Fertility Tests

Contemporary data suggest that embryo quality, rather than uterine receptivity, is the key factor in a successful pregnancy, whether conceived spontaneously or with the help of advanced reproductive treatments.

There Are Three General Categories of Infertility Factors

Male Factor Infertility

A significant portion of all infertility is due to male factor infertility, and the presence of male infertility has a major impact on the direction of fertility testing and treatment.

Unless semen evaluation results are highly abnormal (i.e., a concentration less than 3 million, total motility less than 3%, and normal morphology less than 3%), the test results cannot be reliably used to assess the male fertility potential.

We use your semen assessment to guide us in selecting the optimal method for semen preparation in your fertility treatment.

Egg Quality Factors

Ovaries not only produce eggs, but they also secrete the female reproductive hormones estrogen and progesterone. These hormones are produced by granulosa cells, which line the inside of the ovarian follicles, where the eggs mature.

The function of granulosa cells and the production of the female hormones depend on the eggs’ biological health inside the follicles. Normal egg quality equates to normal levels of estrogen and progesterone.

Egg quality is the most important factor in determining the female fertility potential.

At Bay IVF, we utilize a combination of transvaginal ultrasound examination of the ovaries and an assessment of reproductive hormones levels to estimate your “biological age.” The results of these tests will determine the most appropriate treatment for you.

During your initial visit at Bay IVF, you will have an ultrasound examination of your ovaries to determine the number of antral follicles (seen as small dark circles) within each ovary. The number of antral follicles is related to the quality of the eggs. Ideally, there should be approximately 20 antral follicles in both ovaries combined. Too few or too many antral follicles mean that normal quality eggs may be infrequent or even absent within the ovaries. The majority of women will have 12 to 24 antral follicles.

Ovarian Reserve Assay assesses the likelihood that normal quality eggs can be produced. It consists of the measurement of Follicle Stimulating Hormone (FSH), estradiol (estrogen, E2), and Anti-Mullerian Hormone (AMH) blood levels.

FSH stimulates the ovaries to produce eggs. The FSH level increases if the ovaries cannot produce normal quality eggs. Estradiol production by the ovaries influences FSH secretion and is also related to egg quality. FSH should ideally be less than 7.0 and estradiol less than 30.

AMH level also reflects the quality of eggs, and the result should ideally be 2 to 3. Lower or substantially higher levels signify less than optimal egg quality. AMH result is used to optimize your ovarian stimulation.

Most women will have normal Ovarian Reserve Assay results. An abnormal result does not necessarily mean that you cannot get pregnant with your own eggs. If the test results are abnormal, we typically recommend repeating the test.

Uterine and Fallopian Tubes Factors

Your endometrial cavity must be free of polyps, scarring, and myomas (fibroids) before any treatment can be initiated. The presence of any of these structures inside the uterus could significantly compromise the likelihood of embryo implantation.

We use saline ultrasound to assess the endometrial cavity of your uterus. A thin, soft catheter is passed through the cervix into the uterus, and a small amount of sterile saline solution is gently instilled. A transvaginal ultrasound is used to confirm the absence of polyps, scarring, or fibroids inside the uterus.

This ultrasound image shows a normal endometrial cavity. Polyps and fibroids (myomas) would show as lighter shade “filling defects” within the dark saline-filled endometrial cavity.

FAQ — Find Answers to Your Queries

Here are some of the most commonly asked fertility-related questions. A more comprehensive FAQ selection is available on the FAQ page.

Most patients should expect minimal, if any, side effects from the In Vitro Fertilization medications. You should be able to continue with your everyday activities during your treatment.

It takes approximately 6 to 8 weeks from the beginning of your treatment to egg retrieval and embryo transfer.

Since we use strong pain and relaxation medications, your egg retrieval should be very comfortable. Most patients will sleep through the 5-10 minute procedure. Some may experience minimal menstrual-like cramping.

In the Intracytoplasmic Sperm Injection procedure, a single sperm is inserted directly into the center of an egg. ICSI has been used extensively since 1993, and approximately 2 million babies have been born worldwide without significant side effects using ICSI.

You may consider adding Preimplantation Genetic Testing (PGT) to your In Vitro Fertilization or Donor Egg IVF treatment. If you do, you will not need to do amniocentesis if you conceive.
Adding PGT to these treatments has not been shown to reliably improve the probability of a successful outcome, but it can reduce the probability of a miscarriage.

We follow the recommendation of the American Society for Reproductive Medicine that most patients should transfer only one or two embryos. We will always provide guidance, but you will have the final say in whether to transfer one or two embryos.

It is not recommended from the conception point of view. Recent studies showed that resting after embryo transfer decreases the probability of implantation. You should start moving around immediately after your transfer.

