On the third day of a spontaneous or progesterone withdrawal menstruation, blood is drawn to measure Estradiol (E2), FSH, LH and Inhibin-B. The specimen of blood should be sent to the specified laboratory of the clinic by overnight mail for the performance of the Inhibin-B test.
Blood should also be drawn (any time) for the measurement of Prolactin, TSH and antisperm antibodies (ASA).
Commencing on the second day of the menstrual cycle, a basal body temperature chart should be initiated. A thermometer is placed in the mouth for a period of two 2 minutes upon awakening (prior to the ingestion of food/liquid and brushing of your teeth). The temperature should be documented graphically on the basal body temperature chart provided.
For women younger than 35 who have no evidence or symptoms suggesting underlying organic pelvic disease (e.g., endometriosis, chronic inflammation, pelvic adhesions, fibroids, etc.), a hysterosalpingogram (HSG) should be performed within a week of the cessation of menstruation. This out-patient procedure involves injection of a radio-opaque dye that outlines the fallopian tubes allowing the diagnosis of tubal blockage. To a lesser degree, it permits the detection of surface lesions inside the uterine cavity.
For all women over 35 years of age, and for younger women who have evidence or symptoms pointing to underlying organic pelvic disease (e.g., endometriosis, chronic inflammation, pelvic adhesions, fibroids, etc.), a laparoscopy/hysteroscopy should be performed within a week of the cessation of menstruation.