Post Coital
Test
The post coital (after intercourse)
infertility test is sometimes used to evaluate the interaction of
sperm with the cervical mucus. The couple has normal
intercourse, using no lubricants, and the female comes
to our clinic within twenty-four hours. A sample of
her cervical mucus is examined under the microscope.
Normal, motile sperm should be seen
in the sample. If numerous, inactive or "dead"
sperm are seen, it could be indicative of an antigen
antibody reaction. Sometimes the female's immune system
incorrectly identifies sperm as invading pathogens and
seeks to destroy it in the same manner as bacteria or
viruses. Rarely, a man
may produce antibodies to his own sperm.
If female antibodies are present,
intrauterine insemination (IUI) may be a good treatment alternative.
In IUI, specially prepared sperm are placed directly
in the uterus thus avoiding the cervical. IUI should
only be performed by a health care professional, as
unwashed sperm can cause severe allergic reactions.
IVF might also be an option for
the couple depending upon many factors including age,
previous treatments, and many other variables. IUI
is less expensive than IVF but the success rates are
lower.
Endometrial
Biopsy
The endometrial biopsy involves
scraping and examining a sample of tissue from the lining
of the uterus (endometrium). The procedure makes it
possible for the physician to determine if ovulation
has occurred, and whether the lining of the uterus has
undergone the changes necessary for the implantation
of a fertilized egg and the support of an early pregnancy.
An endometrial biopsy can also detect an infection or
inflammation of the endometrium (endometritis).
The procedure is usually performed
one to four days prior to the onset of menstruation.
In a woman with a 28-day cycle, it is usually scheduled
for Days 24 to 26. From start to finish the test takes
about five minutes. The physician begins by inserting
a speculum into the vagina. The cervical area is cleansed
with cotton swabs and antiseptic and an antiseptic solution
containing iodine. Please advise a team member if you
have an allergy to iodine or shellfish. An instrument
called a tenaculum may be used to stabilize the cervix.
This may cause a brief, slight cramping sensation. A
narrow plastic instrument is passed into the uterus
to collect a small sample of tissue from the side wall
of the uterus. During the 60 seconds, the tissue is
collected; minimal to severe cramping may be experienced.
This will subside spontaneously after a few minutes.
The tissue is evaluated by a pathologist
who will" date" the tissue according to an
ideal menstrual cycle. The lining is considered "in-phase"
if the progesterone is in a certain range and the lining
has thickened to the degree expected on a particular
day of the cycle. A biopsy that is "out of phase"
suggests a lag in the growth of the lining and an inability
of the endometrium to support an early pregnancy. The
time frame between Days 24 and 26 of the cycle is too
early to perform a pregnancy test. However, a woman
undergoing an endometrial biopsy does not need to worry
about disturbing a pregnancy. Studies involving large
numbers of women who had the procedure performed during
the cycles when they conceived showed no greater incidence
of birth defects or miscarriage.
Other Fertility Tests
|
