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Diagnostic Procedures

Testing for Fallopian Tube and Uterine Abnormalities

Pelvic Ultrasound

This refers to a non-invasive method that is used to examine the ovaries and womb by using high sound waves to show the inside of the body. Since the body is made up of over 90 percent water, it is possible to use sound to ‘see’ what is inside the body the same way sonar is used to find and identify objects in water.  An echo is produced every time the sound waves hit a tissue interface e.g., a blood vessel. Using these echoes, some advanced, high-speed computers can create an image of your internal organs. Ultrasound can help the physician to check the endometrium and to know the exact number of mature eggs present, although the procedure comes with little discomfort or risks. Also, ultrasound can be used to diagnose fibroid tumors and ovarian cysts.

Post-Coital Test (PCT)

The post-coital test (also known as a Huhner) is an excellent means of assessing the interaction of the sperm and the cervical mucus. In order to reach the fallopian tube and fertilize an egg therein, the sperm must first migrate through the cervical mucus. There are many factors which can impair the ability of the sperm to survive and traverse the cervical mucus, including infection, prior surgery on the cervix, and production of antibodies (substances that can kill or immobilize the sperm).

During a normal menstrual cycle, there are only a couple of days during which the sperm can survive in the cervical mucus. At other times of the cycle the mucus is a very effective barrier. Around the time of ovulation, the cervical mucus becomes very thin and watery and probably even somehow assists the sperm as they migrate through to the uterus and on to the fallopian tube. The quality of the cervical mucus as well as the number of sperm present and their motility will be assessed. The timing of this test is, therefore, crucial and must be done within 12 hours after Intercourse. The post-coital test is an important part of the evaluation of difficulty conceiving. If it is not normal, other evaluation or therapy may be suggested.

Sperm antibody testing (indirect IBT)

Is used to rule out the presence of sperm antibodies in female partner’s serum. May be drawn at anytime during the woman’s cycle. back to top

Endometrial Biopsy

A procedure by which a sample is taken of the endometrial lining of the uterus, shows evidence of ovulation and degree of maturation of the uterine lining, and can reveal uterine cancer, uterine fibroids, uterine polyps, and adenomyosis. This test also reveals if the woman has a luteal phase defect – a hormonal imbalance which prevents a woman from sustaining a pregnancy because not enough progesterone is produced. The test is typically performed 1-3 days before onset of woman’s menstrual flow.

Hysteroscopy

This is a procedure that involves insertion of a narrow telescope-like instrument through the vagina and cervix into the cavity of the uterus (endometrial cavity). The uterine cavity is then distended with fluid and visualized. This procedure allows us to determine whether there are any defects such as Fibroid tumors, polyps, scar tissue, a uterine septum, or other uterine problems inside the cavity.

Laparoscopy

Around 40 percent of women whose previous fertility workup fails to reveal the cause of their infertility will show abnormal uterine or tubal findings when a laparoscopic examination is carried out. Two small incisions (one above the pubic bone and the other at the belly button) are usually made during a laparoscopy procedure. The patient’s abdomen is then  injected with carbon dioxide gas, which distends the abdomen and pushes the bowel away. A small hollow tube with a tiny camera and lenses known as laparoscope is inserted into the body via the umbilical incision. Next, a probe is inserted through the other incision. This allows the physician to see the external surface of the ovaries, fallopian tubes, and ovaries. Laparoscopy can be used to identify pelvic scar tissue, endometriosis, and blockage of the Fallopian tube. Thankfully, most of these dreaded conditions can be rectified during this procedure either by destroying endometrial implants or by removing scar tissues that may be joining organs together.

Microlaparoscopy

A new minimally invasive diagnostic surgical procedure uses telescopes and instruments that are much smaller than normal. If this procedure is appropriate for your condition, smaller incisions will be made and postoperative abdominal tenderness may be reduced.

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