Read our Privacy Policy  and Cookie Policy

Click 'I agree' if you agree to our Privacy policy and Cookie policy and accept it.

About Fertility Tests FAQ

Why is it necessary to check for tubal patency or to do tube test?


Fallopian tubes are the tubes which help the transfer of egg released from an ovary. Sperm and egg meet in the fallopian tube. After fertilization of the egg, the resultant embryo is transferred to the cavity of the womb for implantation. Some women may be more at risk of blocked fallopian tubes. Therefore, it is necessary to check for tubal patency while investigating subfertility.




What are the different types of tubal patency tests?


Tubal patency can be tested using one of the following methods: a) Hysterosalpingography (HSG) b) Hysterosalpingo-contrast-ultrasonography (HyCoSy) c) Laparoscopy and dye test




How do you choose the tubal patency test?


According to current recommendations, women who are not known to have any gynaecological conditions (such as pelvic inflammatory disease, previous ectopic pregnancy or endometriosis) should be offered hysterosalpingography (HSG). HSG is a reliable test for tubal patency, and it is less invasive. Where appropriate expertise is available, hysterosalpingo-contrast-ultrasonography ( HyCoSy) could be considered as an effective alternative to hysterosalpingography.Women who are thought to have comorbidities should be offered laparoscopy and dye so that tubal and other pelvic pathology can be assessed at the same time.




What is Hysterosalpingography (HSG)?


Hysterosalpingogram is an x-ray procedure. It is an outpatient procedure that usually takes less than 5 minutes to perform. It is usually done after the menstrual period ends but before ovulation.




How is a hysterosalpingogram done?


A woman is positioned under an x-ray machine called fluoroscope on a table. The radiologist performs a speculum examination (like having a smear). The neck of the womb is cleaned, and a plastic tube is placed into the neck of the womb. The radiologist gently fills the uterus with liquid containing iodine (a fluid that can be seen by x-ray) through the tube. The fluid will be seen as white on the image and can show the contour of the womb. The fluid enters the tubes; it outlines the length of the tubes and spills out their ends if they are open.




Is HSG painful?


It is described as more uncomfortable than the painful procedure. An HSG usually causes mild or moderate cramping of the womb for about 5-10 minutes. However, some women may experience cramps for several hours. These symptoms can be greatly reduced by taking painkiller medications before the procedure or when they occur.




What are the risks and complications of HSG?


HSG is considered a very safe procedure. Commonest risks include infection, fainting and pain. In rare cases, the infection can damage the fallopian tubes or make it necessary to remove them. Therefore, NICE guideline recommends screening for Chlamydia trachomatis before undergoing any uterine instrumentation. Prophylactic antibiotics should be considered before uterine instrumentation if screening has not been carried out. Radiation exposure from an HSG is very low and it has not been shown to cause harm, even if a woman conceives later the same month. The HSG should not be done if pregnancy is suspected. If you have an allergy to iodine, intravenous contrast dyes, or seafood, you should inform your doctor. If you experience a rash, itching, or swelling after the procedure, you should contact your doctor. Few women do get vaginal spotting after HSG, however, if you suffer from bleeding, please consult with your doctor.




What is a HyCoSy (Hystero – contrast – sonography)? How is it performed?


Please watch video on knowledge base page. HyCoSy is a special ultrasound test using contrast foam solution (like a dye) to show whether your fallopian tubes are open. First, a transvaginal (internal) scan is carried out. A speculum is then placed in the vagina (like having a smear) and a small plastic tube is inserted into the womb. The foam solution is then passed through the tube into the womb and fallopian tubes. It can then be seen by ultrasound scan. The procedure may cause some period-like pain. Please speak with our p4 fertility consultant for arranging your tube test.




What is a laparoscopy and dye test? How is it performed?


