Your Fertility Journey
Your Initial Consultation
A review of your history, previous treatments, and goals for achieving pregnancy.
Your Evaluation & Workup
Your evaluation involves the assessment of several factors, including female and male infertility testing.
Your Follow Up
Discuss the test results in detail and recommend your most appropriate treatment or next steps.
A plan specific to your needs will be created and you will meet with our nursing staff to coordinate your treatment.
Where Love Grows Life
Your Initial Consultation
Prior to your initial consult, you will fill out a history to help guide your consultation. During your consultation, we will review your history (and partner’s if applicable), previous treatments, and goals for achieving pregnancy. A transvaginal ultrasound and an exam also will be performed at the initial consultation appointment. This important information will help guide further appropriate diagnostic tests as needed. You will leave our facility understanding the next steps in your evaluation/workup as well as what costs to expect. Your visit will conclude with a facility tour and an introduction to our female–to–female care team.
Your Evaluation & Work Up
For a woman to be fertile, the ovaries must release healthy eggs regularly (monthly), and her reproductive tract must allow the eggs and sperm to pass into her Fallopian tubes for fertilization to occur. Her reproductive organs must be healthy and functional. Learn more about Female Infertility Testing.
The female evaluation involves the assessment of several factors:
- A general health evaluation to ensure no medical factors are affecting fertility and that you are healthy for pregnancy to occur.
- Ovarian reserve testing to look for ovarian and egg aging (blood work for specific hormones and ultrasound evaluation of your antral follicle count in your ovaries).
- A tubal & uterine cavity evaluation (HSG or hysterosalpingogram) to determine if one or both Fallopian tubes are open and to assess if any defects are present.
Rarely, an outpatient procedure/surgery such as hysteroscopy and/or laparoscopy for further evaluation of the uterine cavity or abdomen may be necessary to rule out other gynecologic issues.
For a man to be fertile, the testicles must produce enough healthy sperm, and the sperm must be ejaculated effectively into the woman’s vagina. Tests for male infertility attempt to determine whether any of these processes are impaired.
For a male, the evaluation includes the following:
- A general health evaluation to discuss medical history.
- A semen analysis to assess the quality of the semen sample. Sperm motility, count, and morphology (shape) will be analyzed.
For a woman to be fertile, the ovaries must release healthy eggs regularly (monthly), and her reproductive tract must allow the eggs and sperm to pass into her Fallopian tubes for fertilization to occur. Her reproductive organs must be healthy and functional. Learn more about Female Infertility Testing below.
The second evaluation is the semen analysis, performed at Adore Fertility’s laboratory to measure the concentration (number of sperm), motility (movement), and morphology (shape of sperm). Often, sperm concentration fluctuates significantly from one specimen to the next. In most cases, two semen analysis tests are required to ensure accurate results. Treatment options for male factor infertility range from intrauterine insemination (IUI) for mild cases to in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) for more severe cases.
IVF with ICSI may be beneficial for those cases of severe male factor infertility because fewer sperm are needed for fertilization. For ICSI, the embryologist injects only one sperm into each egg. This form of treatment is also effective for those men with no sperm in the ejaculate (azoospermia), which can occur naturally or from a vasectomy. In those cases, a urologist obtains a small number of sperm from the testicle for ICSI. After fertilization, the resulting embryos are grown in an Embryoscope incubator for several days. An embryo can be transferred to the uterus (womb) to attempt pregnancy, while extra embryos are frozen for future attempts at pregnancy. Some patients opt to have their embryos biopsied and tested for chromosomal abnormalities. In these cases, the biopsied cells are sent to a genetics laboratory for testing while your embryos remain frozen at Adore Fertility. It takes approximately two weeks for the report to be released by the genetics lab. After that, an embryo that is chromosomally normal can be thawed and transferred into the uterus for implantation. This is called a frozen embryo transfer (FET) cycle. Hopefully, the baby journey begins!
At Adore Fertility, our exceptional clinical team combines andrology, urology, endocrinology, and embryology to provide a variety of highly successful treatment methods.
