Ovulation tests
The first test in checking your fertility is to establish whether or not you are releasing an egg every month (ovulating). Your fertility specialist will advise on the most appropriate investigation for you.
We may also use ultrasound scanning to assess follicle growth with the added benefit of checking the lining (endometrium) of the uterus and diagnose or exclude the presence of any polyps or fibroids. Urine testing kits are also available to help pinpoint the time of ovulation.
Your fertility specialist may also recommend an AMH test to provide an estimate of your ovarian reserve. This is a simple blood sample that can be taken at any time of the menstrual cycle.
Checking the fallopian tubes and uterus
Your fertility specialist may suggest the need to check that your tubes are open (tubal patency), as well as the condition of your uterus and ovaries, using the following tests:
- Sonohysterogram - a relatively non-invasive test, which involves an ultrasound scan and insertion of a tiny tube into the cervix so as to pass dye through the uterine cavity and tubes.
- Hysterosalpingogram - using X-ray technology to confirm that the fallopian tubes are patent and that the cavity fo the uterus is normal, though this does not provide information about the uterine wall or ovaries.
Diagnostic laparoscopy and hysteroscopy
These important tests require a general anaesthetic to be performed in an operating room and are therefore usually performed after non-invasive tests are completed. You may not need these investigations if the need for IVF is already apparent - your fertility specialist will advise you.
Laparoscopy is performed under general anaesthetic. A small diameter telescope (laparoscope) is passed through a small incision in the umbilicus and a manipulating probe above the pubic hairline, to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. Tubal patency can also be checked by injecting dye through the uterus and observing its progress or not through the tubes. Often two additional small incisions on the abdominal wall are made if treatment of pathology is required.
Hysteroscopy uses a similar small telescope (a hysteroscope) to study the uterine cavity for polyps, fibroids, adhesions and possible congenital anomalies.
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