About Fertility Tests FAQ

What is a laparoscopy?


Laparoscopy is a type of surgical procedure in which a small cut is made through the umbilicus (tummy button) through which a viewing tube attached to camera (laparoscope) is inserted. The laparoscope has a small camera on the eyepiece which allows the doctor to examine the abdominal and pelvic organs on a video monitor. Other small cuts can be made to insert instruments to perform procedures (keyhole surgery). Laparoscopy can be carried out to diagnose conditions or to perform certain types of operations.




When laparoscopy is advised?


Diagnostic procedure: As a diagnostic procedure, a laparoscopy is done to find out the cause of pelvic pain, fertility problems, or gynaecological symptoms that cannot be confirmed by a physical examination or ultrasound. For example, a laparoscopic examination can identify ovarian cysts, endometriosis, adhesions (scarring), ectopic pregnancy or blocked fallopian tubes. It is carried out as a day-case procedure Infertility. A laparoscopy can determine if there is any abnormal anatomy, endometriosis, blocked fallopian tubes, or some other reason for infertility. A dye may be injected through the neck of the womb via the vagina to see if the fallopian tubes are open. If the tubes are open, the dye will be seen spilling out of the ends. As an operative procedure: laparoscopy is used for tubal surgeries, treating endometriosis and/or adhesions, removal of ovarian cysts or abnormal ovaries, and opening or removing damaged tubes. Laparoscopy is less painful and causes less scarring on the outside and inside. It has faster recovery. Because laparoscopy is so much less invasive than traditional abdominal surgery, patients can leave the hospital sooner.




What is salpingostomy and salpingectomy?When is it advised?


Both are operations on tubes and could be done using laparoscopy.Salpingostomy is a procedure in which blocked tubes are opened. It is performed when tubes are blocked but clinically there is no suspicion of damage of functions. Therefore, the opening will help the transfer of egg and natural fertility. However, there is an increased risk of ectopic pregnancy after this procedure. Suitability for salpingostomy – opening of blocked fallopian tubes- is decided by P4 fertility specialist after individualised assessment.Salpingectomy is a procedure in which the tube is completely removed. When the tube is blocked, damaged and may have water collected inside tube (called hydrosalpinx), it reduces the success rate of IVF. Therefore, removal of such tube before IVF improves your chances of getting pregnant following IVF. Such damaged tubes do not work even if they are opened as inside of the tube is scarred and damaged. Therefore, removal of such tubes is advised.




What are the risks of laparoscopy?


Laparoscopy is a relatively safe procedure. However, it does carry a slight risk, as does any abdominal operation, of serious complications. Open surgery may be required to correct any problems that do occur. Serious complications include: • damage to the bowel, bladder, ureters (tubes which drain the kidneys), or major blood vessels. The overall risk of serious complications is approximately 3-4 in 1000. In a small number of cases the surgeon may need to perform a laparotomy (the risk is around 1 in 200). This requires a larger skin cut in the abdomen to allow open surgery to be performed, either to complete the operation or because of complications that may have occurred at the time of laparoscopy. Your anaesthetist will explain these to your anaesthetic risks when you are signing your consent form.




What does happen during a laparoscopy?


Laparoscopy is a surgical procedure performed in the hospital under general anaesthesia. Before starting the procedure, the bladder is emptied with a small catheter and the skin of the abdomen cleaned. After you are anaesthetized a hollow needle is inserted into the abdomen through a small cut through the umbilicus (tummy button), and carbon dioxide gas pumped through the needle to expand the abdomen. This allows the surgeon a better view of the internal organs. The laparoscope is then inserted through this cut to look at the internal organs on the video monitor. Usually one or two additional small cuts are made along the ‘bikini line’ to insert other instruments which are used to lift the tubes and ovaries for examination or to perform surgical procedures.




What are the key things to watch out for after the laparoscopy?


If you have any of the following symptoms, you should seek advice from your GP / gynaecologist: • becoming more unwell with abdominal pain after the procedure - you should gradually be getting better day by day • a swollen abdomen • a raised temperature (over 38°C) • continuous vaginal bleeding which is heavier than a period • offensive (bad) smelling vaginal discharge • continuous bleeding or discharge from the skin incision sites • repeated vomiting.




What shall I do if I have a problem or concern?


If you have any concerns, please: • contact or visit your GP • call the gynaecology team for advice • call NHS Direct and speak to a specially trained nurse • go to your A&E department or call 999 in the event of an emergency





Hormone Tests FAQ

 

Tube Test FAQ

 

What is hysteroscopy (OPH)?


Hysteroscopy is a procedure that involves examining the inside of your uterus (womb). This is done by passing a thin telescope-like device, called a hysteroscope, that is fitted with a small camera through the neck of your womb (cervix). The healthcare professional doing the procedure can then see whether there are any problems inside your uterus that may need further investigation or treatment.




