Fertility Evalutaion

Assessing Female Age and Fertility

Many women hear frightening messages about how age reduces fertility and feel confused about when their fertility changes. A fertility evaluation can address the confusion by providing individualised assessment of egg reserve. Testing includes measuring Anti-Mullerian Hormone (AMH blood test) and the number of small follicles (antral follicle count on ultrasound) and in some women measurement of FSH hormone during a period. These tests provide a measurement of the timeline for natural fertility (assisting with family planning) as well as the expected outcomes of treatments such as IVF.

Assessing Tubal Patency

The most common test for tubal patency in our service is HyCoSy (an ultrasound test). The test is performed at the end of a period. A small catheter (soft tube) is passed through the cervix (neck of the womb) and a “dye” made of glucose/saline and air bubbles is gently injected into the womb. The dye appears white on ultrasound and can be seen passing through the tubes. The test can produce period-like discomfort. Women are advised to take pain relief when having this procedure.

Additional and Specialised Tests

Some couples require more detailed testing. All of the following are available in our service:

A small number of women require keyhole surgery (laparoscopy) to assess for conditions such as endometriosis. If surgical evaluation is required, Dr Anne will refer you to an experienced gynaecology surgeon.

Unexplained Infertility

Many couples complete a fertility evaluation and are told that no cause can be found for delayed conception. Unexplained infertility is defined as not conceiving over 12 months in the setting of regular ovulation, normal fallopian tubes, normal routine blood tests and a normal semen analysis. There are hundreds of events that have to proceed perfectly to achieve an ongoing pregnancy and routine testing cannot assess all of these events. Unexplained infertility is a difficult diagnosis however it is important to know that many couples with unexplained infertility (in particular, younger women) are still able to conceive naturally.