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Assessment of the Cervix, Uterus and Fallopian Tubes
The following methods are available to assess a woman's cervix, uterus and fallopian tubes:
Evaluation of Cervical Mucus:
Cervical mucus is secreted from the cervix during the time of ovulation. The cervical mucus is crucial, as it provides a method for the sperm to travel from the vagina into the uterus. A cervical mucus evaluation is typically performed using a speculum around the time of ovulation. Both the quality and quantity of cervical mucus present is evaluated.
Post Coital Test:
The post coital test is very similar to a cervical mucus evaluation; however, it is conducted 4-12 hours after sexual intercourse around the expected time of ovulation. This evaluation can provide insights into not only the quantity and quality of mucus present, but also an estimate of the concentration of sperm available after interaction with the cervical mucus.
Hysterosalpingogram:
A hysterosalpingogram, often referred to as an HSG, is a method that evaluates the shape of the inside of the cervix, uterine cavity, and fallopian tubes. This test is extremely important in determining whether the uterus has a normal configuration and if the fallopian tubes are open and normal. The test is performed by injecting a small amount of dye into the uterus, which is visible on x-ray examination. As the dye is injected into the uterus, several x-rays are taken to visualize the flow of the dye through the uterus and fallopian tubes. The test takes approximately 3-5 minutes, and preliminary test results are available immediately. Typically performed in a Hospital's Radiology Department, HSGs are performed early in the menstrual cycle, following menstrual flow and prior to ovulation.
Transvaginal Ultrasound Examination:
A transvaginal ultrasound examination is similar to an x-ray machine, except that the images are produced by the absorption of sound waves instead of radiation. Patients can undergo numerous ultrasound examinations with no ill effects, and generally, the procedure is not painful. A transvaginal ultrasound examination is used to visualize the uterus, ovaries, and follicles developing on the ovaries, the developing fetus, and numerous internal organs. This test is essential in monitoring cycles where injectable ovulation stimulation drugs are administered. The number and size of developing follicles is evaluated to help determine the appropriate dosage of medication, as well as when to induce ovulation or plan an egg retrieval.
Another test, a sonohysterogram, combines the transvaginal ultrasound evaluation with the filling of the uterine cavity with sterile saline. Sonohysterograms are useful in visualizing the uterine cavity and identifying polyps, synecchia (scar tissue), or fibroids. Results are similar to those obtained by hysteroscopy or hysterosalpingography.
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