Hysterosalpingogram
A Hysterosalpingogram or hsg is a diagnostic x-ray of the uterus and fallopian tubes. This test allows the gynecologist to observe the inside of the uterus and fallopian tubes for any problems such as blockage, endometrial polyps, fibroids, genital tuberculosis or abnormalities in the uterine cavity. HSG is often used in cases where a sterilization reversal is sought. The gynecologist or radiologist uses a cannula to fill the uterus with iodine. This helps in outlining the fallopian tubes so that any abnormalities in the tubes or uterine cavity is observed. In cases of infertility due to tubal blockage, HSG is used to evaluate the location and extent of blockage. The Hysterosalpingogram procedure takes a few minutes and can be moderately uncomfortable for the woman, with possibility of cramps. Women who have tubal disease may develop pelvic infection. In rare cases, the woman develops iodine allergy. Some women notice spotting for a couple of days after the HSG.
Infertility in woman
A compete medical history and physical examination is the first step undertaken to investigate the cause of infertility. Menstrual history, family history of infertility and sexual factors are examined. Blood and urine tests to determine hormonal levels, prolactin levels, hyperthyroidism and diabetes are taken to evaluate the possible causes of infertility. Hormonal imbalances are sometimes caused by pituitary gland tumors.
Blocked fallopian tubes do not allow the egg to travel to the uterus and can be a cause for infertility. One of the primary tests for detecting infertility in women is to check whether she is ovulating correctly. This can be done by monitoring body temperature and checking the texture of the cervical mucus.
Hysterosalpingogram: In this test for checking the infertility of women, an x-ray of the fallopian tubes and uterus is taken after they are injected with dye. The x-ray displays the shape of the uterus and the state of the fallopian tubes. This diagnostic test is also useful in diagnosing conditions such as endometrial polyps, fibroid tumors and structural abnormalities of the uterus or fallopian tubes.
Laparoscopy: This is a test for checking the fallopian tubes and other female reproductive organs for disease. Chromosomal tests are conducted to detect sperm abnormalities and other abnormal patterns in the man and woman.
- Age is a factor that reduces a woman's chances for fertility. Women above 35 years have decreasing fertility. The decreasing fertility can be on account of the higher rate of chromosomal damage that eggs undergo as time goes by.
- The amount of fat in a woman's body may have a bearing on her ability to conceive. Most of the estrogen in a woman's body is manufactured in her ovaries but some of it is produced in the fat cells. Too high or low weight levels can be a cause for infertility. Decreased body fat in marathon runners and those who indulge in heavy exercise may result in irregular menstrual cycles. Similarly women with eating disorders and restrictive diets can experience infertility. Disturbance in the estrogen balance can throw the reproductive cycle out of gear.
- Occupational and lifestyle factors also play no small role in the process of reproductive health. Exposure to high levels of chemicals and toxic substances, radiation and high temperatures can have a bearing on a woman's fertility. Women who smoke one or more packs a day or consume caffeine or alcohol in excess are at a risk of infertility.
- Pelvic Inflammatory Disease (PID) is a term that covers a gamut of infections affecting the reproductive organs of a woman. Infection in the fallopian tubes (salpingitis) is a common cause of infertility in women. Frequent bouts of infection can lead to tubal damage.
- Ovulation problems caused by hormonal disorders account for nearly a third of all problems of infertility in women. Resultant disorders could range from empty follicles or failure of the ovarian follicle to rupture. The hormonal rhythm is a delicate balance; a slight imbalance of which can cause ovulation disorders.
- Endometriosis is a situation when fragments of the endometrial lining are implanted in other areas of the pelvis leading to cysts that can result in infertility in women.
- Polycystic Ovarian Syndrome is a major cause of infertility in women in America. This is characterized by high levels of male hormones - androgen and testosterone. This results in inability to produce mature eggs and also manifests in symptoms such as acne and increased facial hair.
- Some women's bodies develop antibodies to sperm, which cause infertility and miscarriage. Adrenal or thyroid deficiencies can result in premature ovarian failure resulting in infertility.
Tubal Pregnancy
Tubal pregnancy is also known as ectopic pregnancy - a condition where the fertilized egg implants itself in the fallopian tubes or any other tissue outside of the uterus. Tubal pregnancy can be life threatening, if not attended to in time. This is because it can lead to the rupture of the pelvic organ and consequent hemorrhage. It can also affect the woman's ability to become pregnant later.
Since it is impossible to carry a tubal pregnancy to term, it becomes imperative to resort to surgery to remove the products of conception since they cannot develop into a fetus. This is done without damage to fallopian tubes, as far as possible. This can be done with laparoscopy in non-emergency situations. Tubal pregnancy can happen to any woman but there are some causes that can increase the likelihood of such a pregnancy condition. Some of the causes for tubal pregnancy are: Pelvic Inflammatory Disease, endometriosis or tubal scarring. Infection of the fallopian tubes such as gonorrhea or chlamydia can lead to a tubal pregnancy. The risk of ectopic pregnancy is manifold in cases of pregnancy after tubal sterilization. The use of the 'morning after pill' - emergency contraception is often noticed as a cause for tubal pregnancy.
An ectopic pregnancy is usually detected in the first 5 - 10 weeks of pregnancy. Ultrasound tests and hCG levels in the blood can help in identifying an ectopic pregnancy. The rate of increase of hCG in the blood is much slower in the case of an ectopic pregnancy or a potential miscarriage. Lower progesterone levels can also be an indication of likely tubal pregnancy. A woman having a tubal pregnancy will experience lower abdominal pain with cramping. There may be abnormal vaginal bleeding and breast tenderness. Lower back pain is another symptom. Severe bleeding and hemorrhage is the most dangerous symptom of ectopic pregnancy and needs prompt medical attention. If there is an emergency situation, there may be a need for blood transfusion.
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