Polycystic Ovary Syndrome (PCOS)
Uterine/Tubal Evaluation
Transvaginal ultrasound examinations allow the physician to check the endometrial lining, measure the length and diameter of the uterus, and check for many ovarian or uterine abnormalities, but is not a very good test to evaluate the inside of the uterine cavity. An “intra-uterine” evaluation is essential to every fertility evaluation.
A hysterosalpingogram (HSG) allows the physician to check for blockage or damage to the fallopian tubes or growths inside the cavity of the uterus. During this test, an iodine based contrast fluid is injected into the uterine cavity and tubes, and X-ray pictures are taken over the abdomen. Pictures are taken of the dye filling the cavity and tubes. It is an excellent exam to determine the caliber of the fallopian tubes and their patency, however it only does a fair job of evaluating the inside of the uterine cavity.
Saline infusion sonohysterography (SIS) effectively reveals the presence of intra-uterine abnormalities. SIS is an ultrasound procedure performed to assess the direction of the neck of the endocervical canal, and ensure that there are no uterine polyps or fibroids or abnormalities of the shape of the uterine cavity. Hysteroscopic surgery is the gold standard in evaluating the uterine cavity, where a small camera is placed across the vagina into the cervix and the cavity of the uterus is directly visualized.