Investigations For Female Infertility
- Cervical smear test if not done recently.
- Blood group and blood test to check for German measles (Rubella) which, if contracted during the first three months of pregnancy, can harm the unborn baby.
- Blood test during period i.e between day 2-5, to check for hormone imbalances -measurement of FSH (follicle stimulating hormone, LH (luteinising hormone) and oestradiol. This test can also identify possible early menopause as a cause of subfertility. TSH(Thyroid stimulating hormone), PRL(prolactin) are also done to rule out other hormonal imbalances.
- If irregular periods or excessive hair growth, etc. are a complaint then further hormonal blood tests are also required.
- Baseline viral screen for infectious diseases like VDRL, HIV, HbsAg, HCV are done for both partners.
- Occasionally, a tissue sample is taken from the endometrial lining of the uterus and analysed.
1) Pelvic ultrasound
A baseline ultrasound scan is able to diagnose congenital anomalies of the reproductive tract, uterine fibroids, hydrosalpinx, ovarian cysts, endometriomas, and polycystic ovaries.
2) Hysterosalpingography (HSG)
The most common tool to assess the uterine cavity and opening of the fallopian tube is still the hysterosalpingogram.
Uterine cavity defects such as fibroids, polyps, and synechiae can be clearly demonstrated. HSG is performed after cessation of menses, while the couple are requested to avoid intercourse from the time of menstruation to the time of examination, to prevent interference with an early pregnancy demonstrated with HSG.
Hysteroscopy is a simple procedure to visualize the cervical canal and the inside of the uterus using a thin, lighted, flexible tube designated a hysteroscope. The device is inserted through the vagina. It can be used as a diagnostic, as well as a therapeutic tool. The procedure can be performed with or without a local anesthetic, especially if it is used for a diagnostic procedure only. Occasionally this is performed under general anesthesia, usually to remove a polyp, fibroid, adhesions, or for biopsy.
This procedure is performed under general anesthesia, with tubal patency checked by the transcervical injection of methylene blue dye, and remains the “gold standard” for the accurate assessment of tubal patency. Visualization of the pelvic cavity by laparoscopy is necessary to ascertain tubal patency, adnexal adhesions, and ovarian mass.
- Some abnormalities detected at the time of diagnostic laparoscopy can be treated during the same procedure (for example, lysis of adhesions, salpingectomy, ovarian cystectomy, cauterization or vaporization of endometriotic implants).