Female Fertility tests
The first issues to look at with female fertility tests are egg release (ovulation), to see if the fallopian tubes are open and the ovarian reserve “fertility test”.
Hormones are the body’s way of sending messages from one organ to another. We all know that hormones are important in women’s health and measuring hormone levels will provide information about your probability of being able to conceive, as well as give information about the menstrual cycle.
It is normal to test hormones when woman have problematic periods, when periods stop and when trying to conceive. Some tests need to be done at a specific time in your cycle.
There is not a way tell you how many eggs you have or even how long you will be fertile for. However a blood test called an Anti-Mullerian Hormone test (AMH) in conjunction with an ultrasound will give a good idea about a your current fertility. An AMH can be taken at any point in the menstrual cycle. More information about the AMH test can be found here.
Ovulation is the release of the egg from the ovary. A blood test taken seven days before the onset of your period will normally give a very good ideas if ovulation has occurred. So, if you have a period every 30 days then the test should be taken on day 23. If your periods are very irregular then testing for ovulation is not really worthwhile. There are many reasons for ovulation not to occur, and are normally easy to check for. The vast majority of young women who do not ovulate can be helped with relatively simple treatment.
Ovulation and ovarian reserve are not always connected in young woman. You may have a good ovarian reserve (meaning that there are lots of eggs in the ovaries) but not be ovulating. Treatment would aim to encourage these eggs to grow and hopefully ovulate.
Ultrasound is a very important part of a gynaecological assessment. It provides a thorough check of the uterus and ovaries, and gives much more information than examination alone.
Having the scan performed by a trained gynaecologist means that your symptoms can be assessed during the scan. This is particularly important in women with pelvic pain, heavy periods, infertility or irregular periods.
The ultrasound scan is an internal scan (the scan probe is inserted into the vagina) because it provides much clearer images and more detail than a trans-abdominal (scan over the abdomen) ultrasound. The scan is not painful and uses sound waves rather than X-ray.
The images of the ultrasound are displayed on a screen the findings will be explained to you. Remember that we are all are slightly different from each other, so no two healthy women will have the same scan findings!
Ultrasound is particularly helpful in the diagnosis of many conditions
- Early pregnancy
- Uterine fibroids
- Distortions of the lining of the womb (endometrium) including polyps
- Womb septums/ double wombs
- Swollen tubes (hydrosalpinx)
- Polycystic ovaries
- Ovarian endometriosis
- Ovarian cysts
Fallopian Tube Tests
The fallopian tubes collect eggs from the ovaries and provide the ideal place for the sperm and eggs to mix (fertilise). Blockage of the tubes is an important cause of a delay in conceiving, and I would normally check the fallopian tubes after one year of trying to conceive
There are various ways that we can check the fallopian tubes. Whichever test you have it will be necessary to use a dye. This is needed because the insides of healthy fallopian tubes are not visible even with x-ray or ultrasound so we need to make them visible with a dye.
The best test is unfortunately the most invasive and is an operation called a laparoscopy. I would normally not recommend this procedure unless a woman is having other issues such as heavy or painful periods or when we are suspect endometriosis.
Another way is for an x-ray test called a hystero-salpingogram (HSG). It is a very good way of checking the fallopian tubes but the downsides are that it requires x-ray and some women will have an extremely rare, but severe allergy to the iodine dye used in the procedure.
For the majority of women an ultrasound and dye test called a HYCOSY is suitable. It does not have the same diagnostic accuracy as the other two tests, but is certainly a very good test for most women and is a better test than HSG in assessing the womb cavity.
HYCOSY is a transvaginal ultrasound technique during which a special dye called ExEm Foam is slowly injected into the uterine cavity. The dye will then be seen coming through the tubes. It is a non-invasive procedure and provides invaluable information about the fallopian tubes and the womb.
The procedure is not painful for most women but some may experience mild discomfort, so taking a mild pain relief 30 minutes beforehand is a good idea. The procedure should be done gently and slowly using the least amount of ExEm foam as possible to try and minimise the discomfort.
It is advisable that this scan is carried out between day 5-10 of your cycle. Yvonne will discuss the timing of your appointment with you.
Information about male tests can be found here
Fertility consultations, tests and treatments can be arranged via contacting my PA, Ms Yvonne Baillie on 0207 125 0547 or email her here