Hysterosalpingogram: Hysterosalpingogram (HSG) it’s a procedure that provides information of the fallopian tubes and the uterus. Dye is passed through a small tube through the cervix and into the uterus, this is visualized through X-ray. The dye normally passes through the tubes into the abdominal cavity if the tubes are open. If there is tubal obstruction or complete blockage, the dye is stopped at that point and is seen on x-ray. If the dye does not enter the fallopian tube it may be due to scarring or to spasm of the musculature of the proximal tubes.
HSG is an out-patient procedure, normally takes approximately 20 min, it may cause some discomfort if the tubes are blocked. We recommend that patient take Tylenol half an hour before this procedure, which is done at McMaster Hospital.
Sonohysterography: Sonohysterography is a new procedure, which helps determine tubal patency and is a minimally invasive ultrasound that captures a superior image of the uterine cavity. It uses a combination of a sterile saline catheter placed in the cervix and a transvaginal ultrasound, which produces highfrequency sound waves. The saline expands the uterine cavity this allows an excellent contrast to the lining, resulting in a superior visibility of the uterine and endometrial pathology.
Laparoscopy: Laparoscopy is direct visualization of the peritoneal cavity, ovaries, outside of the tubes and uterus, it is usually performed under general anesthesia. The patient gets a small incision in the belly button to visualize the fallopian tubes, uterus and ovaries.
This helps in the diagnosis of infertility causes such as damaged tubes, endometriosis, adhesions and tuberculosis. Operative laparoscopy is used to correct pathology on ovaries, tubes or other matters associated to infertility.
Hysteroscopy: Hysteroscopy, is a surgical procedure to examine the uterine lining. This procedure can assist in the diagnosis of various uterine conditions which can cause infertility, like: submucous (internal) fibroids, scarring (adhesions), endometrial polyps, uterine septa and other congenital malformations. Operative hysteroscopy is used to correct pathology on ovaries, tubes or other matters associated to infertility.
Ultrasound: Using sound waves transformed into video images, a healthcare provider can “see” the shape, status and position of the uterus, fallopian tubes and ovaries. These images can also reveal any blockages, growths or any other abnormalities within these organs and the surrounding areas. This ultrasound is essential to monitor the growth and development of the follicles when the ovaries are stimulated with fertility drugs to induce ovulation. An ultrasound can also be used to measure the thickness of the uterine lining to help determine if the lining is adequately prepared for an ensuing pregnancy. How It Is Done A full bladder is not needed for this type of ultrasound. A transducer is inserted into the vagina, which feels similar to inserting a tampon.
The transducer relays images of the uterus, fallopian tubes and ovaries onto a computer screen. 3D ultrasound is also useful in fertility investigation. Canadian research has shown that approximately 30 percent of women trying to conceive have a uterine malformation or a variation in the shape of the uterus. Most of these don't cause problems. However, some of these are associated with difficulties in conceiving and with miscarriage.
Having a 3D ultrasound is especially important if there is a history of miscarriages. Before performing hysteroscopy, a hysterosalpingogram (an x-ray of the uterus and fallopian tubes) may be performed to provide additional information about the cavity which can be useful during surgery.
Fertility Tests for Men
Semen Analysis: A semen analysis (SMA) evaluates the various characteristics of semen a male produce. It measures and determines the amount of semen, the number and quality of sperm in the sample. Semen analysis is done to help determine a man's fertility.
Testicular ultrasound: A testicular ultrasound is a test that uses reflected sound waves to produce a picture of the testicles and scrotum, it is not done with radiation. An ultrasound can show the long, tightly coiled tube that lies behind each testicle and collects sperm (epididymis) and the tube (vas deferens) that connects the testicles to the prostate gland. Testicular ultrasound helps disclose varicocele and other pathology that might impair your fertility. “Improving your Fertility” Weigh: A woman's weight can affect her fertility.
We know that at both extremes, very thin and obese, there can be disruption of the normal process of regular ovulation, and anovulation can often result. Body mass index, or BMI, is an index that gives us an indication of whether a person is of normal weight, overweight or obese. The BMI factors-in a person's weight as well as their height to give an overall "index". A high BMI indicates obesity. Go to the WebMD site and use their "BMI Calculator" to find out your BMI and learn more about weight issues:
Diet: Healthy eating plays a very important role in a healthy pregnancy. You need to eat foods from a variety of sources to make sure you get all the vitamins, minerals and nutrients you and your developing baby need. Pregnant women need fruits and vegetables every day. Brightly coloured vegetables and fruit contain more of the kinds of vitamins you and your baby need. You should eat at least one dark green and one orange vegetable each day. Make sure your fruits and vegetables are prepared with little or no added fat, sugar and salt, and choose vegetables and fruit more often than juice.
Smoking: When you smoke, your baby gets less oxygen and nutrients.This can cause your baby to grow more slowly and gain less weight in your womb. Babies with a lower-than-average birth weight tend to have more health problems. And the more you smoke, the higher the risk that your baby will have complications during the perinatal period (just before, during and just after birth). This is true for babies exposed to second-hand smoke too. Your baby may have learning problems, more ear infections and more colds and breathing problems.