A laparoscopy and dye test (camera test) is an operation performed to diagnose tubal patency. Besides, it helps to diagnose any other pathology (abnormality) such as polycystic ovaries, endometriosis, adhesions (scar tissue from previous surgery), infection and fibroids. Laparoscopy is usually performed on a day case procedure under general anaesthesia. After you are put to sleep, a needle is inserted through the belly button and the abdomen is filled with carbon dioxide gas so that the laparoscope (camera) can be placed safely into the abdominal cavity. The laparoscope is then inserted through a cut (10mm long) in the belly button or just below it. A small instrument is usually inserted through another cut (5mm) above the pubic region to move the pelvic organs into clear view. A solution called methylene blue is injected through the neck of the womb which passes through the fallopian tubes to determine if the tubes are open. Skin incisions are closed with stitches after the procedure.




What are the risks and complications of laparoscopy and dye test?


Laparoscopy and dye test is an operation. The gas used during the procedure may cause, shoulder pain, as the gas can irritate your diaphragm (the muscle you use to breathe), which in turn can irritate nerve endings in your shoulder and bloating. These symptoms are nothing to worry about and should pass after a day or so, once your body has absorbed the remaining gas. Minor complications occur in 1 to 2 cases in every 100. These include: • Post-operative infection. • Pain • Nausea and vomiting Major complications following a laparoscopy are rare (1 -2 in every 1,000 cases), include: • Damage to an organ, such as your bowel or bladder. • Damage to a major blood vessel. • A serious allergic reaction to the anaesthetic. Further surgery is usually required to treat any major complications.




Is there anything else I should know?


The choice of appropriate tubal patency test depends upon clinical history. Every test has its advantages and limitations. Therefore, it is advised to discuss with p4 fertility expert.





Hormone Tests FAQ

 

Tube Test FAQ

 

Why is it necessary to check for tubal patency or to do tube test?


Fallopian tubes are the tubes which help the transfer of egg released from an ovary. Sperm and egg meet in the fallopian tube. After fertilization of the egg, the resultant embryo is transferred to the cavity of the womb for implantation. Some women may be more at risk of blocked fallopian tubes. Therefore, it is necessary to check for tubal patency while investigating subfertility.




What are the different types of tubal patency tests?


Tubal patency can be tested using one of the following methods: a) Hysterosalpingography (HSG) b) Hysterosalpingo-contrast-ultrasonography (HyCoSy) c) Laparoscopy and dye test




How do you choose the tubal patency test?


According to current recommendations, women who are not known to have any gynaecological conditions (such as pelvic inflammatory disease, previous ectopic pregnancy or endometriosis) should be offered hysterosalpingography (HSG). HSG is a reliable test for tubal patency, and it is less invasive. Where appropriate expertise is available, hysterosalpingo-contrast-ultrasonography ( HyCoSy) could be considered as an effective alternative to hysterosalpingography.Women who are thought to have comorbidities should be offered laparoscopy and dye so that tubal and other pelvic pathology can be assessed at the same time.




What is Hysterosalpingography (HSG)?


Hysterosalpingogram is an x-ray procedure. It is an outpatient procedure that usually takes less than 5 minutes to perform. It is usually done after the menstrual period ends but before ovulation.




How is a hysterosalpingogram done?


A woman is positioned under an x-ray machine called fluoroscope on a table. The radiologist performs a speculum examination (like having a smear). The neck of the womb is cleaned, and a plastic tube is placed into the neck of the womb. The radiologist gently fills the uterus with liquid containing iodine (a fluid that can be seen by x-ray) through the tube. The fluid will be seen as white on the image and can show the contour of the womb. The fluid enters the tubes; it outlines the length of the tubes and spills out their ends if they are open.




Is HSG painful?


It is described as more uncomfortable than the painful procedure. An HSG usually causes mild or moderate cramping of the womb for about 5-10 minutes. However, some women may experience cramps for several hours. These symptoms can be greatly reduced by taking painkiller medications before the procedure or when they occur.




What are the risks and complications of HSG?


