Fertility Resources
TESTING WELLNESS FERTILITY TERMS TESTING LOCATIONS
Testing
Although there is no single test or even combination of tests that will guarantee that you will be able to conceive, fertility investigations help you and your clinician better understand your reproductive health.
Common tests include blood tests, imaging of the uterus and tubes, as well as sperm testing. These tests can be done at our Toronto location as a bundle known as the One Day Workup, or individually, as necessary. The One Day Workup cost covers all testing not covered by OHIP.
Testing for Eggs and Uterus
Blood work
AMH ($)
AMH is short for Anti-Müllerian Hormone and is made by cells surrounding eggs. AMH is the most accurate test available to estimate fertility treatment success as it provides information about how much fertility medication would be necessary to grow a cohort of eggs, as well as how many eggs we think will grow with fertility medication. Knowing if your AMH level is high, low or average based on age is really helpful so that you can better understand your fertility timeline (“reproductive window”) and estimated success with fertility treatments. However, AMH does not tell us anything about egg quality though we know that with increasing age, the number and quality of your eggs decreases over time.
Thyroid Blood Work (TSH)
The thyroid hormone plays an essential role in many cellular functions of the body. Thyroid function is an important part of fertility care, as it can impact different aspects of reproductive health including ovulation, oocyte quality, miscarriage, and fetal development. It is important to ensure TSH is within a normal range prior to conception to optimize reproductive outcomes.
Vitamin D ($)
Vitamin D plays an important role in many bodily functions, including reproductive health. We recommend that serum Vitamin D levels be over 75 nmol/L to maximize fertility. If levels are low, your care team will recommend supplementation tailored to your specific level.
Infectious Disease and Immune Screening
There are several infectious diseases that can have a negative effect on overall health, pregnant individuals, and their babies. To optimize your health before starting on your reproductive journey, we screen for HIV, Syphilis, Hepatitis B and C through a blood test.
Some infectious diseases including Varicella (chickenpox) and Rubella can harm the developing fetus during pregnancy and are preventable by vaccination. We check to see if you have immunity to these viruses and advise on vaccination if you are NOT immune.
Complete Blood Count (CBC), Hemoglobin Electrophoresis, Blood Type
A CBC is a standard blood test that looks at some markers of general health before starting treatment. A hemoglobin electrophoresis measures the different types of hemoglobin in the blood and can identify if a future pregnancy may be at increased risk of a hemoglobin disorder.
Genetic Carrier Screening through Invitae ($)
In certain patients, this blood test may be ordered. Carrier screening analyzes your DNA and helps to identify people who may be at an increased risk of having a child who is affected with a genetic disorder.
Invitae’s Comprehensive Carrier Screen (CCS) looks at hundreds of genes. By understanding your own carrier status, you can make informed reproductive choices. Once blood work is complete, our team will send a referral to a geneticist to review the results in detail. More information.
Fasting Insulin
In certain patients, this blood test may also be ordered. Insulin is an important hormone that helps regulate blood sugar levels in the body. Ensuring fasting insulin is within a normal range can help optimize chances of conception and healthy pregnancy.
Ultrasound
Pelvic & Transvaginal (Internal)
This ultrasound assessment requires a full bladder and is an assessment of the ovaries including antral follicle count (AFC), number and size of follicles/cysts in the ovaries, and assessment of the uterus.
Sonohysterogram (SHG) (Internal)
A SHG is a procedure that can provide information about the contour of the uterus and patency of your fallopian tubes, without the use of x-rays, x-ray dye, or need for anesthetic. Indications for this test may include diagnostic testing, irregular vaginal bleeding, infertility, miscarriages and/or suspected abnormalities of the uterus. You will be asked to take an antibiotic called Doxycycline to reduce the small risk of infection (0.2- 1%risk). Please advise if you have an allergy.
Testing for Sperm
Bloodwork
Infectious Diseases
In order to optimize your health before starting on your reproductive journey, we screen for HIV, Syphilis, Hepatitis B and Hepatitis C through a blood test.
Hemoglobin Electrophoresis
A hemoglobin electrophoresis measures the different types of hemoglobin in the blood and can identify if a future pregnancy may be at increased risk of a hemoglobin disorder.
Hormones (FSH, Testosterone)
Certain blood tests, including FSH (follicle stimulating hormone) and testosterone levels, can help to provide more information around sperm production and overall health.
Semen Testing
Semen Analysis
A semen analysis provides important information on sperm parameters including sperm concentration (how much sperm is in the sample), sperm motility (how quickly the sperm is swimming) and sperm morphology (the shape of the heads of the sperm), along with volume and pH.
Hyaluronan Binding Assay (HBA) ($)
The HBA is the only test available to determine the proportion of mature sperm in a semen sample. Mature sperm are capable of binding to and fertilizing an egg. Should you require IVF, the results of this test are valuable in guiding our IVF Lab to choose the most effective fertilization method.
DNA Fragmentation Index (DFI) ($)
DFI provides an assessment of the integrity of sperm DNA. A higher DFI indicates a greater degree of DNA damage in the sperm, which can be a significant factor in infertility. Knowing the DFI can help guide treatment options including optimizing sperm health.