It is important to test each component involved in the process of conception. These include, and may not be limited to:
At Dr. Roseff's practice, our laboratory is approved by the State of Florida as a reference lab for semen testing. Our male patients undergo state-of-the-art semen analyses. We also have each sperm sample tested for highly advanced sperm DNA analyses, including DNA fragmentation and DNA decondensation.
Egg quality and quantity decline as a woman ages, and therefore female fertility starts to decline when a woman is in her mid-20’s – We’ve seen 30 year olds with the eggs of a 40 year old! Accordingly, our patients undergo blood testing during their menstrual period to check their ovarian reserve. While other centers may focus on the FSH value, we have incorporated more advanced (and likely more predictive) tests such as inhibin-b and anti-mullerian hormone (AMH) for many years now.
A woman typically starts to produce many eggs at the start of her menstrual cycle, but only one usually goes on to become the “dominant follicle” and ovulate (the others shrivel and dye off). That number of eggs she starts to produce is considered to be predictive of her fertility potential and is called her antral follicle count (AFC). We analyze the AFC around the third day of our patient’s cycle.
Following ovulation, the egg would need to be fertilized by sperm in the fallopian tube. The fertilized egg then traverses the fallopian tube to make its way to the uterus. The uterus is the “vessel” that needs to implant and carry a pregnancy. These structures are analyzed during a test called the hysterosalpingogram (HSG), during which a liquid is injected through the uterus and tubes and x-ray pictures are taken. Thus, this test can tell us if the fallopian tubes are “normal” or abnormal, blocked or opened, and if the uterus is physically and structurally normal to implant and maintain a pregnancy.
A pregnancy needs to implant in the uterine lining (endometrium). If the lining is “abnormal”, the pregnancy may not implant (one doesn’t conceive) or if the pregnancy does in fact implant in an abnormal lining it may miscarry. The endometrium can be analyzed following a procedure called the endometrial biopsy. A thin, flexible catheter is inserted through the cervix into the uterus and a small piece of the uterine lining is removed as the catheter is withdrawn. A pathologist examines the fragment under a microscope to assure the lining is appropriate at the microscopic level for implantation of and maintenance of a pregnancy.
Dr. Scott Roseff's Office
9960 Central Park Blvd
Boca Raton, FL 33428