Further investigations

At your My Fertility Check consultation, your specialist will discuss with your results with you, and what your next steps should be.

Sometimes, depending on your history and results, the specialist may advise you to get further investigations. All your options will be fully explained to you and we will do our utmost to answer any questions you might have.

If you have difficulty understanding any of the terms or would like to know more about your results and what any further investigations would reveal, don’t hesitate to ask your fertility specialist.

Further investigations may include:

Hormone Profile

Normal hormone levels are very important for a woman’s fertility. A full hormone profile gives an accurate assessment of your hormone balance and involves a few simple blood tests. These can be performed at your GP’s surgery or at the clinic. A complete hormone profile will test for:

Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH)

Normal levels of FSH and LH are very important to a woman’s reproductive health. FSH is a hormone which regulates the reproductive processes of the body, while LH triggers ovulation. High FSH levels can indicate that the number of eggs in your ovaries is decreasing, while high LH levels can be a sign of Polycystic Ovarian Syndrome (PCOS) and other reproductive health issues. Blood tests for FSH and LH should only be taken on days two, three or four of the menstrual cycle.

Progesterone

Progesterone hormone levels can also be measured with a blood test. Normal progesterone levels indicate normal ovulation. Blood tests for progesterone levels need to be taken on day 21 of a 28 day menstrual cycle (or seven days before your next period is due).

Prolactin

Prolactin is a hormone produced in the pituitary gland (named because of its role in lactation). High levels of prolactin, however, can cause infertility by preventing the release of FSH and LH. Prolactin levels can be measured in a blood test at any time of the month.

Thyroid Function Tests

Sometimes when you have a low or high thyroid level, this imbalance can affect your ovaries and your ability to conceive. T4 and TSH levels should also be checked as suboptimal thyroid function can impact on ability to conceive, causing irregular ovulation. High TSH levels have been linked to an increased risk of miscarriage. Again, a thyroid function test is a simple blood test which can be done at any time of the month.

Results of Hormone Profile

Your fertility specialists will discuss the results of your hormone profile with you and advise you as to what your next steps should be.

Laparoscopy and Dye Test ('Lap and Dye')

A laparoscopy is a diagnostic procedure that allows the doctor to inspect the health of your reproductive organs (uterus, Fallopian tubes and ovaries) through a small telescope. It checks your Fallopian tubes, to ensure they are not blocked or damaged, and assesses other abnormalities which could affect fertility, such as endometriosis, uterine fibroids, ovarian cysts and adhesions.

A laparoscopy is carried out under general anaesthetic and only takes about 10 minutes. A small incision is made near your belly button and a long thin telescope is inserted for the doctor to examine your organs. A coloured fluid (the ‘dye’) test is performed to see if your Fallopian tubes are blocked. A laparoscopy should be carried out between day five and day 12 of your menstrual cycle, at a time when you could not be pregnant.

It is normally a day case procedure, so you are admitted in the morning and discharged that evening. Laparoscopies are usually carried out for diagnosis, but sometimes minor treatment can be carried out at the same time to destroy deposits of endometriosis and to divide adhesions.

Hysterosalpingogram

A hysterosalpingogram (HGG) is an x-ray test carried out to assess whether Fallopian tubes are open or blocked. It also gives a very clear image of the uterine cavity. During a HSG, a dye is put through a thin tube into the uterus. If all is normal, the dye will fill up the uterine cavity, and then flows into the Fallopian tubes.

If the fluid does not spill out through the Fallopian tubes, this indicated a blockage in the tubes. A HSG must be carried out at a time when you could not be pregnant. The HSG is therefore arranged after a period, but before ovulation could have occurred – ideally between days five and 12 of a cycle (though this may vary depending on cycle length).

Results of Further Investigation

Your fertility specialists will discuss the results of any further investigations with you and advise you as to what your next steps should be and what your options are.