Female Subfertility

What are the causes of subfertility in women?

– Polycystic Ovarian Syndrome (PCOS)
– Endometriosis
– Damage to the fallopian tubes
– Conditions affecting the uterus – Fibroids and Polyps
– Age - Female fertility declines after the age of 35
– Medical conditions such as diabetes, epilepsy and thyroid
– Lifestyle factors such as stress, being overweight or underweight, and smoking

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What tests can be done to investigate the reason?

The only way to really understand the cause of your subfertility is to have comprehensive fertility tests. These should help establish a diagnosis. This in turn would assist the specialist to customise your care based on your individual needs.

Ovarian Reserve Test

The ORT (ovarian reserve test) is performed between days 1 and 5 of the period. It involves doing a fertility scan and and a blood test to assess the baseline hormonal levels (E2, FSH and AMH). This is the most commonly performed fertility test for a women to help establish the extent of ovarian function.

3D Saline Scan

A 3D Saline scan also called an Aqua scan is an investigation which is performed to look for uterine pathology such as polyps and fibroids. It involves passing a catheter through the neck of the womb followed by distension of the uterine cavity. 3-dimensional images of the uterine cavity are taken and assessed.

HYCOSY Tube Test

The HyCoSy is a procedure to test the patency of the fallopian tubes. A catheter is introduced into the cervix and an ultrasound probe is then placed in the vagina. A dye is injected into the uterine cavity and its flow into the tubes is observed.

Endometrial Biopsy

Assessment of the cells of the uterine cavity for the presence of bacteria, inflammation and hyperplasia forms an essential part of fertility workup.

Hysteroscopy

Hysteroscopy is a procedure whereby a telescope is passed into the vagina and through the cervix (entrance to the womb) to view the lining of the womb and the opening of the fallopian tubes. Polyps, fibroids and any adhesions can be removed at the same time using a Resectoscope.

Laparoscopy

Laparoscopy is a surgical procedure that involves insertion of a telescope through a small incision in the belly button. This allows visualization of the abdominal and pelvic organs including the uterus, fallopian tubes and ovaries. This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroid tumors and other abnormalities of the uterus, fallopian tubes and ovaries.