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Fertility & Infertility

Infertility and sub-fertility are common problems in our community. We are often asked to perform ultrasound examinations to look for problems which could interfere with conception. It can be due to a problem in the man, a problem in the woman or a combination of factors.

Sometimes there are ovarian problems like endometriomata or polycystic ovaries which impair release of the egg. Sometimes there are fibroids or polyps in the uterus which prevent implantation of the conceptus. And sometimes the Fallopian tubes are blocked. This prevents the sperm meeting the egg.

Trans-vaginal ultrasound is the best initial investigation for infertility. The following problems can be identified, all with the one test:

In the ovaries

  • Polycystic ovaries
  • Endometriomata
  • Premature menopause
  • Ovarian cysts

In the uterus

  • Fibroids
  • Polyps
  • Adenomyosis
  • Unusual uterine shapes

In the tubes

This Fallopian tube is blocked and filled with secretions. It can no longer transmit the egg to meet the sperm.

If you have had a past history of pelvic inflammatory disease, ectopic pregnancy or a ruptured appendix, it may be that your Fallopian tubes are blocked. 

Sometimes we can see this because the Fallopian tubes tend to fill with clear fluid, a condition known as a hydrosalpinx. Sometimes they do not fill up with fluid, but the blockage can be ident using a contrast agent which we inject into the uterus to see if it flows through the tubes. It is called a HyCoSy (hystero-contrast sonography) procedure.

In the man

This egg is surrounded by many sperm. Only one sperm will fertilise the egg.  

It is quite common that a combination of mild factors in the woman, and perhaps a low sperm count in the male are causing the infertility together. 

Your doctor will probably recommend that as well as you having some tests, your partner should have a sperm count done as well.