What are polyps or fibroids in the cavity?


· Polyps are formed as a result of overgrowth of the lining of the uterus · Fibroids are knots in the muscle of the uterus that are non-cancerous (benign). · They can sometimes bulge like a polyp into the lining of your uterus and your doctor may advise removal to help with your symptoms. · Before fertility treatment it is important to remove any polyps present in the cavity.




What happens during a hysteroscopy?


A hysteroscopy is usually carried out on an outpatient or day-case basis under anaesthesia. This means you do not have to stay in hospital overnight. A general anaesthetic may be used if you're having the treatment during the procedure or you would prefer to be asleep while it's carried out. A hysteroscopy can take up to 30 minutes in total, although it may only last around 5 to 10 minutes if it's just being done to diagnose a condition or investigate symptoms. Most women feel able to return to their normal activities the following day, although some women return to work the same day. You may wish to have a few days off to rest if general anaesthetic was used.




Is a hysteroscopy painful?


This seems to vary considerably between women. Some women feel no or only mild pain during a hysteroscopy, but for others, the pain can be severe. If you find it too uncomfortable, tell the doctor. They can stop the procedure at any time.




What are the risks during Hysteroscopy?


Pain during or after outpatient hysteroscopy is usually mild and similar to period pain. Simple pain relief medications can help. On occasion, women may experience severe pain. Feeling or being sick or fainting can affect a small number of women. However, these symptoms usually settle quickly. Bleeding is usually very mild and is lighter than a period, settling within a few days. It is recommended that you use sanitary towels, not tampons. If the bleeding does not settle and gets worse, contact your healthcare professional or nearest emergency department. Infection is uncommon (1 in 400 women). It may appear as a smelly discharge, fever or severe pain in the tummy. If you develop any of these symptoms, contact your healthcare professional urgently. Damage to the wall of the uterus (uterine perforation) – rarely, a small hole is accidentally made in the wall of the uterus. This could also cause damage to nearby tissues. This happens in fewer than 1 in 1000 diagnostic hysteroscopy procedures but is slightly more common if someone has a polyp or fibroid removed at the same time. It may mean that you have to stay in hospital overnight. Usually, nothing more needs to be done, but you may need a further operation to repair the hole.




Do I need to use contraception before hysteroscopy?


The procedure must not be performed if there is any chance that you are pregnant. To avoid this possibility, it is important to use contraception or avoid sex between your last period and your appointment. You may be offered a urine pregnancy test on arrival at your appointment.





Ultrasound FAQ

 

What is 3D ultrasound scan and how does it help as a test for fertility


3 D ultrasound scan is performed same as routine scan. The probe and machine have special features to produce a 3 dimensional image of the womb and ovaries. It gives better picture of various anomalies of the womb.




What is a follicle mean? How the follicles are monitored during IVF cycle


Follicles are fluid filled sacs in the ovaries which grows. The egg is inside the follicle. You cannot see an egg on ultrasound scan. What you see is a fluid filled sac called follicles. Therefore, follicle size is measured. Follicle development is checked with regular ultrasound scans during IVF cycle. These scans are internal scans. With ultramodern scan machines, we check the follicles where eggs develop for size and other characteristics. When follicles reach to a certain size, we plan egg collection during IVF cycle.




What is scan or USG or ultrasound scan?


Why is it important for fertility test?Ultrasound scan (USG) is one of the most important fertility tests. An ultrasound scan can be used to check your ovaries, womb and fallopian tubes. Certain conditions that can affect the womb, such as endometriosis, polyps and fibroids, can prevent pregnancy. During a transvaginal ultrasound scan, a small ultrasound probe is placed in your vagina. The scan can be used to check the health of your womb and ovaries and for any blockages in your fallopian tubes. Any abnormalities of the womb can be diagnosed using a scan. Our policy is to have a chaperone (someone else present) when you have any internal scans.Ultrasound scan showing polyps.





Sperm Test FAQ

 

What is hysteroscopy (OPH)?


Hysteroscopy is a procedure that involves examining the inside of your uterus (womb). This is done by passing a thin telescope-like device, called a hysteroscope, that is fitted with a small camera through the neck of your womb (cervix). The healthcare professional doing the procedure can then see whether there are any problems inside your uterus that may need further investigation or treatment.




What are polyps or fibroids in the cavity?


· Polyps are formed as a result of overgrowth of the lining of the uterus · Fibroids are knots in the muscle of the uterus that are non-cancerous (benign). · They can sometimes bulge like a polyp into the lining of your uterus and your doctor may advise removal to help with your symptoms. · Before fertility treatment it is important to remove any polyps present in the cavity.




