Infertility is a common problem with one in seven couples seeking help or some form of fertility treatment. As this is such a common occurrence there is plenty of help available; the consultants at Nuada Gynaecology are experts in a wide range of fertility treatments, so whatever your situation they can help you with their expert tailored care, in order to give you the best chance of expanding your family.
After your consultant has taken a full medical history from you there are various diagnostic tests that can be run to ascertain the reason behind your struggle to get pregnant. It is common for a woman to have difficulties becoming pregnant when she wishes, so do not be alarmed if it is happening to you.
Transvaginal ultrasound scan
The transvaginal ultrasound scan is a highly useful scan used in the diagnosis of issues relating to the cervix, ovaries and uterus. It is painless but mildly uncomfortable. It involves scanning the pelvic area with the ultrasound probe lying in the vagina. Transvaginal ultrasound produces better and clearer images of the organs because the probe is closer to the structures. It is a very thin probe, no more than two centimetres in diameter and is only inserted a short distance into the vagina.
There are a number of reasons for this diagnostic test including;
- Follow up from an abnormal physical exam
- Follow up to check for cysts or fibroids
- Diagnosing unexplained vaginal bleeding or pelvic pain
- The development and recovery of an ectopic pregnancy
- Understanding the reason behind infertility.
Transabdominal ultrasound scans are the most common way of assessing a pregnancy, however a transvaginal ultrasound scan can be very beneficial for a number of reasons, such as:
- Monitor the heartbeat of the foetus
- Checking the cervix for any issues that could lead to complications later on in the pregnancy
- Diagnose the source of any abnormal bleeding
- Examine the placenta
- Understand a possible miscarriage.
The process of the scan will be for you to lie down on the examination table and the sterilised ultrasound wand shall be placed in position, you may feel some pressure however it should not be too uncomfortable and will feel similar to a smear, your gynaecologist will then adjust the wand for the best possible images, specifically to the area that is of concern.
It provides a clear view of the uterus, endometrium, cervix, ovaries and fallopian tubes. All transvaginal ultrasound machines at Nuada Gynaecology provide the most advanced 4D images. These images greatly improve the diagnosis of endometrial polyps and their location, fibroids and their location and in investigating recurrent miscarriages.
Your scan will be performed by your gynaecologist so that you will be in safe, familiar hands every step of the way, however there are no known harmful effects of transvaginal ultrasounds. It is not usually necessary to prepare or fast for an ultrasound scan but your gynaecologist may ask for you to have a rather full bladder, the reason for this is it slightly lifts the intestines away which allows for a better view of the general area.
A hormone test will be suggested to check whether you are ovulating, the test looks for progesterone which is an indicator of ovulation; this is a useful test if you are experiencing regular periods, however if you are not, another test looking for gonadotrophins shall be ordered.
Gonadotrophins are the hormone which stimulate the production of eggs.
An X Ray is used to detect any blockages of the fallopian tubes and to provide additional information on the womb. This type of X ray is called an hysterosalpingogram. Similarly but under ultrasound guidance is an hysterosalpingo ultrasonography, this involves a small amount of fluid being injected into the womb, the ultrasound is used to see if the fluid follows the correct course.
In more serious cases when the underlying issue cannot be solved a laparoscopy can be performed. This involves a thin telescope passing into the womb through a small incision in the abdomen. Whilst it sounds invasive it allows your gynaecologist to expect in detail your womb, fallopian tubes and ovaries.
Patient Information Sheets
Nuada Gynaecology makes Patient Information Sheets available to assist patients in understanding their condition and treatment in general. We recommend that patients consult with their specialist to fully appreciate their own personal programme of care.
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