Common tests your RE or OB/Gyn will order:
Semen Analysis

When you first go to the RE, s/he will most likely start with 3 tests:
1. SA for your husband
2. CD3 blood-work
3. an HSG for you.

The HSG (hysterosalpingogram) is an x-ray of the uterus and the fallopian tubes. The purpose of an HSG is to find out if there are any blockages in your tubes, and/or if the uterus has a normal shape. It should be scheduled between CD 5 and 10, after AF and before ovulation. Call your insurance to see if they cover it before you schedule. The costs can vary quite a bit. In a recent poll on 3T the prices ranged from $450 to $1500.

About an hour before your appointment you should take some painkillers to reduce the pain/cramps/discomfort during and after the HSG. Most women take 800 mg of Ibuprofen. The appointment will last anywhere from 15 to 30 minutes. The radioopaque dye is put through a thin tube (catheter.) This is put through the vagina into the uterus, from here it will flow into the fallopian tubes. Some women are able to watch on a monitor while the HSG is done. However, this is not always the case. The results are sometimes given right there, but it can also take a couple of days. Take a pad to the appointment to catch any leakage afterwards. The dye will come out at some point!

Some find this procedure very painful (especially when tubes are blocked), some have AF like cramping, and others don’t have any discomfort. It is different for everybody. Cramping and light spotting is common for a few days after the procedure. However, if it’s something that concerns you call your doctor.

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Semen Analysis:
Your husband/significant other should have an S/A done during the testing phase, even if you have already been diagnosed with another issue.

The World Health Organization (WHO)’s 2009 report considers the follow results “normal”:
Volume: 1.5ml or more
Concentration: 15 million or more (per ml)
Motility: 40% or higher
Morphology: 4% or higher* (this depends on the method they use. 15% or more used to be “normal” but that has been updated in the new report.

Here is the link to the WHO report for more detailed information:

And here’s a great discussion of the numbers (specifically morphology) from an RE at NYU: http://infertilityblog.blogspot.com/2010/07/sperm-morphology-new-guidelines.html

What do I do if our S/A comes back abnormal?
1. Repeat S/A. Have another S/A done several weeks apart because one test cannot give you a full picture and several lifestyle issues can effect sperm (including temporary illness).
2. See an urologist. Have YH see an urologist who specializes in fertility to see what if, anything can be done to improve the numbers. The urologist should be getting his entire medical history, S/A results and should be doing a physical exam and taking blood to test hormone levels, etc.
3. Consider vitamins/supplements. Some couples have found that vitamins/supplements have helped increase sperm quality/quantity. It is not a magic bullet, but it may help. Fertility Blend for Men is one we recommend (it's available online and at GNC stores). You might also look into: pycnogenol (especially for morphology), CoQ10 and L-arginine (which aren’t in Fertility Blend).
4. Consider lifestyle changes. Again, some couples have seen improvement in numbers when lifestyle changes were made. Quit smoking, decrease drinking, switch to boxer shorts, no hot tubs or hot computers on the lap, healthier diets, increased exercise, etc. Also, some men have seen success with acupuncture.

**Remember, it takes approximately 3 months from the time sperm is "born" to when it's released so any lifestyle/medical/vitamin changes will take three months to show up in a sperm analysis. And if YH was sick 3 months before your S/A, it may affect the results.

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