What happens during a hysteroscopy?


A hysteroscopy is usually carried out on an outpatient or day-case basis under anaesthesia. This means you do not have to stay in hospital overnight. A general anaesthetic may be used if you're having the treatment during the procedure or you would prefer to be asleep while it's carried out. A hysteroscopy can take up to 30 minutes in total, although it may only last around 5 to 10 minutes if it's just being done to diagnose a condition or investigate symptoms. Most women feel able to return to their normal activities the following day, although some women return to work the same day. You may wish to have a few days off to rest if general anaesthetic was used.




Is a hysteroscopy painful?


This seems to vary considerably between women. Some women feel no or only mild pain during a hysteroscopy, but for others, the pain can be severe. If you find it too uncomfortable, tell the doctor. They can stop the procedure at any time.




What are the risks during Hysteroscopy?


Pain during or after outpatient hysteroscopy is usually mild and similar to period pain. Simple pain relief medications can help. On occasion, women may experience severe pain. Feeling or being sick or fainting can affect a small number of women. However, these symptoms usually settle quickly. Bleeding is usually very mild and is lighter than a period, settling within a few days. It is recommended that you use sanitary towels, not tampons. If the bleeding does not settle and gets worse, contact your healthcare professional or nearest emergency department. Infection is uncommon (1 in 400 women). It may appear as a smelly discharge, fever or severe pain in the tummy. If you develop any of these symptoms, contact your healthcare professional urgently. Damage to the wall of the uterus (uterine perforation) – rarely, a small hole is accidentally made in the wall of the uterus. This could also cause damage to nearby tissues. This happens in fewer than 1 in 1000 diagnostic hysteroscopy procedures but is slightly more common if someone has a polyp or fibroid removed at the same time. It may mean that you have to stay in hospital overnight. Usually, nothing more needs to be done, but you may need a further operation to repair the hole.




Do I need to use contraception before hysteroscopy?


The procedure must not be performed if there is any chance that you are pregnant. To avoid this possibility, it is important to use contraception or avoid sex between your last period and your appointment. You may be offered a urine pregnancy test on arrival at your appointment.





Hysteroscopy FAQ

 

What is hysteroscopy (OPH)?


Hysteroscopy is a procedure that involves examining the inside of your uterus (womb). This is done by passing a thin telescope-like device, called a hysteroscope, that is fitted with a small camera through the neck of your womb (cervix). The healthcare professional doing the procedure can then see whether there are any problems inside your uterus that may need further investigation or treatment.




What are polyps or fibroids in the cavity?


· Polyps are formed as a result of overgrowth of the lining of the uterus · Fibroids are knots in the muscle of the uterus that are non-cancerous (benign). · They can sometimes bulge like a polyp into the lining of your uterus and your doctor may advise removal to help with your symptoms. · Before fertility treatment it is important to remove any polyps present in the cavity.




What happens during a hysteroscopy?


A hysteroscopy is usually carried out on an outpatient or day-case basis under anaesthesia. This means you do not have to stay in hospital overnight. A general anaesthetic may be used if you're having the treatment during the procedure or you would prefer to be asleep while it's carried out. A hysteroscopy can take up to 30 minutes in total, although it may only last around 5 to 10 minutes if it's just being done to diagnose a condition or investigate symptoms. Most women feel able to return to their normal activities the following day, although some women return to work the same day. You may wish to have a few days off to rest if general anaesthetic was used.




Is a hysteroscopy painful?


This seems to vary considerably between women. Some women feel no or only mild pain during a hysteroscopy, but for others, the pain can be severe. If you find it too uncomfortable, tell the doctor. They can stop the procedure at any time.




What are the risks during Hysteroscopy?


Pain during or after outpatient hysteroscopy is usually mild and similar to period pain. Simple pain relief medications can help. On occasion, women may experience severe pain. Feeling or being sick or fainting can affect a small number of women. However, these symptoms usually settle quickly. Bleeding is usually very mild and is lighter than a period, settling within a few days. It is recommended that you use sanitary towels, not tampons. If the bleeding does not settle and gets worse, contact your healthcare professional or nearest emergency department. Infection is uncommon (1 in 400 women). It may appear as a smelly discharge, fever or severe pain in the tummy. If you develop any of these symptoms, contact your healthcare professional urgently. Damage to the wall of the uterus (uterine perforation) – rarely, a small hole is accidentally made in the wall of the uterus. This could also cause damage to nearby tissues. This happens in fewer than 1 in 1000 diagnostic hysteroscopy procedures but is slightly more common if someone has a polyp or fibroid removed at the same time. It may mean that you have to stay in hospital overnight. Usually, nothing more needs to be done, but you may need a further operation to repair the hole.