HSG is considered a very safe procedure. Commonest risks include infection, fainting and pain. In rare cases, the infection can damage the fallopian tubes or make it necessary to remove them. Therefore, NICE guideline recommends screening for Chlamydia trachomatis before undergoing any uterine instrumentation. Prophylactic antibiotics should be considered before uterine instrumentation if screening has not been carried out. Radiation exposure from an HSG is very low and it has not been shown to cause harm, even if a woman conceives later the same month. The HSG should not be done if pregnancy is suspected. If you have an allergy to iodine, intravenous contrast dyes, or seafood, you should inform your doctor. If you experience a rash, itching, or swelling after the procedure, you should contact your doctor. Few women do get vaginal spotting after HSG, however, if you suffer from bleeding, please consult with your doctor.




What is a HyCoSy (Hystero – contrast – sonography)? How is it performed?


Please watch video on knowledge base page. HyCoSy is a special ultrasound test using contrast foam solution (like a dye) to show whether your fallopian tubes are open. First, a transvaginal (internal) scan is carried out. A speculum is then placed in the vagina (like having a smear) and a small plastic tube is inserted into the womb. The foam solution is then passed through the tube into the womb and fallopian tubes. It can then be seen by ultrasound scan. The procedure may cause some period-like pain. Please speak with our p4 fertility consultant for arranging your tube test.




What is a laparoscopy and dye test? How is it performed?


A laparoscopy and dye test (camera test) is an operation performed to diagnose tubal patency. Besides, it helps to diagnose any other pathology (abnormality) such as polycystic ovaries, endometriosis, adhesions (scar tissue from previous surgery), infection and fibroids. Laparoscopy is usually performed on a day case procedure under general anaesthesia. After you are put to sleep, a needle is inserted through the belly button and the abdomen is filled with carbon dioxide gas so that the laparoscope (camera) can be placed safely into the abdominal cavity. The laparoscope is then inserted through a cut (10mm long) in the belly button or just below it. A small instrument is usually inserted through another cut (5mm) above the pubic region to move the pelvic organs into clear view. A solution called methylene blue is injected through the neck of the womb which passes through the fallopian tubes to determine if the tubes are open. Skin incisions are closed with stitches after the procedure.




What are the risks and complications of laparoscopy and dye test?


Laparoscopy and dye test is an operation. The gas used during the procedure may cause, shoulder pain, as the gas can irritate your diaphragm (the muscle you use to breathe), which in turn can irritate nerve endings in your shoulder and bloating. These symptoms are nothing to worry about and should pass after a day or so, once your body has absorbed the remaining gas. Minor complications occur in 1 to 2 cases in every 100. These include: • Post-operative infection. • Pain • Nausea and vomiting Major complications following a laparoscopy are rare (1 -2 in every 1,000 cases), include: • Damage to an organ, such as your bowel or bladder. • Damage to a major blood vessel. • A serious allergic reaction to the anaesthetic. Further surgery is usually required to treat any major complications.




Is there anything else I should know?


The choice of appropriate tubal patency test depends upon clinical history. Every test has its advantages and limitations. Therefore, it is advised to discuss with p4 fertility expert.





Ultrasound 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.





Sperm Test FAQ

 

What kind of doctor does a male / a man see for fertility?


Fertility specialist consultants treat men and women as a couple for subfertility. It is advised to see a fertility expert (expert in IVF, ICSI and surgical sperm retrieval) first who may then get input from endocrinologist or urologist if required depending on the reason for subfertility. The plan of fertility treatment is made by a fertility expert.




How you diagnose male subfertility or male infertility? What tests are done for male fertility?


Two important steps to diagnose the problem in men 1. General physical examination and medical history. – Clear medical history about your sexual habits and about your sexual development during puberty, further history on any inherited conditions, childhood conditions causing damage to testicles, chronic health problems, illnesses, injuries or surgeries that could affect fertility. Where necessary, clinical examination of about your sexual habits and about your sexual development during puberty. 2. Semen analysis also called a semen test or sperm test




What is Sperm Test or semen analysis?


