INFERTILITY INVESTIGATIONS
Below are a brief description of some of the investigations your doctor may recommend prior to commencing In Vitro Fertilisation (IVF), Gamete Intrafallopian Transfer (GIFT) or Intrauterine Insemination (IUI) procedures.
Baseline Hormone Investigations
Performed between cycle days 1-5 and can involve all or a combination of the following:-
Performed between cycle days 1-5 and can involve all or a combination of the following:-
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Vaginal ultrasound scan
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Blood tests for FSH, E2, LH, AMH, Thyroid function and prolactin.
Semen Analysis
A semen analysis is done as part of the initial consultation. We recommend two to three days' abstinence before producing the sample. Due to differing parameters between clinics we strongly recommend having an analysis performed here.
A semen analysis is done as part of the initial consultation. We recommend two to three days' abstinence before producing the sample. Due to differing parameters between clinics we strongly recommend having an analysis performed here.
This investigation is usually recommended in instances of multiple treatment failure or recurrent miscarriage. The DNA fragmentation index is an indicator of the fragility or DNA damage present within the sperm. Sperm with high DNA fragmentation may fertilize an egg but embryo development may be compromised . There is evidence that there might be an increased risk of miscarriage.
HysteroSalpingoGram (H.S.G)
Usually performed between days 9-12 of the cycle. This is an X-ray and dye test to check that the fallopian tubes are patent (open).
Ultrasound Follicular Tracking
Usually commences day 10, 11 or 12 of the cycle and involves a series of ultrasound scans on alternate days monitoring you towards ovulation. Often done in conjunction with the Post-Coital Test and the Progesterone Blood Test.
Post-Coital Test
This is performed approximately 24-48 hours after ovulation and is done to assess the receptivity of the cervical mucus. The doctor will advise you to have intercourse then attend the Unit for the test the next morning or later the same day.Often done in conjunction with the Ultrasound Follicular Tracking and Progesterone Blood Test.
Progesterone blood test
Taken approximately one week after ovulation occurs and is checked to ensure that the progesterone level rises as it should after ovulation.
Often done in conjunction with the Ultrasound Follicular Tracking and Post-Coital Test.
The OST is performed on Day 3 and 4 of the period. Day 3 involves a transvaginal scan, baseline blood hormone profile (E2, FSH and AMH) and a stimulating injection of FSH.
A repeat blood test on Day 4 is taken to ascertain the body's reaction to the stimulating injection.
AMH (Anti-Mullerian Hormone) is a hormone that is produced by the ovaries and is strongly correlated with the egg follicle pool. This hormone does not fluctuate month to month like other hormones, and is a strong predictor of ovarian reserve.
Ovarian Reserve Test (O.R.T.)
Ovarian Reserve Test (O.R.T.)
The ORT (Ovarian Reserve Test) is performed between days 2-5 of the period. It involves a transvaginal scan and baseline blood hormone profile (E2, FSH and AMH).
The Dummy Embryo Transfer is a trial run for the process of embryo transfer. This is necessary to establish whether the actual transfer will be likely to encounter difficulties. It also allows us to take measurements and/or note any deviations of the uterus. When the time comes for the actual embryo transfer this information allows us to proceed with the least amount of trauma to the fragile embryos. Should the doctor encounter resistance to the passage of the catheter they may recommend a Dilapan.
The HyCoSy is a procedure where a catheter is introduced to the uterus via the vagina and an ultrasound probe is then placed in the vagina. When the uterus is visualised the contrast medium is then injected via the catheter and the results can be seen on the ultrasound screen. If any potential polyps are viewed the doctor may recommend a Hysteroscopy. Swabs for infection will be taken from the cervix to check for infection.
A hysteroscopy is a procedure performed under anaesthetic where a tiny telescope is passed into the vagina and through the cervix (entrance to the womb) to view the lining of the womb and the opening of the Fallopian tubes. Sometimes a sample of the womb lining is taken for laboratory examination. This procedure also allows for the removal of small polyps present in the uterus.
Laparoscopy
A laparoscopy is a keyhole procedure to look inside the woman's pelvic area and examine the ovaries and womb. The procedure is performed under general anaesthetic and involves passing a telescope into the abdomen (tummy) through a small cut.
