TRANSVAGINAL SCAN AND FEMALE INFERTILITY IN NIGERIA
Infertility in a couple that relates to factors associated with the woman rather than the man.
DESCRIPTION OF FEMALE INFERTILITY
Many women trying to conceive for the first time panic if their periods continue for even three or four months. But the standard definition of infertility is unsuccessful conception after an entire year of unprotected intercourse. At that point, a couple should seek a comprehensive examination that includes menstrual and pregnancy history, semen analysis, ovulation tests, and sometimes a laparoscopy to detect endometriosis or pelvic adhesions. Such testing determines the causes of infertility in 70 to 85 percent of all couples.
CAUSES AND RISK FACTORS OF FEMALE INFERTILITY
Many factors may account for infertility: abnormalities of the uterus (such as fibroids); ovarian dysfunction; endometriosis; scar tissue from previous surgery; thyroid problems or other hormonal imbalances; sexually transmitted diseases or other infections in the man or woman; and a low sperm count.
Female reproductive problems account for 40 percent of all infertility cases; male reproductive problems account for another 40 percent; and 20 percent of the time physicians cannot determine precisely what is wrong.
DIAGNOSTIC STUDIES THAT ASSIST FERTILITY
The uterus (womb) is lined by a specialized layer of cells called the endometrium. It is on this lining that embryos implant and begin to develop in pregnancy. It is critical to thoroughly evaluate the uterine cavity for potential defects or obstacles to implantation of the embryo. Examples of such include uterine scar tissue (from previous pregnancies or procedures), polyps (benign glandular growths), fibroids, or other structural defects in the uterus.
TRANSVAGINAL ULTRASOUND EXAMINATION
Ultrasound, or sonography, involves sending sound waves into the body. These sound waves are reflected off the internal organs, and the reflections are then recorded by special instruments that create an image of the organs. No ionizing radiation (X-ray) is involved in ultrasound imaging.
This is an ultrasound examination performed by placing a probe (medical camera) into the vagina. A transvaginal ultrasound provides images that are much more clear than those obtained by placing the probe on the abdominal wall. This examination may be performed at the onset of your menstrual cycle on Day 2, 3, or 4 or it may be performed midcycle. Midcycle examinations (performed when the lining is at its thickest point) may provide more information about the quality and integrity of the endometrial cavity.
This test, which may also be performed on any day of the menstrual cycle, provides information on the overall size and volume of the ovaries. It also enables your physician to obtain an antral follicle count. Antral follicles are small (With transvaginal ultrasound, the ultrasound transducer (a hand-held probe) is inserted directly into the vagina. Transvaginal ultrasound is most commonly used to examine the uterus and ovaries and to monitor the health and development of the embryo during pregnancy. Ultrasound images can help to identify palpable masses such as ovarian cysts and fibroids, as well as ovarian or uterine cancers. IVF cycling patients are checked regularly with a transvaginal ultrasound to monitor the size and number of developing follicles.
Transvaginal ultrasound is performed very much like a gynecologic exam. The tip of the transducer is smaller than a gynecologic speculum. A protective cover lubricated with gel is placed over the transducer, which is then inserted into the vagina. Only two to three inches of the transducer end are inserted into the vagina. The images are obtained from different orientations to get the best views of the uterus and ovaries.
FALLOPIAN TUBE EVALUATION
Issues with the fallopian tubes account for approximately 30% of female infertility problems. Common problems result from tubal blockage or scarring from previous, sometimes undiagnosed, pelvic infection. Other conditions, such as abdominal infections like appendicitis, prior surgeries, prior ectopic pregnancy, or endometriosis may also lead to fallopian tube damage. Tubal blockage or scarring may occur from previous pelvic or abdominal infection, pelvic surgery, ectopic pregnancy, or endometriosis. Prior tubal ligation (tying of the tubes) for contraception would also prevent the tubes from functioning normally.
Hysterosalpingogram is a procedure in which radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix and X-ray pictures are taken as the dye is expelled from your reproductive system. The uterine cavity fills with dye, and if the fallopian tubes are open, the dye will then fill the tubes and spill out into the abdominal cavity. In this way we can determine whether the fallopian tubes are open or blocked and whether the blockage is located at the junction of the tube and the uterus (proximal) or whether it is at the end of the fallopian tube (distal).
If a blockage is detected, we will discuss with you effective treatments for tubal factor infertility.
Your HSG can also give us a better picture of the uterine cavity and detect the presence of polyps, fibroids, or scar tissue. The fallopian tubes can also be examined for defects within the tube or suggestion of a partial blockage.
The hysterosalpingogram takes only about 20 minutes to perform. During the procedure you are likely to experience some mild cramping, so you may wish to ask your doctor about taking pain medication such as Tylenol or Ibuprofen a half hour prior to the HSG . The test involves the following steps:
The specialist places a speculum in the vagina and examines the cervix. Your cervix is cleaned with an antibacterial soap.
A clamp may be attached onto your cervix to hold it steady. A small, bendable plastic tube is gently pushed through the opening of your cervix into your uterus, and a tiny balloon on the end of the tube is filled with air to hold it temporarily in place.
The speculum is removed but the thin tube will be left in place, with one end (about 6 inches of tubing) remaining outside of your vagina.
A small amount of contrast dye is injected through the tube into your uterus, and several X-ray pictures are taken. Your doctor may ask you to move your pelvis slightly or roll from side to side to provide the clearest view of your uterus. You may experience some uterine cramping as the contrast dye goes into the tube.
The procedure is now complete. The balloon will be emptied of air from the outside and the tube will be gently pulled out.
After the procedure, your doctor will review the X-ray pictures and discuss the results of the hysterosalpingogram with you.
You may experience slight vaginal bleeding and cramping after the procedure, and some sticky vaginal discharge as some of the gel and fluid drains out. A pad can be used for the vaginal discharge. Do not use a tampon.
Pregnancy rates in several studies have been reported to be slightly increased in the first months following a hysterosalpingogram. This may be due to the flushing of the tubes with the contrast, which could open a minor blockage or clean out some debris that may be hindering conception.
TREATMENT OF FEMALE INFERTILITY
The treatment of infertility has made enormous progress in the last decade as a result of advances in assisted reproductive technology, or ART. This technology combines the use of fertility drugs – hormonal therapy – with artificial insemination using any of a group of techniques: intrauterine insemination (IUI), in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), or oocyte (egg) donation.
Intrauterine insemination (IUI): In this procedure, a small amount of concentrated sperm, first “washed” to remove most of the seminal plasma that surrounds it, is placed in the uterus through a thin plastic catheter that is passed through the vagina and cervix. Usually painless, the IUI procedure takes only a few minutes to accomplish.
IUI is almost always used in combination with a fertility drug – clomiphene or Pergonal – to stimulate ovulation followed by an HCG injection to trigger the release of an egg. The timing of the IUI is determined with the help of vaginal ultrasound, previous cycle lengths, BBT temperature graphs, or urinary LH correlation kits.
JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI].
For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.
For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact
JOAS MEDICAL DIAGNOSTIX
JOAS MEDICAL DIAGNOSTIX——-WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.
We are located at
JOAS HOUSE, 2, Okesuna Street,
Opposite The Synagogue Church Busstop,
Bolorunpelu, Ikotun, Lagos
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