Base line investigations
- Clinical assessment
- Hormonal assays: Hormones produced by the hypothalamus, pituitary and ovaries play a key role in ovulation. Abnormalities in other hormonal or organ systems may also contribute to infertility. A blood test measures the level of various hormones at different times of a woman’s menstrual cycle.
- Ovarian reserve testing includes blood tests and a transvaginal scan to assess the quality and quantity of eggs
- Cycle monitoring involves tracking the release of an egg
- Hystero-contrast- salpingo-sonography (HyCoSy scan) and saline infusion sonography (SIS for uterine cavity assessment): This is an outpatient procedure sometimes requiring sedation, where the fallopian tubes are tested by passing a special fluid through the cervix under transvaginal ultrasound guidance. This is much less comfortable than an HSG and allows you to continue trying for a pregnancy in the same cycle. SIS is a similar procedure to assess the womb cavity.
- Hysterosalpingogram (HSG): This is an outpatient procedure sometimes requiring sedation where the fallopian tubes are tested by passing a special fluid through the cervix under radiological guidance.
- Laparoscopy, dye test and hysteroscopy: A laparoscopy is a procedure to check the fallopian tubes along with the woman’s pelvic organs. It is a minimally invasive procedure in which a telescope called laparoscope is inserted through the abdominal wall to visualize the fallopian tubes, ovaries and uterus to exclude problems such as endometriosis, fibroids, ovarian cysts and adhesions (scar tissues). Many infertile couples require a diagnostic laparoscopy for a complete evaluation of their infertility. This is usually done as a day care surgery under general anaesthesia. A hysteroscopy is a procedure where the telescope is passed into the uterus at the same time to assess the inside of the womb. A coloured dye (methylene blue) is then passed through the cervix. If the tubes are not blocked, the dye will pass through and spill into the abdomen
- Genetic testing: It is a blood test that looks at a person’s DNA or genetic information. It may also be ordered to diagnose various congenital or inherited syndromes This may be recommended if you have repeated IVF failures or miscarriages.
- Immunological assessment: Dysfunction of the immune system could contribute to infertility and pregnancy loss. Blood tests related to the immune system may help to diagnose a problem.