Sperm test is the key test for fertility. A complete semen analysis measures the quantity and quality of the fluid released during ejaculation. Sperm test checks the liquid portion, called semen or seminal fluid, and the microscopic, moving cells called sperm. Sperm are reproductive cells in semen that have a head, midsection, and a tail and contain one copy of each chromosome (all of the male's genes.




What is tested in a semen analysis? When to repeat sperm test?


Each semen sample is between 1.5 and 5.5 millilitres of fluid. A typical semen analysis measures: Volume of semen Viscosity - consistency or thickness of the semen Sperm count - total number of sperm concentration (density) - number of sperm per volume, Sperm motility - % able to move as well as how vigorously and straight the sperm move, Number or % of normal and abnormal (defective) sperm in terms of size and shape (morphology), Coagulation and liquefaction - how quickly the semen turns from thick consistency to liquid Fructose - a sugar in semen that gives energy to sperm pH – measures acidity Number of immature sperm Number of white blood cells (cells that indicate infection). ). Occasionally there is an abnormal result on the first semen test. If this happens a repeat test should be offered, ideally 3 months later. However, if it looks as though your sperm count is very low or you have no sperm at all, the test should be repeated as soon as possible.




How the test results are interpreted?


According to world health organisation 2010, a normal semen sample has the same or better than,




What can cause problems in sperm test or semen analysis? What are the causes of male subfertility or infertility?


In many cases, it's not obvious what causes a low sperm count. Below are some of the lifestyle choices that can damage a man’s sperm and cause male infertility, all these can reduce both sperm counts and the ability to move. Smoking Regular use of marijuana and other recreational drugs Chronic high alcohol intake Anabolic steroid use and high-intensity exercise- can cause testicular shrinkage Exposure to environmental hazards and toxins such as pesticides, lead, paint, solvents, radiation and heavy metals. Regular high card fast-food diet with too few vitamins Stress Age Certain conditions can cause problems with sperm test results like A hormone imbalance, such as hypogonadism (reduced hormone production) A genetic problem such as Klinefelter syndrome, Y chromosome microdeletions, cystic fibrosis gene. Having had undescended testicles as a baby. A structural problem – for example, the tubes that carry sperm being damaged and blocked by illness or injury, or being absent from birth A genital infection such as chlamydia, gonorrhoea or prostatitis (infection of the prostate gland) Varicoceles (enlarged veins in the testicles) Previous surgery to the testicles or hernia repairs The testicles becoming overheated Certain medications, including testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), some antibiotics and some antidepressants




What are additional tests if the sperm test is not normal?


Genetic tests Hormonal tests to check hormone balance




Which genetic tests are advised when the sperm count is too low or no sperms seen and why?


Men with no sperms in the sample (azoospermia) or very low count (severe oligozoospermia, <5 million sperm/mL ejaculate fluid) could have genetic abnormalities. Genetic testing, including karyotype/cytogenetic testing, Y chromosome microdeletion (YCMD) testing, congenital hypogonadotropic hypogonadism (HH) mutation screening, and cystic fibrosis transmembrane conductance regulator (CFTR) gene screening, may reveal the cause and likelihood of successful treatment, and potential risks to the baby. Informed discussion with the patient about the role of genetic testing and the prognostic and psychological effects of genetic findings should be completed before testing. We discuss the genetic testing risk and refer to genetic counselling where it is appropriate. It is important to find out if there is any genetic issue as some of them has the potential to affect the baby.




What is surgical sperm retrieval? What are the risks?


Men who are found to have no sperms in semen (azoospermia), often require a surgical procedure to obtain the sperms. Sperms can be obtained from small tubes at top of testicles, the technique is called by percutaneous epididymal sperm aspiration (PESA). This can be done under local anaesthetic by numbing the area or general anaesthetic (putting patient to sleep). Sperms can be extracted from testicles by aspirating testicle (TESA) or by small biopsy of testicles (TESE). The risk involved in these procedures is the risk of infection or bleeding. To avoid the risk of blood collecting in the testicle, scrotal support is advised after the procedure. When the microscope and microsurgical technique are used is called, microdissection of testicles, it is done after putting the patient to sleep. However, this facility may not be present in all units. P4 fertility consultant will discuss the process in detail.




