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Comprehensive Diagnostic Evaluation

Infertility is a difficult and frustrating condition that often leaves couples feeling alone. Even after an infertility evaluation, many couples feel like their questions remain unanswered, their inability to achieve pregnancy a seemingly unsolvable mystery.

Veritas Fertility & Surgery is committed to giving couples hope, providing answers they desperately seek and helping them achieve pregnancy naturally. Understanding that every couple and woman is unique, we start with a comprehensive diagnostic evaluation tailored to each patient’s individual situation and concerns. Since we are evaluating underlying medical conditions and gynecologic symptoms, the diagnostic testing we perform is almost always covered by insurance.

During an initial consultation with Dr. Puthoff, each patient’s medical history and symptoms are thoroughly reviewed. We also have the chance to learn what your goals are for your fertility journey.  From there, Dr. Puthoff will develop a personalized plan for a comprehensive infertility evaluation, which can include blood tests, ultrasounds, office hysteroscopy, semen analysis, and more. We also encourage our patients to track their menstrual cycle using the Creighton Model, which helps us accurately time tests and more quickly arrive at a treatment plan.

Unlike most fertility clinics, which typically provide only limited diagnostic testing, our individualized, comprehensive approach ensures we evaluate the problem from every possible angle.  This is important, as infertility can be caused by a variety of complex factors, including ovulatory disorders, endometriosis, uterine anomalies, poor sperm quality, and more.

Diagnostic Testing We Provide:

Blood testing is an important part of the comprehensive diagnostic evaluation at Veritas Fertility & Surgery. Blood tests can help to identify endocrine disorders, aid in the diagnosis of certain conditions such as polycystic ovary syndrome, and give a clear picture of the function of a woman’s reproductive system.

A woman’s fertility and ovulation depend on a complex array of hormonal signals that occur throughout her cycle, leading to ovulation and preparing the uterus for embryo implantation. By carefully timed blood tests, we can determine whether these hormonal changes are occurring properly.

In order to get pregnant, a woman’s eggs must be able to travel through the fallopian tubes to the uterus. When one or both tubes are blocked due to scar tissue or other conditions, this can impede pregnancy or increase the risk of an ectopic pregnancy.

To determine whether fallopian tubes are open and functioning normally, Dr. Puthoff performs two tubal tests, depending on each woman’s history:

  • Hysterosalpingogram (HSG): The most common tubal test, this involves injecting an X-ray contrast fluid inside the uterus and watching how it travels throughout the tubes. An HSG takes about 5-10 minutes to complete.
  • Selective salpingogram with fallopian tube recanalization (SS-FTR): This is a specialized version of the HSG which allows for a more precise evaluation of the fallopian tubes. During a selective salpingogram, Dr. Puthoff can not only determine if a fallopian tube is blocked but also perform a fallopian tube recanalization, reopening the tube with a small wire. Learn more >

Pelvic ultrasounds are a vitally important test for any infertility or gynecologic evaluation, as it allows use to visualize the uterus and the ovaries and assess for any abnormalities. The best ultrasound images are obtained with an internal vaginal ultrasound, so this is the recommended form of ultrasound in most cases. Ultrasounds can help to identify uterine fibroids, ovarian cysts, adenomyosis, and sometimes pelvic adhesions. In most cases, endometriosis cannot be seen on ultrasound. Ultrasound can also be used to perform an antral follicle count, which is a helpful marker of egg reserve. Learn more >

An SIS is a specialized pelvic ultrasound that provides more detailed imaging of the uterus. This 10-minute, in-office procedure is helpful in diagnosing:

  • Scar tissue inside the uterus (intrauterine adhesions)
  • Uterine fibroids that can increase the chance of miscarriage
  • Uterine anomalies such as a uterine septum
  • Problems with a prior C-section scar on the uterus (uterine isthmocele) that can lead to abnormal bleeding and infertility

A follicle study is a series of ultrasounds performed over the course of several days around the time of ovulation and helps to identify if ovulation is occurring as it should. Ovulation involves the growth and development of a dominant follicle, which is a fluid-filled cyst containing an egg. After the follicle grows to a mature size, it ruptures and releases the egg. The follicle study in an important part of the fertility evaluation that we provide and is also used to assess a woman’s response to fertility medications.

A semen analysis evaluates sperm count, motility and morphology (shape of sperm). This is an important part of the evaluation of an infertile couple, as poor sperm quality can be a significant factor in approximately 1/3 of infertility cases.

At Veritas Fertility & Surgery, we ask couples collect a sperm sample at home during intercourse using our semen collection kit (a perforated condom). Not only does this method of testing provide the most accurate results, but it also is preferred by most couples.

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Veritas Fertility & Surgery helps diagnose and solve infertility issues.

“I appreciate Dr. Puthoff’s approach in looking for underlying issues. He was able to find something my other fertility doctor missed for years. I only wish that I had found Dr. Puthoff sooner.”

“Dr. Puthoff has a wonderful way of making you feel like you are his only patient and that he is going to do everything in his power to figure out the underlying issues.”

“Dr. Puthoff listened to everything I had to say and has already made more progress than any other doctor has in the four years I have been trying to conceive.”
“I would absolutely recommend Dr. Puthoff to anyone I knew struggling with infertility. I couldn’t imagine a better doctor for this type of care.”
“Dr. Puthoff is very easy to talk to and very informative. You can tell he really cares about his patients and wants to help them the best he can.”
“Dr. Puthoff is so wonderful! He always takes the time to thoroughly explain everything until he knows we understand. We are so grateful to be under his care!”
“Dr. Puthoff’s attention to detail and explanations are outstanding. He used drawings to ensure we could visualize the example he was using. We were impressed by this.”
“We greatly appreciated the time and attention we were given at our appointment. Dr. Puthoff really seemed to care and took the time to answer all our questions.”
“Dr. Puthoff is fantastic and we are so thankful God led us to him!”
“Dr. Puthoff listened to every single one of my concerns and set up an individualized care plan for me quickly.”
“Dr. Puthoff is very personable and genuinely concerned with your health and well-being.”