Checking the Womb
When investigating the causes of infertility, the missing part of the jigsaw is often to understand whether this uterus is receptive and working normally. Obviously, the first point of any fertility investigation is usually an ultrasound of the pelvis. If this identifies issues within the ultrasound imaging itself, such as fibroids or polyps, then there are more extreme tests that can be done, perhaps surgical or imaging tests beyond basic ultrasound, which can gather much more useful information about the structure of the uterus and to understand whether the womb is functioning normally.
Looking Inside in the Womb
The womb cavity is essential to successful conception, but how do you understand whether there’s any issues with the womb lining or the uterine cavity? There are surgical ways to look inside the womb with a camera, but of course, every patient that has a fertility problem doesn’t have to go through surgery to understand whether their wound cavity looks normal.
A far better way to start is a pelvic ultrasound – the cornerstone of fertility investigations and a trans vaginal ultrasound – looking closely at the womb cavity at chronological time points throughout a woman’s menstrual cycle can give you a really clear guide as to whether it looks normal. Clear patterns emerge throughout the different phases of the menstrual cycle, which are easily recognizable on ultrasound, and this is usually the starting point to understand whether the womb lining looks and whether the womb cavity has a high chance of of being normal inside.
There are of course other tests that can be done such as a saline sonogram. You can infuse saline inside the womb whilst performing an ultrasound scan. This causes the two walls of the womb to separate and any pathology such as polyps or fibroids that may be encroaching into the cavity can be identified more clearly.