Examinatin methods for women
Frequently used methods:
Various hormones can have an effect on fertility. Besides the determination of basal hormone levels, change in hormones during the cycle can provide information about possible causes of impaired fertility. Therefore, blood levels of various hormones are determined on certain days of the menstrual cycle. At the beginning of the cycle, these are primarily: estrogen, LH, FSH, androgens, prolactin and TSH. Progesterone and estrogen levels may be measured in the second half of the cycle. In specific cases, further hormone function tests may be necessary.
Ultrasound examinations are used to check important functions of female reproductive apparatus. Firstly, the regular structure of the uterus, the lining and the ovaries can be examined, and, if present, diseases such as fibroids, polyps or mucous cysts in the ovary can be diagnosed. Secondly, during the cycle, the regular maturation of ovarian follicles and the uterine lining, or lack thereof, are tracked.
If damage to the fallopian tubes is suspected, imaging or surgical examination methods may be used for clarification. The method most frequently used to examine the uterine cavity and fallopian tubes is an X-ray method (hysterosalpingography or HyCoSy). To ensure that images are particularly meaningful, the use of a contrast agent is necessary. This examination can be performed without anesthesia and on an outpatient basis, however, it can be painful, especially if the fallopian tubes are blocked.
At Döbling Private Hospital's fertility center we alternatively offer a new method for the study of the fallopian tubes. With a special ultrasound technique it is possible to examine the fallopian tubes largely pain-free and without radiation exposure (HyCoSy). In addition to being safer than conventional X-ray exams, this method is also less prone to produce flawed results (a disadvantage of conventional X-ray examination is that painful cramps of the fallopian tubes can sometimes give the appearance of occluded fallopian tubes).
Therefore, HyCoSy provides a significantly better and more easily tolerated alternative when checking the fallopian tubes. If for some reason a laparoscoy is necessay, the examination of the fallopian tubes can also be performed at the same time as part of the laparoscopy.
Preliminary investigations may lead to suspected diseases that can only be diagnosed and/or treated by laparoscopy. This procedure is performed under general anesthesia. First, through a very small incision in the abdomen below the navel, a tubular instrument (laparoscope) is inserted into the abdominal cavity.
This instrument features a camera which is connected to a monitor, yielding a very accurate picture of the internal reproductive organs. At the same time, it is possible to remove fibroids, cysts , adhesions or endometriosis. Potential complications associated with this study are very rare.
If there is a suspicion of uterine malformations, disruptive muscle knots or mucosal changes in the uterine cavity, further diagnostics and, if necessary, therapeutic measures can be carried out by means of a hysteroscopy (under general anesthesia). Here, a very fine probe is inserted through the vagina and cervix into the uterus, allowing the doctor to accurately evaluate the uterine cavity, as well as interstitial and isthmus of the fallopian tubes via a camera mounted in the probe and to perform surgery if deemed necessary.