Female fertility examinations

Sonohysterography

A painless ultrasound test that provides an accurate image of the endometrial cavity using a thin, disposable and sterile catheter positioned inside the cervical canal. The catheter is used to inject a few millilitres of physiological solution (sterile water) into the uterine cavity. By means of a transvaginal ultrasound, this allows any conditions within the cavity (endometrial polyps, submucosal uterine myomas, uterine septa) to be displayed. The examination generally lasts 15-20 minutes and allows the patient to avoid more invasive and painful diagnostic tests such as a hysteroscopy. It is recommended that the sonohysterography be performed within a few days of the patient’s period ending.

Hysterosalpingography

Contrast X-ray examination that involves inserting a radiopaque contrast medium into the uterine cavity and the tubes so that they show up clearly. This allows us to diagnose uterine malformations, to highlight synechiae, polyps and fibroids and to verify tubal patency, but it does not allow us to assess if the tubes are physiologically intact.

Sonohysterosalpingography

Contrast X-ray examination that does not require the use of a radiopaque contrast medium or radiographs. A thin catheter is inserted into the cervical canal and a small amount of physiological solution is injected into the uterus; using a transvaginal ultrasound probe, we then observe whether the liquid comes out of the tubes or not. In addition to tubal patency, it is also possible to assess the presence of polyps, myomas and endocavitary uterine disorders.

3D and 4D ultrasound

These allow us to obtain static and moving images of the uterus in real time to view and assess any malformations. The standard (two-dimensional) ultrasound provides images of the anatomical structures in sections, rendering them in various shades of grey; with the 3D and 4D methods, meanwhile, the ultrasound system memorises a certain number of sections, creating an extremely accurate three-dimensional image of the anatomical structures being displayed. In the field of gynaecology, the use of 3D and 4D ultrasound often avoids the need to resort to more invasive diagnostic tests, such as a hysteroscopy.

Hysteroscopy

Used to examine the uterine cavity, it involves passing a small fibre optic instrument (the hysteroscope) through the cervical canal in order to display the entire cavity. It is the most reliable test to evaluate endocavitary conditions such as myomas, polyps, and complete and incomplete septa, which are not always detected by other diagnostic methods.

Laparoscopy

Visual examination of the anatomy of the tubes. It also shows their position with respect to the ovaries and allows us to identify adhesions and other morphofunctional alterations of the peritoneal cavity that could cause infertility. It is performed by inserting an optical probe into the peritoneal cavity through a small incision made in the abdominal wall. Once the reproductive organs have been inspected, a contrast liquid can be injected through the cervical canal to observe how it passes through the tubes. A laparoscopy is often done in conjunction with a hysteroscopy to obtain a complete picture of the reproductive system. Unlike the other procedures described here, it requires general anaesthetic and a 1-2 day hospital stay.


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