Yes! We are proud of being one of the first Northern California fertility clinics to provide In Vitro Fertilization for lesbian partners. We are a very friendly LGBTQ+ fertility clinic that is quite versed in both lesbian IVF and Reciprocal IVF.

Your reproductive history, together with the result of your testing, will determine which treatment will most likely result in pregnancy.

Prerequisites for IVF, Embryo Banking, and Gender Selection

Only a few treatment prerequisites are needed before the start of your treatment. They assess the egg and sperm quality and ensure that embryos can be accurately placed in a healthy uterus.

The likelihood of a successful IVF treatment significantly decreases by the age of 44. To be eligible for IVF treatment, you must be 43 years and 11 months or younger when your treatment begins. Patients who are 44 and older should strongly consider Donor Egg IVF as the most effective treatment option for achieving a successful pregnancy.

For an optimal ovarian response and your safety during the egg retrieval procedure, it is important that your BMI is no greater than 31. If your BMI is higher, we recommend following the IVF Diet and Lifestyle (PDF) recommendations as closely as possible. By doing so, you can achieve weight loss at an appropriate rate, which may significantly enhance your chances of a successful pregnancy.

This testing is required by the State of California. You and your partner (if applicable) must be tested for Hepatitis B-Surface Antigen, Hepatitis C-Antibody, HIV I&II, HTLV I&II, and RPR.

ORA assesses the likelihood of producing normal-quality eggs. It involves measuring the levels of Follicle Stimulating Hormone (FSH), estradiol (estrogen, E2), and Anti-Mullerian Hormone (AMH) in the blood.

These test results provide insights into the quality of eggs and are utilized to optimize your ovarian stimulation.

Knowing the length of the uterus is essential for precise embryo placement. Saline ultrasound is performed to eliminate the presence of intrauterine polyps and fibroids.

The male partner’s semen will be assessed at the Bay IVF laboratory to determine the optimal method of semen preparation for IVF egg insemination.

All prospective parents should consider genetic screening for hundreds of the most prevalent genetic diseases. Please inform us during your initial appointment at Bay IVF if you would like to have your blood sample sent for genetic screening.

Environmental factors can greatly influence reproductive health. We encourage you to review the IVF Diet and Lifestyle document (PDF) for a comprehensive list of requirements regarding reproductive health and a recommended source for dietary supplements.

Meet Your Doctor

Dr. Polansky received his medical diploma from Charles University in Prague, the Czech Republic, in 1978.
After completing his OB/GYN residency at Jewish Hospital in Saint Louis, MO, he graduated from the Reproductive Endocrinology and Infertility (REI) fellowship at Stanford University in 1985.
In the same year, he co-founded the Stanford IVF Clinic.
Dr. Polansky obtained board certification in Obstetrics and Gynecology in 1986 and became REI subspecialty board certified in 1988.
In 1987, he left Stanford University and established Nova IVF.
In 2011, he founded Bay IVF, where he provides advanced fertility treatments with a holistic approach, utilizing state-of-the-art techniques.
Dr. Polansky personally performs ultrasound examinations, egg retrievals, embryo transfers, and ovarian and endometrial stimulations for his patients.
He is deeply committed to his patients and is always ready to lend a helping hand.

Frank Polansky, M.D.

Initial Appointment Questions

When you call to schedule your consultation, one of our Front Office Coordinators will ask you a short series of questions regarding your reproductive history.

Your name
Your date of birth
Your height
Your weight
Do you know which treatment you plan to have?
How many times have you been pregnant?
For each of your pregnancies, what was the conception date? (month and year)
What was the outcome?
Were the pregnancies with your current partner?
If known, what is the cause of your infertility?
What is your average cycle length? (number of days between onsets of your periods)
Are you currently taking any medications? If yes, which ones?
Are you allergic to any medications? If yes, which ones?
Your partner’s name (if applicable)
Your partner’s date of birth (if applicable)
What is the length of your relationship with your current partner? (years and months)
When was the last time either of you used any contraception?
Is the male partner currently taking any medications? If yes, which ones?
Is the male partner allergic to any medications? If yes, which ones?
What is the total number of pregnancies the male partner has ever caused?
Has the male partner ever caused a pregnancy without the ICSI (Intracytoplasmic Sperm Injection) procedure?
Has the male partner had a vasectomy or vasectomy reversal?
If available, for each Semen Analysis, please give the date (day, month, and year), volume, concentration (sperm count), percentage of motile sperm, and percentage of morphologically normal sperm.
Have you ever had any treatment for, or problems with, your lungs, heart, blood and blood vessels, breasts, digestive system, genito-urinary system, thyroid disease, diabetes, or neurological disorder? (female partner only)
For each X-ray of your uterus and Fallopian tubes (hysterosalpingogram), laparoscopy, hysteroscopy, or laparotomy, please give the procedure date (day, month, and year) and the findings.
If available, for each FSH, LH, estradiol (estrogen, E2), and AMH (Anti-Mullerian Hormone) test you have had, please give the date of the test (day, month, and year) and the result.
Have you done any intrauterine inseminations (IUI)? If yes, how many?
Have you had ovarian stimulation with injectable medications?
For each IVF treatment you have had, please provide the following information if available: Date (month and year), the dose of medications to stimulate your ovaries, your highest estrogen level, number of ovarian follicles that developed, number of eggs retrieved, whether ICSI was done, number of embryos available, number of embryos transferred, number of embryos frozen, and the treatment outcome.
Have you ever smoked cigarettes? If yes, how many cigarettes a day during the last three months? (Please remember that you must not smoke during your treatment.)

