FERTILITY INVESTIGATIONS & CHECK UP

Before you embark on fertility treatments, it is necessary to go for an assessment to find out your fertility levels as well as your partners. These fertility investigations are important for evaluation and determination of the accurate treatment.

Fertility investigations involve both partners solely because conception involves the two, not just the woman. As revealed by the American Society of Reproductive Medicine, one-third (1/3) of infertility cases are caused by male factor infertility; one-third of these cases occur as a result of female factor infertility while the remaining one-third infertility cases occur due to unexplainable cause or problems from both couple.

COUPLE FERTILITY INVESTIGATIONS

These fertility investigations involve the couple. These tests are carried out in addition to individual testing. These include accurate and comprehensive female blood hormone (AMH) testing, as well as, an ultrasound scan to determine the ovarian reserve of the eggs in the woman. A sperm analysis test is also carried out on the male partner.

At Women’s Health Care, we offer intensive fertility investigations for couples who need fertility treatment. After these investigations, you would be allowed to have a consultation with our expert gynaecologists who will provide a detailed explanation of the test results.

The Couple fertility investigation at Women’s Health Care costs £450.

OVARIAN RESERVE TESTING

This is a fertility investigation that determines a woman’s ovarian reserve. The ovarian reserve is simply a woman’s fertility potential. In essence, this test helps to determine the period you have left to conceive. This decrease naturally with age on a faster or slower pace. Ovarian reserve is also greatly helpful in the planning of fertility treatment.

Ovarian reserve testing is the investigation done to understand a woman’s ovarian reserve.  Precisely, there are two major tests carried out for ovarian reserve testing; antral follicle count and AMH blood tests.  These two tests provide a reliable and accurate assessment of the female reproductive potential.

  • ANTRAL FOLLICLE COUNT

The antral follicle count is the total number of theantral follicles that are available at the beginning of the menstrual cycle &can grow and become mature follicles (antral follicles are small follicles (2-9 mm) thatcan be seen, measured and counted. The antral follicle count can be gotten through a vaginal ultrasound examination.  The total sum of the antral follicles in the ovaries can determine the fertility potential of a woman,as well as the response to treatment through the stimulation of the ovaries.

The total number of the antral follicles in the ovaries can help determine the response to treatment through the stimulation of the ovaries, especially for in-vitro fertilisation (IVF). It can help provide an insight into the chances of getting successful treatment. Above all, the ovarian reserve testing assessment will aid in the calculation of treatment doses.

A woman has a low ovarian reserve if her antral follicle count is less than five. This identifies the need for high doses of medication for the production of more eggs for IVF.

Antral follicles count varies in women with lower egg count from cycle to cycle.

  • ANTI-MULLERIAN HORMONE (AMH) BLOOD TEST

Anti-Mullerian Hormone (AMH) hormone is produced by the ovarian follicles. Hence, the levels of AMH is linked to the number of antral follicles in the ovary. Isolated AMH levels show the ovaries’ life span. The level of AMH in the bloodstream can indicate the number of egg-containing follicles that are available in the ovaries, as well as, their potential to ovulate. AMH declines naturally with age, and when high levels are noticed, it can suggest polycystic ovaries, which is important when considering fertility treatments such as IVF.

Women’s Health Care offers a complete package for ovarian reserve testing to help determine your fertility potential & how much time you have to conceive. We also help with fertility treatment planning.

The following are the benefits of choosing us for your ovarian reserve testing:

  • Up to an hour and a half consultation with our consultant fertility specialists
  • AMH blood test
  • Results review with our consultant fertility specialist
  • An ultrasound scan to assess the follicles in your ovaries

The initial egg count package costs £350 only.

3D/4D OVARIAN RESERVE TESTING ASSESSMENT

It is necessary to know your ovarian reserve (i.e. the number of eggs in the follicles that can be stimulated at the onset of a cycle). These eggs must have the potential to ovulate. Technology has made it easy to identify the amount of these eggs per cycle.

Through the use of 3D scanning technology, the total number of the antral follicles present at the onset of a menstrual cycle can be accurately counted via a vaginalultrasound examination.

The total number of the antral follicles in the ovaries can help determine the response to treatment through the stimulation of the ovaries, especially for in-vitro fertilisation (IVF). It can help provide an insight into the chances of getting successful treatment. Above all, the ovarian reserve testing assessment will aid in the calculation of treatment doses.

A woman has a low ovarian reserve if her antral follicle count is less than five. This identifies the need for high doses of medication for the production of more eggs for IVF.

If a woman has an antral follicle count of more than 15, she might be having polycystic ovary syndrome. This means she has a good chance of having an impressive number of eggs. To this effect, a moderate dose of stimulating medication is required.

HyCoSy

Hystero-Salpingo Contrast Sonography(HyCoSy) is a fertility investigation that is used to check the uterine cavity as well as the patency of the uterine tubes. Saline Infusion Sonography (also called Aqua Scan) is used to examine the uterine cavity to rule out pathological conditions such as fibroids, polyps, as well as, identify abnormalities in the cavity of the uterus.

WHEN IS HyCoSy DONE?

HyCoSy is usually carried out between the 6th and 12th day of your menstrual cycle. This is usually when you stop bleeding; as well as before ovulation occurs.

