Endometrial Biopsy Office procedure that serves as a helpful tool in diagnosing various uterine abnormalities.
Hysterosalpingogram (HSG) The HSG is a special X-ray that reveals the internal contour (shape) of the uterus. Certain malformations of the uterus can show up on this test. The HSG also shows whether the fallopian tubes are patent (open). The fallopian tube is the passageway through which egg and sperm travel; a blocked tube can prevent conception.
To do this test, the doctor places an instrument through your vagina and cervix into your uterus and injects a contrast material, a dye that shows up on X-ray images. X rays are taken as the dye fills the uterus, enters the fallopian tubes, and spills out the ends of the fallopian tubes into the pelvic cavity. If one of the tubes is blocked, the dye will not be able to pass through the tube.
This test is usually performed after you finish your period but before you ovulate. You may feel some cramping during the procedure; to lessen this, your doctor may suggest that you take ibuprofen one hour before the procedure. To prevent infection, your doctor may prescribe an antibiotic for you to take before the test and for a few days afterward.
The advantages of this test are that it is minimally invasive and it rarely gives false negative results — that is, if the test shows normal results, you can be assured that you really do have a normally shaped uterus and open fallopian tubes.
However, the test does have a false positive rate of about 15 percent. That is, about 15 percent of the time, the test will show a problem when there actually is none. Also, this test does not reveal anything about the external contour (outside shape) of the uterus or about other structures inside the pelvis. That means it will not show signs of disease outside the uterus, such as adhesions (scar tissue) or endometriosis.
Hysteroscopy The doctor uses a special instrument called a hysteroscope, a narrow lighted tube with a viewing device on the end. The doctor uses a speculum to hold your vagina open, and then places the hysteroscope through your vagina and cervix and into your uterus. This lets the doctor look directly at the inside of the uterus.
Sonohystogram Like an HSG, a sonohystogram reveals the inside shape of the uterus and shows whether the tubes are open. The procedure is also similar to the HSG. However, instead of injecting dye into the uterus, the doctor injects sterile salt water. Then, instead of taking an X-ray, the doctor uses ultrasound equipment, which produces an image based on sound waves, to watch the progress of the fluid through the uterus and tubes.
Post-Coital Test This test (also called the PK or Sims-Huhner test) is meant to assess the performance of a man's sperm in his partner's reproductive tract. Originally, this test was part of the routine fertility assessment. It was thought that the test would show how receptive your cervical mucus is at the time of ovulation and how well your partner's sperm could survive in it.
The post-coital test is performed one to three days before your anticipated ovulation (generally between Days 11 and 13 in a 28-day menstrual cycle) or on the day of the LH surge as determined by urine testing. You should not have sexual intercourse for at least two days before the test. At the designated time, you have sexual intercourse, and the test is performed within the next 12 hours.
This test is also used to evaluate the quality of the cervical mucus. Some of the mucus is placed on a glass slide and covered, while some is placed on another slide and allowed to dry uncovered. When the mucus dries on a slide, it should form a distinct fern?like pattern. This pattern is graded based on the extent of crystal formation. The covered slide is used to assess the "stretchability" of the mucus. The doctor pulls the cover slip gently off the slide and measures how far the mucus stretches. Normal mucus should stretch at least 3-4 inches.
Cervical Mucus Penetration TestIn this test, your cervical mucus is placed on a slide. Cervical mucus from a fertile donor (or, in some cases, from a cow) is placed on a second slide. Your partner's sperm and sperm from a fertile donor are put at the edges of the cervical mucus slides. The doctor then compares how fast and how far each type of sperm penetrates into each mucus sample.
A cervical culture can reveal the presence of infection. In this test, a sample of your cervical fluid is placed in a laboratory dish with special nutrients and watched to see whether particular microorganisms grow there.
Ovarian Reserve Testing Helps assess whether your ovaries are properly responding to the hormonal messages that signal them to prepare eggs for ovulation. These are sometimes called tests of "egg quality" or "ovarian age."
Laparoscopy In this surgical procedure, a doctor makes a small cut in your abdomen and inserts a tiny viewing device. This enables the doctor to look for problems in the pelvic cavity, such as adhesions (scar tissue that can interfere with the reproductive organs) or endometriosis (growth of uterine lining tissue outside of the uterus).
Polycystic Ovarian Syndrome (PCOS), a condition often marked by insulin resistance and irregular or absent ovulation. Tests typically show elevated testosterone levels and normal 17-hydroxyprogesterone levels.
It is defined chiefly by two symptoms: irregular ovulation that causes irregular or skipped periods, and elevated male hormone levels (hyperandrogenism).
PCOS is associated not only with infertility, but is also characterized by severe obesity, excess hair growth (hirsutism), acne, high cholesterol and triglyceride levels, high blood pressure, and enlargement of the ovaries from cysts (fluid-filled growths). Women with this disease may also complain of abnormal bleeding, hair loss and acne.
Adrenal Hyperplasia This is a genetic condition of the adrenal gland. Ovulation may be irregular or absent, and both testosterone and 17-hydroxyprogesterone levels may be elevated.
Ovarian or Adrenal Tumor Ovulation does not occur, testosterone levels are very high, and 17-hydroxyprogesterone levels may be elevated.
Unexplained (Idiopathic) Excess Hair Growth (Hirsutism) In these cases, ovulation is normal and male hormone tests are normal.
Primary Amenorrhea (also called pubertal-onset amenorrhea) Means your periods never started as they should. This is diagnosed if you reached age 16 without starting your period, or if you did not start your period within two years of your breast development.
Secondary Amenorrhea (also called adult-onset amenorrhea) Means you have not had a period for at least six months.
If you have irregular periods coming more than 35 days apart (oligomenorrhea), tests for FSH, PRL and TSH are called for.
If you have a milk like nipple discharge from your breasts (galactorrhea), then your doctor will probably order tests for PRL and TSH.
Ovarian Cysts Fluid-filled noncancerous growths that form in the ovaries.
Endometriosis Occurs when tissue of the same type as the uterine lining (endometrium) is found growing outside the uterus. Growths of endometrial tissue may appear in many places in the pelvis, attached to organs such as the ovaries, fallopian tubes, bladder, and bowels. In some cases, endometrial tissue has been found as far away as the lungs. The growths may be small, superficial patches (called implants), larger nodules, or masses within the ovary called endometriomas. Some women only have a few growths, which may look like grey, blue, black, or brown spots. In other women, the misplaced tissue grows into large red lesions that prompt the formation of scar tissue (adhesions). Together, the growths and adhesions can damage or pull on the pelvic organs, interfering with their position and function.
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