Referral & Treatments

Investigations

We will need to take a full medical and social history. This will include, a gynaecological history, details about previous pregnancies and their outcomes, previous contraception used.

Female investigations

Examination

The doctor in clinic may want to perform an abdominal and vaginal examination. The doctor is trying to determine the cause of your infertility. A cervical smear may be taken if this has not recently been carried out.

Blood tests

There are a number of blood tests that are important for us take, to enable us to assess if there is a problem with your hormones. These need to be taken at certain times within your menstrual cycle and you will be told exactly when they need to be taken.

We will also check if you are immune to rubella (German Measles). If you are not immune you will need to have the rubella vaccination and wait a month before you try and get pregnant.

Cycle tracking/Follicle Tracking

Cycle/follicle tracking involves a series of internal ultrasound scans and blood tests during your menstrual cycle to determine if and when you ovulate.

Tubal patency tests

It is important that your fallopian tubes are patent, as this is where fertilisation of the egg by the sperm occurs. It will depend upon your gynaecology and medical history as to which investigation will be performed, this will be discussed at your consultation.

Hysterosalpingography (HSG)

An x-ray of the fallopian tubes and uterus. It is performed in the x-ray department and usually does not require a general anaesthetic. A radio-opaque dye is passed up through the cervix into the uterine cavity, the dye shows up on the x-ray and the doctor is able to see if the dye flows out of both fallopian tubes into the abdominal cavity.

Hysterosalpingo-contrast sonography (HyCoSy)

Similar to a HSG but instead of x-rays a special echo-contrast medium is used to show the flow of fluid through the Fallopian tubes.

Laparoscopy

An operation that requires a general anaesthetic. A slim telescope called a laparoscope is inserted through a small incision made in the abdominal cavity to enable the doctor to see the uterus, fallopian tubes and ovaries. Injecting methylene blue dye into the uterus via the cervix tests tubal patency. If the tubes are healthy the dye can be seen passing along them and escaping through the outer opening of the tubes.

Male Investigations

Examination

The doctor may need to examine your testicles to ascertain there are any abnormalities present.

Blood test

A blood test may be taken to assess your hormone levels and chromosome status in certain type of male infertility.

Ultrasound scan

This may be required to look at the accessory male glands that form part of the reproductive system. This is usually performed transrectally and is known as a 'TRUSS' test.

Semen analysis

You will be asked to arrange an appointment to produce a semen sample. It is important that we know a number of things about the sperm you are producing. We need to know the volume and number of sperm you produce, the percentage of sperm moving, the percentage of abnormal sperm and the number of white cell in the sample. A second test may be requested if the first sample is poor as semen samples can vary immensely.