Female infertility accounts for 40-50% of cases walking in our clinic. There are lots of causes of this kind of infertility including hormonal and anatomical abnormality.
Blood for Hormone Assessment
The first step in the investigation of a woman’s fertility is to establish ovulation status and ovarian reservation. This can normally be confirmed by performing blood tests to measure the level of hormones at specific stages of the woman’s cycle. The hormones responsible for the development of eggs within the ovary include Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH),while Progesterone and Estrogen are produced during this time by the ovary. The levels of these hormones will rise and fall depending on the stage of the woman’s cycle.
Normally, our clinic evaluates hormonal profile when we start IVF process on Day2 of menstruation. The women with abnormal period need to investigate early to find out the cause of menstrual abnormality.
Based on the the principle of sonar, an ultrasound scan is a non-invasive technique allowing internal organs to be seen on a screen. A small probe is inserted in the vagina so the uterus and both ovaries can be seen. Ultasound scan is a major tool to monitor ovarian stimulation during IVF, to check patients for fibroids or ovarian cysts and also to monitor pregnancy.
If conception is to occur easily and naturally, it is essential for a woman to have patent (open) and undamaged Fallopian tubes in order for the sperm and egg to meet. In order to check the patency of the Fallopian tubes as well as the condition of the uterus and ovaries, a Laparoscopy can be performed. This procedure involves inserting a small telescope known as a laparoscope through the abdominal wall when the pelvic organs can be clearly seen. A diagnostic laparoscopy is performed in the operating theatre, usually as a day-case under a general anaesthetic. Laparoscopic surgery, for fibroid or cyst, needs to be stay in a hospital for 1-2 days.
A hysterosalpingogram may also be used to check whether or not the Fallopian tubes are blocked. This is an x-ray procedure involving the injection of a special safe dye through the cervix and into the uterus. The passage of the dye through the Fallopian tubes can be observed on the x-ray. If the dye fails to spill out through the end of the tubes, this indicates that they are blocked or that a spasm has occurred and needs further investigation.
A small telescope connected to a camera is inserted through the cervical canal. This is done either under general anaesthetic or under sedation as a day case. The uterine cavity will therefore be seen and examined under direct vision. Pathology best seen with this technique includes sub-mucous fibroids (fibroids developed within the uterine cavity), endometrial polyps or adhesions.