THE PROCEDURE

You must empty your bladder before the HyCoSy procedure. You will be told to lie down on the couch in the examination room, and a speculum will be inserted into the vagina. A thin catheter will then be inserted into the cervical opening. A vaginal ultrasound probe is then inserted to inject sterile fluid into the cavity to examine the cavity (aqua scan).

This aspect of the examination is referred to as a saline infusion, sonohysterography or hydrosonohysterography. Afterwards, a contrast medium is injected into the catheter to examine whether the Fallopian tubes are patent (i.e. to check if they are open or blocked). You may likely experience some cramps and discomfort when the dye is injected at this point.

The HyCoSy procedure takes about 10-15 minutes & requires no anaesthesia. If you experience unbearable pain, you can opt for sedation or general anaesthesia; this would, however, be subject to additional costs.

This is a 3D scan of the uterus, its lining, and the ovaries. It also reviews the antral follicular count (the egg reserve).After the HyCoSy procedure, you will have to stay in the waiting room for about 10 to 15 minutes for close observations. This is to ensure you do not develop any reactions to the contrast.

We strongly advise that you come to the clinic with someone who can drive you home in case you feel unwell after the procedure. You should be able to get back to work on the same day if there is no reaction to the dye. You might need sanitary towels as the dye may cause some spotting.

WHEN TO GET THE RESULTS

Few minutes after the procedure, your fertility specialist will discuss with you the results alongside the treatment plans

WHAT ARE THE SIDE EFFECTS OF HyCoSy PROCEDURE?

Cramping and abdominal pains might be experienced after the procedure. There is also the possibility of getting light bleeding after the testing, which should last for 24 to 48 hours. If the pain and spotting continue more than 48 hours, do contact us.

WHAT ARE THE RISKS ASSOCIATED WITH THE HyCoSy PROCEDURE?

The infection might develop after the procedure and could be persistent for days, but this is very rare. If you experience fever, foul-smelling discharge or pain, please contact us as soon as possible. In such cases, we may do a swab test and dispense antibiotics. We always give 1gram of Azithromycin as a single dose after the procedure.

PLEASE TAKE NOTE!

You must abstain from sex from the 1st day of your menstrual period until after the HyCoSy procedure. You need to adhere to this to avoid getting pregnant before the test.

You must perform a Chlamydia test before the procedure to confirm the presence or absence of an infection before the dye is introduced into the womb and the fallopian tubes.

Open up to us if you are allergic to contrasts or iodine before the HyCoSy procedure.

COST

You can get the cost of the procedure when you contact us.

FALLOPIAN TUBE TESTING

The fallopian tubes are very important for natural conception to occur. This is because the egg and the sperm meet, fuse and fertilise in the fallopian tubebefore it gets transported into the uterus for implantation. Damage or blockage to the tube would interfere with conception.

Tubal patency can be examined through the use of HSG- Hysterosalpingogram or HYCOSY- ultrasound-guided dye test without anaesthetics.

Laparoscopy nonetheless remains the best as it offers more detailed analysis. It also offers the significant advantage of correcting any blockage in the tube. It, however, requires a general anaesthetic.

MALE FERTILITY TEST

Male fertility is dependent on the quality, as well as the quantity of the man’s sperm. If there is an issue with the quality and quantity of the sperm, the man would be faced with fertility issues.

Male fertility issues can be caused by poor or absent sperm count, poor sperm motility, testicular problems, genetic problems and blockage along the sperm pathway.  Male fertility problems account for 1/3 of infertility cases.

These are some common misconceptions about male fertility issues:

  • Low libido is a sign of male fertility problem: No! Lack of libido is never a sign of poor sperm but may cause infertility by less sexual activities.
  • Abstinence from sex can improve sperm quality: There is no scientific evidence that proves that sperm DNA may improve if sex is avoided for a long period.

At Women’s Health Care, we provide a male fertility test that will help to determine the presence of fertility issues affecting the male partner, as well as the nature of the specific fertility issue.  Our male fertility test package encompasses the following:

  • 30 minutes of initial consultation with a consultant fertility expert.
  • Results review with a consultant fertility expert, as well as, treatment planning to solve the issue.

The male fertility test goes for£300 and results would available within 5 days.

HORMONE BLOOD TEST

Hormones in women fluctuate naturally throughout the monthly menstrual cycle, as well as, during the fertility treatment cycle.

Blood tests that are carried out on specific days during a menstrual cycle give us enough insight to understand the hormone levels of a woman and also plan & accurately monitor a treatment cycle.

E2 (Estradiol), FSH (Follicle Stimulating Hormone), LH (Luteinising Hormone), AMH (Anti Mullerian Hormone), Progesterone, Prolactin, Thyroid Function Test are the common hormones checked in the hormone blood test. In some women, specific hormones are checked for certain conditions such as the polycystic ovaries (PCO).

Some men also need the FSH, LH, testosterone levels checked via a blood test, most especially if the sperm count is very low or completely absent. These hormone blood tests can sometimes be enough to help determine the cause of infertility.

WHERE TO SEEK FOR SUPPORT AND ADVICE

Women’s Health Care provides professional support services and reliable information on fertility issues.  You can reach out to us or walk into our office at Harley Street, London to speak with a Gynaecologist. We are always happy to help!