Is there any treatment to improve the sperm count? How do you fix low sperm count?


Lifestyle changes including stopping smoking, healthy lifestyle, weight loss, vitamins supplements may help to improve sperm count. Clinical consultation and diagnosis of why sperm test results are not normal are important before discussing further treatment. At p4 fertility, we personalise the treatment plan based on the diagnosis. If the sperm count is low due to the hormonal issue (hypogonadotropic hypogonadism), we advise hormonal treatment. There is no specific treatment to improve the sperm count in general when it is from testicular failure.




Is there a role of tablets to improve sperm count?


Men with semen abnormalities due to unknown causes should not be offered anti-oestrogens, gonadotrophins, androgens, bromocriptine or kinin-enhancing drugs because they are not effective. Over the counter medications and supplements including herbal medications are not supported by robust evidence to improve sperm count.




What is the anti-sperm antibody? Is there a role of steroid treatment with anti-sperm antibody is seen in the semen sample?


The significance of antisperm antibodies is unclear and the effectiveness of systemic corticosteroids is uncertain.




What is donor sperm treatment?


Donor sperm is used in a different type of fertility treatments where sperms from donor individuals are used for assisted conception. The type of fertility treatment you will receive depends on your circumstances and medical history. For further independent information visit https://seedtrust.org.uk





Hysteroscopy FAQ

 

What kind of doctor does a male / a man see for fertility?


Fertility specialist consultants treat men and women as a couple for subfertility. It is advised to see a fertility expert (expert in IVF, ICSI and surgical sperm retrieval) first who may then get input from endocrinologist or urologist if required depending on the reason for subfertility. The plan of fertility treatment is made by a fertility expert.




How you diagnose male subfertility or male infertility? What tests are done for male fertility?


Two important steps to diagnose the problem in men 1. General physical examination and medical history. – Clear medical history about your sexual habits and about your sexual development during puberty, further history on any inherited conditions, childhood conditions causing damage to testicles, chronic health problems, illnesses, injuries or surgeries that could affect fertility. Where necessary, clinical examination of about your sexual habits and about your sexual development during puberty. 2. Semen analysis also called a semen test or sperm test




What is Sperm Test or semen analysis?


Sperm test is the key test for fertility. A complete semen analysis measures the quantity and quality of the fluid released during ejaculation. Sperm test checks the liquid portion, called semen or seminal fluid, and the microscopic, moving cells called sperm. Sperm are reproductive cells in semen that have a head, midsection, and a tail and contain one copy of each chromosome (all of the male's genes.




What is tested in a semen analysis? When to repeat sperm test?


Each semen sample is between 1.5 and 5.5 millilitres of fluid. A typical semen analysis measures: Volume of semen Viscosity - consistency or thickness of the semen Sperm count - total number of sperm concentration (density) - number of sperm per volume, Sperm motility - % able to move as well as how vigorously and straight the sperm move, Number or % of normal and abnormal (defective) sperm in terms of size and shape (morphology), Coagulation and liquefaction - how quickly the semen turns from thick consistency to liquid Fructose - a sugar in semen that gives energy to sperm pH – measures acidity Number of immature sperm Number of white blood cells (cells that indicate infection). ). Occasionally there is an abnormal result on the first semen test. If this happens a repeat test should be offered, ideally 3 months later. However, if it looks as though your sperm count is very low or you have no sperm at all, the test should be repeated as soon as possible.




How the test results are interpreted?


According to world health organisation 2010, a normal semen sample has the same or better than,




What can cause problems in sperm test or semen analysis? What are the causes of male subfertility or infertility?


