Investigations for Infertility
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.
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 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 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 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.