See All

Or Download a PDF

This is Erica

She will be providing you with exceptional support throughout your treatment journey at Bay IVF.

Listen to a typical conversation between Erica and a new patient.

Your name
Your date of birth
Your height
Your weight
Do you know which treatment you plan to have?
How many times have you been pregnant?
For each of your pregnancies, what was the conception date? (month and year)
What was the outcome?
Were the pregnancies with your current partner?
If known, what is the cause of your infertility?
What is your average cycle length? (number of days between onsets of your periods)
Are you currently taking any medications? If yes, which ones?
Are you allergic to any medications? If yes, which ones?
Your partner’s name (if applicable)
Your partner’s date of birth (if applicable)
What is the length of your relationship with your current partner? (years and months)
When was the last time either of you used any contraception?
Is the male partner currently taking any medications? If yes, which ones?
Is the male partner allergic to any medications? If yes, which ones?
What is the total number of pregnancies the male partner has ever caused?
Has the male partner ever caused a pregnancy without the ICSI (Intracytoplasmic Sperm Injection) procedure?
Has the male partner had a vasectomy or vasectomy reversal?
If available, for each Semen Analysis, please give the date (day, month, and year), volume, concentration (sperm count), percentage of motile sperm, and percentage of morphologically normal sperm.
Have you ever had any treatment for, or problems with, your lungs, heart, blood and blood vessels, breasts, digestive system, genito-urinary system, thyroid disease, diabetes, or neurological disorder? (female partner only)
For each X-ray of your uterus and Fallopian tubes (hysterosalpingogram), laparoscopy, hysteroscopy, or laparotomy, please give the procedure date (day, month, and year) and the findings.
If available, for each FSH, LH, estradiol (estrogen, E2), and AMH (Anti-Mullerian Hormone) test you have had, please give the date of the test (day, month, and year) and the result.
Have you done any intrauterine inseminations (IUI)? If yes, how many?
Have you had ovarian stimulation with injectable medications?
For each IVF treatment you have had, please provide the following information if available: Date (month and year), the dose of medications to stimulate your ovaries, your highest estrogen level, number of ovarian follicles that developed, number of eggs retrieved, whether ICSI was done, number of embryos available, number of embryos transferred, number of embryos frozen, and the treatment outcome.
Have you ever smoked cigarettes? If yes, how many cigarettes a day during the last three months? (Please remember that you must not smoke during your treatment.)

See All

Or Download a PDF

This is Nisha

Your invaluable resource for effortlessly managing your appointments at Bay IVF.

Listen to a typical conversation between Nisha and a new patient.

Your Initial Visit at Bay IVF

Attending a new patient appointment at a fertility clinic can be stressful. Our primary objective is to ensure that your initial visit is friendly and relaxing. We encourage you to ask questions at every step of the process.

1 — When You Arrive

You will be welcomed by one of the clinic receptionists. One of our nurses will measure your height and weight and take your blood pressure

2 — Meet Your Doctor

Dr. Polansky will ask you a series of clarifying questions and then provide you with a summary of the factors contributing to your infertility

4 — Exam Room

One of the nurses will escort you to an examination room. Your examination will begin with listening to your lungs and heart

3 — Ask Your Questions

You will then have a discussion with him about the most suitable reproductive treatment(s) for you. During this time, you will have the opportunity to ask any questions you may have

5 — Ultrasound of the Ovaries

The next step is a pelvic ultrasound to examine the uterus and ovaries. This ultrasound will help determine the number of antral follicles present within the ovaries

6 — Financial Part

Following that, you will have a discussion with one of the financial advisors regarding the financial aspects of your treatment, including potential treatment financing options

8 — Support 24/7

If you have any questions after leaving the clinic, please feel free to reach out to us via phone call, text, or email. Open and discreet communication is an integral part of the care we provide at Bay IVF