In many cases, it's not obvious what causes a low sperm count. Below are some of the lifestyle choices that can damage a man’s sperm and cause male infertility, all these can reduce both sperm counts and the ability to move. Smoking Regular use of marijuana and other recreational drugs Chronic high alcohol intake Anabolic steroid use and high-intensity exercise- can cause testicular shrinkage Exposure to environmental hazards and toxins such as pesticides, lead, paint, solvents, radiation and heavy metals. Regular high card fast-food diet with too few vitamins Stress Age Certain conditions can cause problems with sperm test results like A hormone imbalance, such as hypogonadism (reduced hormone production) A genetic problem such as Klinefelter syndrome, Y chromosome microdeletions, cystic fibrosis gene. Having had undescended testicles as a baby. A structural problem – for example, the tubes that carry sperm being damaged and blocked by illness or injury, or being absent from birth A genital infection such as chlamydia, gonorrhoea or prostatitis (infection of the prostate gland) Varicoceles (enlarged veins in the testicles) Previous surgery to the testicles or hernia repairs The testicles becoming overheated Certain medications, including testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), some antibiotics and some antidepressants




What are additional tests if the sperm test is not normal?


Genetic tests Hormonal tests to check hormone balance




Which genetic tests are advised when the sperm count is too low or no sperms seen and why?


Men with no sperms in the sample (azoospermia) or very low count (severe oligozoospermia, <5 million sperm/mL ejaculate fluid) could have genetic abnormalities. Genetic testing, including karyotype/cytogenetic testing, Y chromosome microdeletion (YCMD) testing, congenital hypogonadotropic hypogonadism (HH) mutation screening, and cystic fibrosis transmembrane conductance regulator (CFTR) gene screening, may reveal the cause and likelihood of successful treatment, and potential risks to the baby. Informed discussion with the patient about the role of genetic testing and the prognostic and psychological effects of genetic findings should be completed before testing. We discuss the genetic testing risk and refer to genetic counselling where it is appropriate. It is important to find out if there is any genetic issue as some of them has the potential to affect the baby.




What is surgical sperm retrieval? What are the risks?


Men who are found to have no sperms in semen (azoospermia), often require a surgical procedure to obtain the sperms. Sperms can be obtained from small tubes at top of testicles, the technique is called by percutaneous epididymal sperm aspiration (PESA). This can be done under local anaesthetic by numbing the area or general anaesthetic (putting patient to sleep). Sperms can be extracted from testicles by aspirating testicle (TESA) or by small biopsy of testicles (TESE). The risk involved in these procedures is the risk of infection or bleeding. To avoid the risk of blood collecting in the testicle, scrotal support is advised after the procedure. When the microscope and microsurgical technique are used is called, microdissection of testicles, it is done after putting the patient to sleep. However, this facility may not be present in all units. P4 fertility consultant will discuss the process in detail.




Is there any treatment to improve the sperm count? How do you fix low sperm count?


Lifestyle changes including stopping smoking, healthy lifestyle, weight loss, vitamins supplements may help to improve sperm count. Clinical consultation and diagnosis of why sperm test results are not normal are important before discussing further treatment. At p4 fertility, we personalise the treatment plan based on the diagnosis. If the sperm count is low due to the hormonal issue (hypogonadotropic hypogonadism), we advise hormonal treatment. There is no specific treatment to improve the sperm count in general when it is from testicular failure.




Is there a role of tablets to improve sperm count?


Men with semen abnormalities due to unknown causes should not be offered anti-oestrogens, gonadotrophins, androgens, bromocriptine or kinin-enhancing drugs because they are not effective. Over the counter medications and supplements including herbal medications are not supported by robust evidence to improve sperm count.




What is the anti-sperm antibody? Is there a role of steroid treatment with anti-sperm antibody is seen in the semen sample?


The significance of antisperm antibodies is unclear and the effectiveness of systemic corticosteroids is uncertain.




What is donor sperm treatment?


Donor sperm is used in a different type of fertility treatments where sperms from donor individuals are used for assisted conception. The type of fertility treatment you will receive depends on your circumstances and medical history. For further independent information visit https://seedtrust.org.uk





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





Book an appointment with

Dr. Jeve

The best and fastest way to book an appointment with us is to fillup the online booking form.

  • p4facebook
  • p4insta

© 2020 h50 Promotions