indications are as follows:
    • 20% for women under the age of 30
    • 15 % for women aged between 30 and 35.
    • 10 - 15% for women aged 35 to 39.
    • 5 - 10% for women over the age of 40.
  • However, the projected success rates need to be individualized.

  • It depends on a woman's age, her ovarian reserve, type of medication used, number of eggs being released, and the sperm quality.

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