Vaginal swabs can be taken to check for Chlamydia and other infections such as gonorrhoea, bacterial vaginosis, Trichomonas and thrush. It is important to check you don’t have any infection on board befoe undergoing any invasive investiagtion such as HSG (see below). It is also important to check you don;t have Chlamydia before embarking on fertility treatment as untreated Chlamydia can compromise your treatment’s success and increase the risk of miscarriage.
- A blood test to see if you are ovulating. This is done by measuring progesterone in a blood sample taken seven days before your period is due.
- Blood test to check for German measles (Rubella) which, if contracted during the first three months of pregnancy, can harm your unborn baby.
- Blood test during your period to check for hormone imbalances –measurement of FSH (follicle stimulating hormone, LH (luteinising hormone) and oestradiol. This test can also identify possible early menopause as a cause of subfertility.
- Blood test to check you AMH (anti-Mullerian Hormone) to assess your egg reserve and help deciding the best fertility treatment option.
Pelvic ultrasound scan to look at your uterus and your ovaries and ensure no other problems that can affect your fertility are present.
Assessment of Fallopian tubes
Your Fallopian tubes can be checked by one of three methods:
- Hysterosalpingography (HSG): this is an X-ray taken at your pelvis after injecting a special dye through the cervix into your womb’s cavity. A special cannula or catheter is gently passed through the cervix and a dye is injected via the catheter into your womb’s cavity. The dye can be see on a screen filling the womb’s cavity and your tubes. If your tubes are not blocked, the dye will spill out of the tubes into your pelvis. The test is good for initial assessment of the Fallopian tubes.
- HyCoSy: This is similar to HSG, but using vaginal ultrasound scan instead of X-ray.
- Diagnostic laparosocpy and dye test: This is the gold standard for assessment of the Fallopian tubes. It involves passing a camera through a small cut in the belly button under general anaesthetic to examine the abdomen and pelvis, assess the uterus, ovaries and Fallopian tubes and perform a dye test to ensure the tubes are open. A key hole surgery ca be performed at the same time to cut and release any adhesions (scar tissue) that may be blocking the Fallopian tubes or treat other diseases such as endometriosis.