Fertility Procedures Explained

Trying to get to the bottom of why you are not conceiving requires thorough examination

We turned to Dr Amanda Jefferys, Medical Director and Consultant Gynaecologist and Specialist in Reproductive Medicine at at BCRM and asked her to explain.

Fertility tests may reveal the reason you haven’t conceived yet and may find something that can be reversed, avoiding the need for fertility treatment. However, it is important to remember that in some couples no cause is found. It is also important to stress that fertility treatment may be less likely to work if you have an unresolved medical issue.

Some of the key ingredients to conception, are the correct functioning of your uterus, fallopian tubes, and ovaries, with no blockages, so your doctor may suggest one of several procedures that can check the health of these organs. Here, we have listed the common procedures that your doctor may discuss with you.

The Aquascan (also known as a 3D Hydroscan or a Saline Infusion Sonography) is an internal ultrasound scan procedure that is used to assesses the uterine cavity. By using a saline solution, gently inserted into the vagina and then cervix via a catheter, your doctor can detect the presence of scar tissue, polyps, fibroids, or other uterine abnormalities. This procedure may also be helpful when looking in to why a woman is experiencing recurrent miscarriage.

The HyCoSy scan (which stands for Hysterosalpingo Contrast Sonography) is an ultrasound scan, used to check whether the fallopian tubes are open. This procedure involves the use of a foam dye, which helps the sonographer see clearly if there are any blockaages. As you would have during a smear test, a speculum is inserted, followed by a catheter which is passed through the cervix. At the end of the catheter is a tiny balloon, which is then inflated once inside the uterus. The reason for this is to keep the catheter in position. Once in position, a small amount of water is passed through the catheter to show up the cavity of the uterus. Following that, the contrast fluid, or foam dye, is then passed through the catheter to highlight any blockages. This procedure does not use X-rays or any kind of radiation, but instead, a transvaginal ultrasound probe.

The HSG (which stands for Hysterosalpingogram) is similar to the. HyCoSy in that a dye is used to highlight blockages, but in the procedure, a series of X-rays are taken rather than a transvaginal ultrasound scan. The X-rays are taken after your doctor injects liquid dye through the cervix. The HSG can help your doctor see if your fallopian tubes are blocked.

The Transvaginal ultrasound is a simple procedure whereby your doctor places an ultrasound probe into the vagina and brings it close to the pelvic organs. Using sound waves, they’ll be able to see images of the ovaries and uterus to check for problems there.

The Hysteroscopy is a procedure whereby your doctor passes a fine camera through the cervix and into the uterus. This enables your doctor to directly visualize the cavity of the womb see any problems and take tissue samples if needed.

The Laparoscopy procedure, which is described as keyhole surgery, allows your doctor to examine the pelvic anatomy for causes of female infertility. In this procedure, your doctor makes small cuts (1cm or less) in your belly and passes a camera inside to check your entire pelvis.  Dye is also passed to check for blockages to the tubes.  This can also be an opportunity to correct problems such as endometriosis, scar tissue or tubal blockages which may improve chances of natural conception.  This procedure requires a general anaesthetic, you will usually be discharged from the hospital on the same day as the procedure.

Learn more about fertility testing here:

Fertility tests


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