We strongly believe in the value of talking to our patients and getting to know them before running fertility tests on them. Hence, our female fertility test begins with a consultation, in which a fertility specialist will take a detailed medical history to discuss any existing medical conditions and explore any problems that could be relevant.
If you have had relevant investigations performed elsewhere or you have had treatment elsewhere please bring those reports with you for your consultant to review. Any investigations will be discussed with you first prior to being carried out.
The specialist will advise you on your fertility status, as well as provide advice on any changes that may be required to your lifestyle to improve your health and maximise your fertility potential. If assistance is needed, they will also discuss treatment options to help you conceive or help you plan for the future.
Further investigations
The baseline scan and blood test provide a good picture of your fertility status but do not provide complete information. In certain cases, your specialist may advise you to have further investigations.
The most common fertility investigations are:
Midcycle scan
A further pelvic scan performed during the middle of your cycle (days 10 – 12 of a 28 day cycle) allows us to monitor follicular development towards ovulation and the thickness of your endometrium (the lining of your uterus).
A 3D saline infusion scan (SIS), in which saline is used as a contrast agent, allows the specialist to examine the uterine cavity in greater detail for presence of any pathology, such as endometrial polyps, submucous fibroids and congenital uterine abnormalities. Such pathology might interfere with getting pregnant.
A Hysterosalpingo-Contrast Sonography (HyCoSy) is an ultrasound procedure used to assess the patency (open-ness) of the fallopian tubes and detect abnormalities of the uterus and endometrium. The procedure uses a non-toxic contrast agent for visualisation under ultrasound. The HyCoSy is a safe and reliable alternative to the conventional hytsterosalpingogram (HSG) that uses X-rays.
If you are considering trying naturally, timed sexual intercourse, ovulation induction or intra-uterine insemination (IUI), you will require patent fallopian tubes in order to achieve a pregnancy. Occluded (blocked) fallopian tubes are a common cause of infertility. Tubal occlusion can occur as a result of a number of conditions, including previous pelvic infection, previous appendicitis, pelvic adhesions and severe endometriosis. Many women will be unaware that these conditions are present or that tubal occlusion has occurred.
There is also some recent evidence to indicate that blocked fallopian tubes may reduce the chances of pregnancy in IVF.
The triple Test
Harley Street Fertility Clinic now offers all three of the above investigations, in a single combined appointment. Combined with the baseline scan and hormone profile, these results will provide you with a detailed picture of your fertility status.
Is it painful?
A Triple-Test is considered a simple procedure lasting approximately 40 minutes and no anaesthetic is required. Most women experience mild to moderate discomfort similar to period cramping. If you are sensitive or have a low threshold for pain you can have some local anaesthetic to minimise the pain. This can be discussed with your consultant.
We advise that you take over the counter pain relief 30 minutes prior to the procedure.We recommend Ibuprofen (400 mg)and Buscopan (10 mg). If you are allergicto Ibuprofen anotheroptionisParacetamol (1 gram).
A prophylactic course of antibiotic will be prescribed: 1gm of Azithromycin and 1gm Metronidazole tablets 1 to 2 hours before procedure.
You may eat and drink normally before the procedure.
How is a Triple Test performed?
Initially, a normal pelvic scan is performed to measure the development of your follicle(s) and thickness of your endometrium. Then a small amount of saline is introduced into the uterine cavity, which allows ultrasound visualisation of the contour and shape of the cavity. The specialist will be looking for presence of uterine pathology detailed above.
Next, a small amount of contrast dye will be introduced through the catheter. The injection of the contrast dye may cause some discomfort similar to the uterine cramps experienced during menstruation. The dye can be clearly visualised under ultrasound. The specialist will be looking to see if the dye freely flows through both fallopian tubes and spills out at the end of the tube into the area around the ovaries. If this occurs, the tubes are open.
What are the risks of a Triple-Test
The Triple-Test is a safe and well-tolerated procedure for the assessment of tubal patency. Infection of the uterus or pelvis is not common but can occur in rare cases. You should contact the clinic immediately if you have the following symptoms:
Persistent or foul-smelling vaginal discharge
Increasing lower abdominal pain
Unexplained fever
Extended general malaise
Such symptoms may indicate treatment with antibiotics. Please inform your consultant if you have a history of pelvic infection because they may prescribe you with antibiotics to prevent infection prior to the procedure
Post procedure
It is advisable to wear r a sanitary towel after the procedure as there may be persistent vaginal discharge for a few hours as the fluid used in the HyCoSy drains out of the vagina. This discharge is sometimes blood stained, so do not become alarmed if this occurs. You should be able to resume normal daily activities after the procedure.
Your consultant will discuss the results of the procedure with you directly after it has been performed.
Female fertility Health check-ups
Female fertility health check-up
• Initial Consultation • Ultrasound Scan (D2-5) • AMH blood test • Follow-up consultation to discuss results
Suitable for egg free and general fertility health
