INFERTILITY DIAGNOSTIC PROCEDURES
Unfortunately, infertility is becoming a frequent problem and concerns both men and women. It is estimated that around one in five couples may need the help of gynaecologists to have their own baby. Problems with conceiving would have various reasons. As in case of other health problems, diagnosing the reasons of infertility is vital in finding the solution for the problems. In Top Medical Clinic, we offer the following procedures to diagnose infertility:
MENSTRUAL CYCLE MONITORING
Menstrual cycle monitoring is one of the basic procedures performed in women unsuccessfully trying to conceive. The procedure allows to assess the phases of menstrual cycle: when/if the ovulation takes place (the discharge of a mature egg from the Graafian follicle) and the thickness and structure of uterine lining (endometrium).
How is menstrual cycle monitoring performed?
‘Monitoring’ is carried out with transvaginal ultrasound scan. The scans need to be performed at specific time intervals. The first scan should take place at the beginning of patient’s menstrual cycle (between the 2nd and 3rd day, counting from the first day of menstrual period), the next one between 8th and 12th day of cycle, and the third one on 14th day of cycle. The gynaecologist monitors the symptoms of upcoming ovulation – measures the thickness of uterine lining, the number and size of follicles. During the next appointment (21st day of the cycle), the doctor analyses whether the ovulation has taken place – if the dominant follicle has burst and the egg has been discharged to the fallopian tube. In order to assess the whole cycle, usually 3-4 appointments are necessary. In case of irregular cycles (the reason for them being irregular should be determined by the doctor), the number of scans might be higher. The scan takes from 5-15 minutes and is completely painless.
When diagnosing female infertility, it is extremely important to check the hormones. One has to remember that balanced hormone levels in the woman’s organism are vital in order to conceive. The hormones that should be tested are not only the female ones: oestradiol and progesterone, but also pituitary hormones (FSH, LH, Prolactin), thyroid hormones (TSH, fT3, fT4). It is also very important to check AMH (antyMullerian hormone), the substance produced by granulosa cells in ovarian follicles. The levels of all above hormones are assessed by the doctor on the basis of blood test results (done in our clinic by a qualified nurse).
FALLOPIAN TUBE PATENCY TEST ‘HyCoSy’
Dysfunction of the female reproductive organs is apparent in around 40% of infertile couples. The method used to check if fallopian tubes are damaged or blocked is a safe and reliable ultrasound procedure - hysterosalpingo-contrast-sonography (HyCoSy).
How is the ‘HyCoSy’ procedure performed?
The doctor gently inserts a speculum into the vagina. Then, under ultrasound guidance, a thin tube (catheter) is passed into the uterus through the neck of the womb (cervix). The speculum is then removed and a contrast agent is passed into the uterus and the fallopian tubes to assess the tubes. The progress of the fluid can be monitored by ultrasound and any blockages or abnormalities can be detected.
The procedure takes about 10 minutes and is pain-free. However, in case of blocked tubes, some pain or discomfort may occur. The contrast agent passed into the uterus and the fallopian tubes is quickly degraded and does not cause any allergic reactions.
How to prepare for the procedure?
The best time to perform a HyCoSy is between the last day of menstrual period and fertile days (the first phase of menstrual cycle). A few days before the procedure, the patient should have a vaginal swab to exclude infection. That would eliminate the possibility of inflammation.