Investigations for Infertility

 

Hormonal evaluation

 

Hormones regulate every step of the way from stimulating the egg development to ovulation, implantation of an embryo and eventually pregnancy. On day 2 or day 3 of menstrual cycle, a baseline testing for Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH) and Estradiol (E2) will be done in order to evaluate the ovarian function and to help plan for the best treatment. Another blood test check for the level of progesterone will be done on day 21 to check for ovulation and luteal support. The levels of androgen, prolactin and thyroxine may be tested in addition to look for other infertility factors.

 

Hysterosalpingogram (HSG)

 

HSG is carried out to check for the patency of the Follo[pian tubes, and any aberration of the uterine cavity. It is done after the mense and before ovulation in order to prevent any effect on early pregnancy. HSG technique makes use of x-ray and a radio opaque dye to test the Fallopian tubes and the shape of the uterus and usually takes about 10 to 30 minutes in a radiology lab. The gynaecologists or radiologists will insert a speculum into your vagina and place a thin plastic tube through the cervix. A dye will then be injected to fill the uterus and Fallopian tubes. X-rays will then be taken for diagnosis. Analgesic may be taken to reduce the pain during testing. When the dye is injected, a number of women may feel some cramping. Alternative using ultrasound scanning with fluid an air to the uterus provides an alternative method for diagnosis.

 

Ultrasound Testing

 

Ultrasound testing is a common procedure in normal gynaecological check-up. There are pelvic ultrasound and transvaginal ultrasound for infertility testing. Generally, transvaginal ultrasound is used to provide a clearer image for the conditions of cervix, ovary, uterus and Fallopian tubes.

 

Laparoscopy

 

Laparoscopy helps in the diagnosis of fibroids, scar tissue, endometriosis, and blocked fallopian tubes. If any problems are diagnosed, your doctor may be able to correct them during this procedure. Laparoscopy is a surgical procedure which is performed under anesthesia. Your doctor will insert a narrow laparoscope through a tiny incision around your navel and so as to examine your ovaries, Fallopian tubes, the outer uterine structure and the pelvis. A dye may be injected into your uterus and Fallopian tubes though the cervix. It will give the information of whether the fallopian tube is open or blocked.

 

Semen Analysis

 

Semen analysis is important in revealing any male factors and plan for the most appropriate treatment for the couples. Not only the volume of the ejaculate will be measured, the sperm count, motility and morphology will be observed and taken into account for the male fertility. It is generally suggested to have a second analysis if any problems are noticed in the first analysis in order to give an accurate result.

 

 

 

 

檢查項目

 

荷爾蒙血液化驗

 

從刺激卵子生長到排卵、胚胎著床到最後懷孕,每一步都受到荷爾蒙影響。在月經週期的第二、三天,我們會為你進行FSH、LH和雌二醇(E2)的基準值測試,以評估卵巢功能並計劃最佳的治療方案。第21天,我們會進行另一次抽血,檢查黃體酮(P)水平以檢查排卵及黃體支持。如要找出其他不育因素,可能也會進行額外的雄激素、催乳激素和甲狀腺素水平測試。

 

子宮輸卵管造影檢查 (HSG)

 

子宮輸卵管造影檢查(HSG)的作用,是確保輸卵管暢通及子宮腔狀態是否正常。造影檢查會在來經後及排卵前進行,以防止對早期懷孕造成影響。HSG技術採用X光及造影劑來檢查輸卵管及子宮形狀。檢查於放射實驗室內進行,一般需時10-30分鐘。婦科醫生或放射治療師會經由你的子宮頸,透過幼細的塑膠導管將內窺鏡插進陰道,再往子宮和輸卵管裡注射造影劑,然後拍攝X光照片以作診斷。

檢查期間可能會用鎮痛劑來減輕痛楚。注射染料時,有些病人會出現輕微痙攣感覺。

另一種診斷方法就是子宮輸卵管超聲造影(HyCoSy) 就是以造影劑及超聲波掃瞄替子宮及輸卵管進行檢查。

 

超聲波測試

 

超聲波測試是一種常見的婦科檢查程序,不育檢查分為盆腔超聲波和陰道超聲波兩種。一般來說,陰道超聲波照片可較清楚顯示出子宮頸、卵巢、子宮和輸卵管的狀況。

 

腹腔鏡

 

腹腔鏡有助診斷肌瘤、瘢痕組織、子宮內膜異位症和輸卵管閉塞。一旦發現任何毛病,醫生或可在這個程序其間同時治療有關問題。

腹腔鏡手術須在麻醉下進行。醫生會在你肚臍附近開一個小切口,將窄小的腹腔鏡插進你的體內,查看卵巢、輸卵管、子宮外壁結構和盆腔;醫生也可能會經由你的子宮頸,將造影劑注射到子宮和輸卵管內,這樣就會知道輸卵管是否暢通。

 

精液常規檢驗

 

精液常規檢驗可以找出男性因素,對計劃最合適的治療方案非常重要。我們不但會量度射出精液的容量,還會觀察精子的數目、活動力和形態,歸納分析男方的生育能力。一般來說,若在首次分析中察覺任何問題,我們會建議男方進行第二次分析,確保結果準確。

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