DIAGNOSTIC METHODS

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USG

An ultrasound scan is a medical test that uses high-frequency sound waves to capture live images from the inside of your body. It's also known as sonography. ... An ultrasound allows your doctor to see problems with organs, vessels, and tissues without needing to make an incision.

Medical ultrasound (also known as diagnostic sonography or ultrasonography) is a diagnostic imaging technique based on the application of ultrasound. It is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs.

Gynecologic ultrasonography examines female pelvic organs (specifically the uterus, ovaries, and Fallopian tubes) as well as the bladder, adnexa, and Pouch of Douglas. It commonly uses transducers designed for approaches through the lower abdominal wall, curvilinear and sector, and specialty transducers such as endovaginal.

Obstetrical sonography was originally developed in the late 1950’s and 60’s by Sir Ian Donald and is commonly used during pregnancy to check on the development and presentation of the fetus. It can be used to identify many conditions that could be potentially harmful to the mother and/or baby possibly remaining undiagnosed or with delayed diagnosis in the absence of sonography. It is currently believed that the risk of leaving these conditions undiagnosed is greater than the small risk, if any, associated with undergoing an ultrasound scan. But its use for non-medical purposes such as fetal "keepsake" videos and photos is discouraged.

    Obstetric ultrasound is primarily used to:

    • Date the pregnancy (gestational age)
    • Confirm fetal viability
    • Determine location of fetus, intrauterine vs ectopic
    • Check the location of the placenta in relation to the cervix
    • Check for the number of fetuses (multiple pregnancy)
    • Check for major physical abnormalities.
    • Assess fetal growth (for evidence of intrauterine growth restriction (IUGR))
    • Check for fetal movement and heartbeat.
    • Determine the sex of the baby

Ultrasonography in Infertility

Ultrasonography forms a key tool in monitoring patients with infertility. It mainly helps in monitoring the growth of the follicle (Egg in the ovary), its rupture and also to monitor the response of the endometrial lining in response to the egg growth and subsequently its release from the ovary. This basic procedure is done by transvaginal sonography(TVS), is a non invasive and cost effective method of determining ovulation. This facility in available at all fertility clinics and at certain sonography institutes and clinics and is called follicular study.

However some women have the fear of transvaginal sonography which is completely baseless. It is mainly psychological and we have seen that most of them get used to it as they proceed in their treatment. This is important because TVS gives more detailed and accurate information as compared to abdominal scan. Also it is many a times needed to do this scan when the women is menstruating and it is perfectly normal to do so.

1. Follicular Study

Two main things that are monitored in a follicular study are the ovaries and endometrium. It is ideally started on the second or the third day of the periods when the woman is actually menstruating. The antral follicular count (AFC, number of eggs recruited in one particular cycle) is noted. This is an indirect method to detect the egg producing capacity in the woman. The ideal AFC is 3-6 eggs of size less than 10mm size in each ovary. Less means low egg producing capacity commonly seen in women above 30 years of age. More may indicate presence of polycystic ovary.

 

2. Ovarian causes:

Two main things that are monitored in a follicular study are the ovaries and endometrium. It is ideally started on the second or the third day of the periods when the woman is actually menstruating. The antral follicular count (AFC, number of eggs recruited in one particular cycle) is noted. This is an indirect method to detect the egg producing capacity in the woman. The ideal AFC is 3-6 eggs of size less than 10mm size in each ovary. Less means low egg producing capacity commonly seen in women above 30 years of age. More may indicate presence of polycystic ovary.

 

3. Tubal causes

Hydrosalpinx (fluid filled in the tube), Pyosalpinx (pus filled in the tube) these are the signs of infected tube. Ectopic pregnancy can also be diagnosed eary with TVS.

 

4. Uterine causes

Abnormal uterine shapes (Septate uterus, bicornuate uterus), Fibroid uterus,

 

5. Endometrial Pathology

Endometrial polyp, Calcifications, Adhesions or Ashermann syndrome.

 

6. Cervical causes

Cervical causes

HYSTEROSCOPY

Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus.

HSG

HSG Hysterosalpingography, also known as uterosalpingography, is a radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the fallopian tubes. This means it is a special x-ray using dye to look at the womb and Fallopian tubes.

PAP SMEAR TEST

A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that's at the top of your vagina. Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure.

BIOPSIES

A biopsy is the removal of tissue from any part of the body to examine it for disease.

An endometrial biopsy is a procedure performed to obtain a small tissue sample from the lining of the uterus, called the endometrium. After the biopsy, the endometrial tissue is examined under a microscope to identify the presence of abnormal cells, or the effects of hormones on the endometrium.

A cervical biopsy is a surgical procedure in which a small amount of tissue is removed from the cervix. The cervix is the lower, narrow end of the uterus located at the end of the vagina. A cervical biopsy is usually done after an abnormality has been found during a routine pelvic exam or Pap smear.

Diagnostic Methods - Seeds IVF Fertility Centre, Nashik