Post-Coital
Test
The post-coital test is used to assess
the function of the sperm within the cervical mucus and is usually
scheduled 1-2 days prior to ovulation. Several hours after the
patient has intercourse, a small sample of the cervical mucus is
examined under the microscope. The amount of sperm seen in the
mucus and the quality of motility are evaluated. Cervical mucus
that has an adverse effect on the function of the sperm can be
associated with infertility.
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Follicle
Study Ultrasound
Each cycle, eggs mature in the ovaries
within small sacs called follicles. It is important to monitor
the formation of the follicles during the first half of the monthly
cycle as the amount and size of the follicles tell the physician how
many eggs are being produced by the body. Adjusting
medication can regulate the number of eggs produced. A slender
wand attached to an ultrasound machine is introduced into the vagina and
directed towards the ovaries. The ovaries and follicles can be
seen on a screen. Follicles are counted and measured and
medication is adjusted accordingly. The procedure takes
approximately 15 minutes in the office and causes very minimal
discomfort.
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Follicular
Cyst Aspiration
Typically, ovarian cysts are not disease
related and disappear on their own. During ovulation, a follicle
grows but fails to rupture and release an egg. It retains fluid
and becomes a cyst. Ovarian cysts can cause a variety of symptoms
including abnormal uterine bleeding, pelvic pain, and nausea and
vomiting. An ovarian cyst can be drained in the office using a
needle with ultrasound guidance. The procedure takes approximately
15 minutes.
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Endometrial
Biopsy
The lining of the uterus is called the
endometrium. The endometrium responds to changing hormone levels
during the menstrual cycle. Sending a small sample, or biopsy, of
this lining for microscopic examination can tell your doctor if your
ovaries are producing enough progesterone, a hormone needed to support a
pregnancy. The biopsy is usually scheduled just prior to the
beginning of the menstrual cycle. Before the biopsy, a urine
pregnancy test will be performed. If the pregnancy test is
negative, a speculum is introduced into the vagina. Then, a small
catheter is passed through the cervix to obtain a piece of tissue.
The entire procedure takes approximately 5 minutes and may cause minimal
menstrual-like cramping.
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Cultures:
Occasionally a microorganism harbored in
the reproductive tract can be the cause of infertility. Culture
swabs of the area can give your physician valuable information regarding
any unusual organisms.
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Hysteroscopic
Evaluation of the Uterus
The uterine cavity can be visualized by
inserting a small optical tube called a hysteroscope, through the vagina
and cervix. The uterus is filled with saline to enhance visualization.
The physician can evaluate the size and depth of the uterus, the
presence of abnormalities inside the uterus, the presence of polyps or
adhesions, and the quality of the endometrium. The procedure is
usually performed in the early half of a woman’s cycle and can be done
in the office. It takes approximately 20 minutes.
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Reversal
of Tubal Ligation:
Tubal ligation is a term used when the
fallopian tubes have been surgically tied to prevent pregnancy. Patients
usually request reversal due to a change in marital status.
Success depends very much on what type of tubal ligation was done.
Generally, success varies from 50% - 70%. Reversal of tubal ligation is
a surgical procedure, and hospital stay is 2 – 3 days.
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Hysterosalpingogram:
A hysterosalpingogram (HSG) is a
procedure used to x-ray the uterine cavity and fallopian tubes. It
is performed in the x-ray department and takes approximately 15 minutes.
The patient is allowed to go home after the procedure. A thin
catheter is passed through the cervix into the uterus. The uterine
cavity and fallopian tubes are then flushed with an x-ray contrast dye
(through the catheter). There may be some cramping associated with
the injection of the dye. The movement of the dye is observed as it
makes its way through the uterus into the fallopian tubes and spills
into the pelvic area. An HSG can detect: an abnormally shaped
uterine cavity, fibroid tumors, polyps, scar tissue, partially or
completely blocked fallopian tubes, and normally shaped uterine cavity and
tubes.
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Tubal
Catheterization:
When a blocked fallopian tube is
discovered with a hysterosalpingogram (HSG), a tubal catheterization can
be performed to correct the blockage. The procedure is performed
in the x-ray department and takes approximately 20 minutes. The patient can go
home after the procedure. Under fluoroscopic guidance, a thin
balloon catheter is threaded through the cervix, uterus and into the
affected fallopian tube. At the site of the blockage, the balloon
is inflated, correcting the obstruction. The area is then flushed
with an x-ray contrast dye to verify results. There is an 85 –
90% chance that a blocked tube will be opened. About 60% of those
will still be open after 6 months, and 30 – 40 % will conceive.
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