Do I need to use contraception before hysteroscopy?


The procedure must not be performed if there is any chance that you are pregnant. To avoid this possibility, it is important to use contraception or avoid sex between your last period and your appointment. You may be offered a urine pregnancy test on arrival at your appointment.





Laparoscopy FAQ

 

What is a laparoscopy?


Laparoscopy is a type of surgical procedure in which a small cut is made through the umbilicus (tummy button) through which a viewing tube attached to camera (laparoscope) is inserted. The laparoscope has a small camera on the eyepiece which allows the doctor to examine the abdominal and pelvic organs on a video monitor. Other small cuts can be made to insert instruments to perform procedures (keyhole surgery). Laparoscopy can be carried out to diagnose conditions or to perform certain types of operations.




When laparoscopy is advised?


Diagnostic procedure: As a diagnostic procedure, a laparoscopy is done to find out the cause of pelvic pain, fertility problems, or gynaecological symptoms that cannot be confirmed by a physical examination or ultrasound. For example, a laparoscopic examination can identify ovarian cysts, endometriosis, adhesions (scarring), ectopic pregnancy or blocked fallopian tubes. It is carried out as a day-case procedure Infertility. A laparoscopy can determine if there is any abnormal anatomy, endometriosis, blocked fallopian tubes, or some other reason for infertility. A dye may be injected through the neck of the womb via the vagina to see if the fallopian tubes are open. If the tubes are open, the dye will be seen spilling out of the ends. As an operative procedure: laparoscopy is used for tubal surgeries, treating endometriosis and/or adhesions, removal of ovarian cysts or abnormal ovaries, and opening or removing damaged tubes. Laparoscopy is less painful and causes less scarring on the outside and inside. It has faster recovery. Because laparoscopy is so much less invasive than traditional abdominal surgery, patients can leave the hospital sooner.




What is salpingostomy and salpingectomy?When is it advised?


Both are operations on tubes and could be done using laparoscopy.Salpingostomy is a procedure in which blocked tubes are opened. It is performed when tubes are blocked but clinically there is no suspicion of damage of functions. Therefore, the opening will help the transfer of egg and natural fertility. However, there is an increased risk of ectopic pregnancy after this procedure. Suitability for salpingostomy – opening of blocked fallopian tubes- is decided by P4 fertility specialist after individualised assessment.Salpingectomy is a procedure in which the tube is completely removed. When the tube is blocked, damaged and may have water collected inside tube (called hydrosalpinx), it reduces the success rate of IVF. Therefore, removal of such tube before IVF improves your chances of getting pregnant following IVF. Such damaged tubes do not work even if they are opened as inside of the tube is scarred and damaged. Therefore, removal of such tubes is advised.




What are the risks of laparoscopy?


Laparoscopy is a relatively safe procedure. However, it does carry a slight risk, as does any abdominal operation, of serious complications. Open surgery may be required to correct any problems that do occur. Serious complications include: • damage to the bowel, bladder, ureters (tubes which drain the kidneys), or major blood vessels. The overall risk of serious complications is approximately 3-4 in 1000. In a small number of cases the surgeon may need to perform a laparotomy (the risk is around 1 in 200). This requires a larger skin cut in the abdomen to allow open surgery to be performed, either to complete the operation or because of complications that may have occurred at the time of laparoscopy. Your anaesthetist will explain these to your anaesthetic risks when you are signing your consent form.




What does happen during a laparoscopy?


Laparoscopy is a surgical procedure performed in the hospital under general anaesthesia. Before starting the procedure, the bladder is emptied with a small catheter and the skin of the abdomen cleaned. After you are anaesthetized a hollow needle is inserted into the abdomen through a small cut through the umbilicus (tummy button), and carbon dioxide gas pumped through the needle to expand the abdomen. This allows the surgeon a better view of the internal organs. The laparoscope is then inserted through this cut to look at the internal organs on the video monitor. Usually one or two additional small cuts are made along the ‘bikini line’ to insert other instruments which are used to lift the tubes and ovaries for examination or to perform surgical procedures.




What are the key things to watch out for after the laparoscopy?


If you have any of the following symptoms, you should seek advice from your GP / gynaecologist: • becoming more unwell with abdominal pain after the procedure - you should gradually be getting better day by day • a swollen abdomen • a raised temperature (over 38°C) • continuous vaginal bleeding which is heavier than a period • offensive (bad) smelling vaginal discharge • continuous bleeding or discharge from the skin incision sites • repeated vomiting.




What shall I do if I have a problem or concern?


If you have any concerns, please: • contact or visit your GP • call the gynaecology team for advice • call NHS Direct and speak to a specially trained nurse • go to your A&E department or call 999 in the event of an emergency





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