INVESTIGATION FOR FEMALE
The doctor will ask questions about your past to try to get clues as to the cause of your infertility. These questions will be regarding your medical, surgical, gynecological, and obstetric history, as well as some “lifestyle” questions. A review of fertility-related records from other doctors that you have seen is also important.
A directed physical exam that may include a pelvic ultrasound should be performed. Ultrasound can help us discover abnormalities with the uterus, fallopian tubes and/or ovaries. We can sometimes see evidence of pelvic scarring, such as when an ovary appears to be stuck to the uterus. We can also get some information regarding the woman’s potential for adequate ovarian stimulation for infertility treatment cycles by counting antral follicles.
Assessment of ovarian reserve
This is a very important assessment of a woman’s remaining egg storage. It is generally done with day 3 FSH and estradiol testing and a vaginal ultrasound assessment of ovarian volume and antral follicle counts
Assessment of adequate ovulation
This can be done in a variety of ways. About 25% of all infertility is caused by an ovulation disorder. One type of ovulation problem, polycystic ovarian syndrome, is usually quite amenable to treatment with medications.
Trans vaginal sonography with 3D evaluation of uterine cavity has become the most important tool in the armamentarium of the physician to diagnose & treat infertility. TVS has a high sensitivity & specificity for follicular monitoring, prediction & conformation of ovulation.
While evaluating the female genital system by TVS, the examiner should scan every part in detail.
Trans vaginal ultrasound examination of the body of uterus is done to observe a detailed view of the myometrium & to diagnose any mullerian anomalies like septate uterus & bicornuate uterus , fibroid & adenomyosis.
Cervix is evaluated for the length of the cervix, nabothian cyst & cervical mucous.
Endometrial cavity is scanned for endometrial thickness, endometrial pattern, endometrial polyps & presence of any foreign bodies or synechia, endometrial blood flow.