Take a look at Dr Ahmed Ismail’s interviews with the BBC and Kalsan TV about fertility & treatment on our Youtube Channel.
Stage 1: Hormonal Testing
Hormonal testing focuses on three areas: the pituitary glands, ovarian hormonal tests & reserves, and thyroid function. These tests provide a firm basis of assessment for conception.
- Pituitary testing examines the hormonal levels in the pituitary glands, which can indicate deteriorating ovarian function
- Ovarian testing will provide an insight into the level of your ovarian hormones
- Thyroid function testing examines whether the thyroid hormones are interfering with ovulation or the quality of eggs produced
The hormonal testing is performed using blood tests. The pituitary and ovarian hormonal tests must be carried out on the second or third day of your menstrual cycle, whereas the thyroid function tests can be performed at any time.
Stage 2: Ovulation Testing
Ovulation testing incorporates three key stages: blood testing to determine the ovulation hormonal levels, an ultrasound, and examination of the cervical mucus and the lining of the uterine cavity. It is important that these tests are carried out at a specific stage of the menstrual cycle, to be able to clearly track the ovulation process.
Cervical and uterine cavity testing is performed using a HyCoSy ultrasound and a hysteroscopy. The HyCoSy ultrasound scan will determine:
- The thickness of the uterus lining
- The length of the cervix
- If the uterus is anatomically abnormal
- If there are any pathological abnormalities or any other abnormalities of the pelvis
The hysteroscopy is performed by placing a special camera inside the uterine cavity, along with additional fluids. If there is a possibility of a natural pregnancy instead of IVF/ICSI, the procedure will be carried out in combination with a laparoscopy.
Stage 3: Tubal Testing
This stage is usually only assessed in women who have had primary infertility for a long period of time, or who are experiencing secondary infertility following operative procedures.
Your gynaecologist will examine your fallopian tubes, pelvis and ovaries using an ultrasound scan, a laparoscopy or a HSG which involves X-ray. This examination will determine three things:
- Whether the fallopian tubes are open or blocked, and their viability
- The efficacy of your ovulation and how well your ovaries are working
- If endometriosis, adhesions or Pelvic Inflammatory Disease (PID) is impacting your ability to conceive
If the investigations determine that you can have a natural pregnancy, we will begin to work on solving any problems to help you to achieve a successful pregnancy. If you cannot, we will work on AIH, IVF, ICSI or other methods to help you.