- The ability to make quality eggs (ovarian reserve).
- The uterine environment.
- The condition of the Fallopian tubes.
- The overall health of the patient.
Ovarian reserve is the term used to describe the ability to make healthy eggs. The ovarian reserve is assessed by evaluating the patient’s age, ultrasound of the ovaries, and testing a blood sample for hormone levels. Age is the most critical factor affecting ovarian reserve. No new eggs are created after a woman is born, and the number of eggs within the ovaries decreases with age. Therefore, with increasing age, a woman has fewer eggs available with which to make a baby. The quality of the eggs within the ovary also decreases with age, meaning that the eggs present are less capable of creating a pregnancy as the woman ages.
Ultrasound helps your physician visualize the size of the ovaries and the number of follicles in the ovaries. Follicles are fluid-filled structures within the ovaries that each contain an egg. This ovarian reserve evaluation is performed early in your menstrual cycle, and it is used to determine your antral follicle count, The antral follicle count helps your physician estimate the number of healthy eggs that can be produced during a cycle
Blood tests measure hormone levels predictive of ovarian reserve. Two hormones that help predict ovarian reserve are follicle-stimulating hormone (FSH) and Anti-Mullerian hormone (AMH). The brain releases FSH to stimulate follicular development in the ovary and to mature the eggs within the follicles. The Anti-Mullerian hormone produced by the cells that surround the pre-antral follicles provides an idea of the number of eggs that remain in the ovary (reserve) and their quality. These two hormone levels help your doctor predict your ovarian reserve and your ability to produce healthy eggs capable of resulting in a pregnancy.
The endometrial lining of your uterus (womb) is what allows the embryo to implant and continue to grow. We evaluate the uterus through ultrasound and hysterosalpingogram (HSG) studies. The ultrasound assesses the uterine wall and the endometrial lining of the cavity, which will support implantation. Abnormalities, such as fibroid tumors, are detected on ultrasound examination. A hysterosalpingogram study (HSG) fills the uterus cavity with contrast fluid to determine the shape of the uterine cavity, which is a critical factor for embryo implantation and continued growth.
The Fallopian tubes are the route by which the sperm and the egg come together during fertilization. The Fallopian tubes must be open to conceiving naturally or by intrauterine insemination. The HSG procedure evaluates the Fallopian tubes. The contrast solution placed into the uterine cavity will hopefully enter, travel through, and exit each tube. This means that the fallopian tubes are open and capable of allowing for egg and sperm to meet.
Your Follow Up
After all initial testing is completed, we will schedule a follow-up visit to discuss the test results in detail and recommend your most appropriate treatment or next steps. This visit typically lasts 30-40 minutes. The goal is for our patients to understand the results and their diagnosis so they understand the why behind treatment plans and can make the best decisions for their family planning. Occasionally the initial workup will yield information that requires further testing or a referral to a male urologic specialist. See: Male Infertility & Female Infertility.
We want the right treatment for you and realize that can look different for different individuals & couples. Based on your diagnosis (See female infertility & male infertility), and your family planning desires, a treatment plan specific to your needs will be created and you will meet with our nursing staff to coordinate your treatment. Regardless of your treatment plan, you will be offered a one-on-one in-person or telehealth financial consultation convenient to your schedule to explain your treatment costs and help provide the most affordable options available. At Adore, we believe in transparent & ethical pricing and supply discounted self-pay packages, in addition to financing, to ensure that the possibility of parenthood is accessible for everyone. See: Services, Transparent Pricing, and Financing.
Treatments are based on your diagnosis and can vary pending on family planning desires, long-term outcomes, religious beliefs, cultural beliefs, and financial situations. We are here to support every individual and couple.
“Dr. Cox is by far the best doctor I have ever had! She was with us while she was on active duty, caring for military families. Not only did she stick by me and my husband through all the years of my fertility journey, but she also delivered my handsome little boy!"
1280 Hospital Drive, Suite 300
Mount Pleasant, SC 29464
Monday - Thursday: 9am - 4pm
Friday: 9am - 2pm