Being born small can affect your baby's health into adulthood. Second-hand smoke contains the same toxic chemicals and carcinogens that smokers inhale. Children regularly exposed to second-hand smoke are at least 50% more likely to suffer damage to their lungs and to develop breathing problems such as asthma. When you breathe in secondhand smoke, you have a greater risk of developing lung cancer, heart disease, breathing problems and irritation of the eyes, lungs and throat. Alcohol: Drinking alcohol while pregnant elevates risk of giving birth to a baby with Fetal Alcohol Spectrum Disorder (FASD). FASD is a term that describes a range of disabilities (physical, social, mental/emotional) that may affect people whose birth mothers drank alcohol while they were pregnant. Research shows that children born to mothers who drank as little as one drink per day during pregnancy may have behavior and/or learning problems.
Exercise: Regular physical activity during pregnancy is great.
• Improve your mood and self-image.
• Help ensure appropriate weight gain.
• Help you relax and reduce stress.
• Promote better sleep.
• Increase your muscle tone, strength and endurance.
• Help build your stamina for labour and delivery.
• Speed up your recovery after labour and delivery.
• Help increase your energy levels.
Stress: Clinical research has demonstrated the following facts concerning stress and fertility: Stress has an immediate, chemical effect on endocrine function through its major motivator the hormone cortisol.
Stress is an adaptive response to perceived or real danger, referred to as the fight or flight response. This stress response is an evolutionary function that supported survival during life-threatening situations in primitive times. In the face of danger, an enormous physical effort is asserted to mobilize the body including increased blood flow to the muscles from the heart and increased oxygen flow for breathing, both functions are required to meet the metabolic demands of fight. This is the job of the hormone cortisol. In moments of danger, the hypothalamus signals the adrenal glands to release the hormone cortisol.
The result is immediate: Increased blood flow to muscles. Decreased blood flow to internal organs. Increased heart and respiratory rate. Once the real or perceived danger is resolved cortisol levels return to normal. This is a very different situation from the stress response of the modern day. Stress has a profoundly negative impact on other areas of our life that are important to reproductive function such as sleep, eating habits, sex, drive, mental health. Stress brought on by anxiety and/or depression can alter immune function. We have all heard about how the effects of depression can lower our immunity, making us more vulnerable to colds and other viruses during emotionally stressful periods. Sometimes its outcome is the use of chemical substances such as alcohol and cigarettes.
The result is that cortisol levels in the body remain elevated and this can have severe consequences for fertility. Cortisol down-regulates bodily functions associated with rest and digestion, including reproductive function. The increased blood flow to the musculature associated with the stress response comes at the expense of the uterus and ovaries. Some of the physical symptoms of stress are: tight muscles, shallow and quick breathing, poor digestion and poor sleep are some of these symptoms, which can be monitored and managed with mind/body skills.
Yoga and Meditation: Yoga and meditation are both relaxation techniques that can help calming the mind. Meditation can help discover feelings and manage them by finding deep in ourselves what causes us to feel in certain way. Benefits • Reduce physical symptoms of stress, anxiety and depression.
• Develop new lifestyle behaviors, to enhance fertility.
• Learn a variety of relaxation methods and cognitive behavioral strategies to help you regain
• Control of your life
• Determine the safety and efficacy of alternative medicine.
• Learn the art of self-nurturance and effective communication.
• Restructure negative thoughts and manage feelings of anger, loss and grief.
• Create a circle of support with other women experiencing similar issues.
Traditional Chinese Medicine Chinese medicine has a high success rate with functional infertility, which results from factors such as hormone imbalances, endocrine gland disorders, and emotional problems. Chinese medicine can also significantly improve some structural infertility problems, such as pelvic inflammatory disease, endometriosis, vaginitis, ovary dysfunction, and immune-system-related infertility.
Supplements: Folic Acid Folic Acid, or folate, is one of the B vitamins important for healthy growth of your unborn baby. It is essential to the normal development of your baby's spine, brain and skull, especially during the first four weeks of your pregnancy. It is, therefore, important to start taking vitamin supplements with Folic Acid before you get pregnant to reduce the risk of neural tube defect Vitamin B6 This vitamin is the first line treatment for N/V (nausea/vomiting), prevents cardiovascular malformations and protects placenta vascular bed. CoQ10 Lowers risk of pre-eclampsia, helps to improve oocyte and embryo quality by increasing ATP concentration. It has been found, that low CoQ10 levels in maternal blood have to do with abortions and pre-term deliveries. Probiotics Can be used as a treatment for diarrhea, to lower atopic disease. Antioxidants Pycnogenol is a potent antioxidant.
Recommended intake is 50-120 mg per day. This can be particularly useful for women 40 years of age and older. Multivitamins Prenatal vitamins contain all the vitamins and minerals that you need for pregnancy in order to meet all the requirements you and your baby need to be healthy.