Both an abdominal and pelvic ultrasounds are essential and important investigations. A Pelvic Ultrasound (Transvaginal Ultrasound) is a technique in which an ultrasound probe is placed in the vagina to look at the pelvic organs. Being close to the pelvic organs any abnormalities in the uterus, fallopian tubes and ovaries can be seen easily with this technique. Many gynaecological diseases such as fibroids, ovarian cysts and endometriosis can be diagnosed with an ultrasound. Transvaginal ultrasound is also used to do follicular tracking, in which serial ultrasounds are done to determine the increase in size of the follicles.
Semen Analysis is an essential investigation. We provide a private room whereby the male partner will need to produce a semen sample by masturbation. It is essential to abstain from sex for 3 days before this test can be done. An embryologist will assess the semen sample under a microscope for sperm concentration, motility and morphology. You can get the results after 1 hour.
This test is performed in the X ray department and is performed between days 7 and 10 of a menstrual cycle. There are several important reasons for doing this test at this specific time:
- The chance that you are already pregnant at this time is very low. We do not want to perform an Xray at a time when you are pregnant but sill undiagnosed.
- At this time the uterine lining is not so thick and so it will not block the opening of the fallopian tube and thus creating a false impression of blockage.
In this technique a small tube is placed at the cervix (neck of the womb via the vagina) and a liquid (contrast medium) is injected and viewed on a TV screen. This liquid will be seen entering the uterine cavity and the fallopian tubes and it can be seen spilling out of the fallopian tubes. When all of the above happens, it constitutes a normal test implying that the tubes are patent. X rays are taken at the same time. This is less invasive compared to a laparoscopy. It only takes a few minutes to perform and it does not require any anaesthesia. You can go home after the procedure. The procedure can be slightly painful.
Hysteroscopy is a procedure whereby a narrow telescope (called a hysteroscope) attached to a camera is passed via the cervix into the uterus to visualize the inside of the uterus (endometrial cavity). This is usually performed in the clinic without any anaesthesia. The aim of this investigation is to ensue that there are no growths such as polyps that may interfere with the implantation of an embryo. You may experience slight discomfort during this procedure.
There are many blood tests that can be performed. The aims of these blood tests are:
- To assess your potential for producing eggs (test for ovarian reserve)
- To see whether you are going to ovulate (Test for Ovulation)
- To see whether there are any other diseases that may interfere with your ovulation
- To check whether you have ovulated (Serum Progesterone)
Blood tests that are specifically done on the 2nd day of your cycle are:
FSH, LH, Oestradiol, Progesterone
Blood tests that can be done at any time are:
Prolactin, AMH (antimullerian hormone), Thyroid function tests
Serum Progesterone may be tested 7 days after you have ovulated.
Laparoscopy is a surgery that may be suggested if some diseases are diagnosed during the investigations. You can obtain more information about this keyhole surgery in the section on laparoscopic surgery.