Surgical & Office Procedures
In this procedure we use an X-ray contrast dye to expand the uterine cavity. We then take an X-ray while the uterus and fallopian tubes are injected with dye. The goal of the HSG is to assess whether the fallopian tubes are open. The HSG is also good for evaluating uterus abnormalities like those shown below, but it is not as good as the sonohysterogram for picking up subtle lesions. We usually do this test between cycle days 6-12, or while on birth control pills. You will be given a prescription for an antibiotic before the procedure to reduce the risk of infection.
Sonohysterography (SHG) or Saline-infusion Sonography (SIS)
In this procedure, sterile saline is used to expand the uterine cavity and then a transvaginal ultrasound image is taken. The saline enhances the ultrasound’s ability to detect whether the uterus is normal or contains a defect or lesion, such as a polyp, fibroid tumor or adhesions.
A surgical procedure that involves looking directly into the abdomen and pelvis using a small camera that is placed through an incision. This allows our experts to evaluate and potentially treat gynecologic problems such as scar tissue (adhesions), endometriosis, and ovarian cysts that may affect fertility.
A hysteroscopy is a procedure used to look inside the uterus. This is done by inserting a thin telescope (called a hysteroscope) through the cervix and into your uterus. Salt water (saline) flows into the uterus once the hysteroscope is in place. This opens the uterine cavity and creates a clear picture on a TV monitor. Hysteroscopy can be used to diagnosis or treat problems of the uterus. Our fertility exsperts may suggest a diagnostic hysteroscopy if you have irregular or heavy menstrual periods, frequent miscarriages (lost pregnancies) or difficulty getting pregnant. It may also be used to investigate unusual findings on an HSG (x-ray of the uterus and tubes).
For Endometriosis Treatment
If our fertility experts suspect that you might have endometriosis, they may recommend a laparoscopy to confirm this diagnosis. Treatment depends on the extent of the condition and other symptoms that you may have. It may involve surgical removal of the endometriosis and associated scar tissue at the time of the laparoscopy, or hormone treatment to suppress the menstrual cycle and inhibit the growth of endometriosis. If treatment for endometriosis does not result in a successful pregnancy, IVF will often be an appropriate option.
For Tubal Damage
If you have any tubal damage or abnormality, this will be diagnosed during the laparoscopy. Some of these conditions may affect your chances of success with IVF unless treated. If tubal surgery does not result in a successful pregnancy, or where damage to the tubes and other pelvic organs is so severe as to make surgery unlikely to be successful, IVF will be the treatment option with the best chance of success.