Terminology Tuesday: Anatomic Evaluation for Infertility

Dr. Ku is an infertility specialist at Dallas IVF, one of the nations’ leading infertility centers that consistently has among the highest success rates in the United States.  (www.DallasIVF.com)

Last week we discussed the evaluation your infertility doctor might perform to determine your ovarian reserve.  This week, we will discuss the anatomic evaluation your infertility doctor might perform in order to elucidate the etiology of your infertility.

Determining the health of the pelvis is essential.  Abnormal female anatomy may lead to infertility or recurrent miscarriages. Dallas IVF has a wide array of state of the art imaging and operative equipment to evaluate female anatomy, specifically the uterus, tubes, ovaries and pelvis.  At Dallas IVF, at least one, if not more, of the below described studies will be requested by one of our physicians:

Transvaginal Ultrasound: The principal diagnostic study employed by reproductive endocrinologists and gynecologists to determine the overall female anatomy is the transvaginal ultrasound. The ultrasound will help assess the condition of the uterus and ovaries. Ovarian masses and uterine fibroids can commonly be seen through this simple diagnostic study. Endometriosis, unless it involves the ovaries and is large, cannot be visualized on ultrasound.

Sonohysterogram/Saline Infusion Sonogram (SIS): This office-based procedure allows our physicians to view the uterine cavity. During the transvaginal ultrasound, sterile saline is inserted through the cervix and into the uterus through a narrow tube. This well-tolerated procedure allows the physician to visualize the walls of the uterus and evaluate for the presence of intrauterine growths, such as polyps or fibroids. Additionally, a SIS is an excellent screening study to determine the location of fibroids and their relationship to the uterine cavity.

Hysterosalpingogram (HSG): This radiological procedure has been a mainstay of infertility physicians for decades. It is regarded as the principle screening study to help determine if the fallopian tubes are patent (open) or occluded. Additionally, an HSG can help determine if the uterine cavity has any filling defects, including fibroids or polyps. Radio-opaque dye is inserted past the cervix and into the uterine cavity while X-ray images are obtained. HSGs are not always accurate, but are considered a very good screening study.

Office Hysteroscopy: This office-based procedure, now available at Dallas IVF, allows our physicians to directly view the uterine cavity. A thin hysteroscope (a small fiber optic telescope) is inserted through the cervix and advanced into the uterine cavity with the patient awake and alert. The procedure is usually well tolerated. Although the hysteroscope does not allow for visualization of the fallopian tubes, the procedure is a direct view of the uterine cavity and is an excellent diagnostic study that can diagnose fibroids, scarring, polyps, or other intrauterine pathology.

Surgical Evaluation: If your doctor is suspicious for anatomical problems that may interfere with your ability to conceive or maintain a pregnancy, surgery will be recommended. Common indications for surgery include blocked fallopian tubes, endometriosis, and adhesions (intra-abdominal scar tissue). Common surgical procedures to diagnose and treat infertility include operative hysteroscopy, diagnostic and operative laparoscopy, and abdominal myomectomies (the removal of large fibroids through an abdominal incision).

For more information on the anatomic evaluation including pictures of the above tests, please visit http://www.dallasivf.com/diagnostic-testing-dallas-tx/anatomical-evaluation.html