One-Stop Fertility Diagnosis
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Treatment of infertility depends on the cause, but too often a comprehensive and systematic investigation may not be done. Since pregnancy rate drops sharply with age, some couples may unknowingly lose their chances to have a family. At The Women's Clinic we have designed a single visit one-stop fertility diagnosis program to fast track diagnosis and maximize success by minimizing the time delay within one physiological cycle.

It is recommended when appropriate and indicated by our specialist, and additional fee is required.

Schedule

  1. Patient needs to call for appointments (D2/3 registration, D7-11HSG) on D1
    Tel: 2523 3007 & 2208 6388
    Address: 12/F., Central Tower, 28 Queen's Road Central, Hong Kong
    *** should mention any drug allergy to our staff
  2. D2/3:
    1. blood test (CBC, Blood Group & Rh, VDRL, HIVab, E2, FSH, LH, Prolactin, DHEA-S, T4, TSH) ;
    2. Semen Analysis;
    3. pick up medication for HyCoSy
      1. Register and make payment at the clinic
        Mon-Fri 9-10am; 2:30-3pm
      2. Pick up laboratory forms (one for wife and one for husband) for blood test & semen analysis and a sample container for semen collection
      3. Pick up medication for HyCoSy
      4. Proceed to laboratory, Central Diagnosis Clinic (Room 1301, 13/F., Central Tower, 28 Queen's Road Central, Hong Kong) for blood test and provide a semen sample

        Produce a Semen Sample:
        • Patient can collect a container from our clinic in advance, and produce a semen sample at home on D2/3. Semen should be kept at room temperature and brought into the laboratory Central Diagnosis Clinic (Room 1301, 13/F., Central Tower, 28 Queen's Road Central, Hong Kong) within 1.5 hours.
        • Wash both your hands and genital area 2-3 times and then dry thoroughly with paper towels.
        • Semen should be obtained by masturbation only.  Lubricants and condom must not be used during the production of the sample.
        • Try best to avoid contact of the penis with the inside of the specimen sample container as this may contaminate the semen.
        • Refrain from sex for 3-5 days prior to semen collection.
        • Semen sample should arrive laboratory during Mon-Fri: 9:00am- 3:30pm (open during lunch hour)
  3. D7-11 HSG, and see Doctor for consultation (please take medication accordingly)

Remarks

According to the guideline from the Council on Human Reproductive Technology
(Tel: 2961 8952,Email: hrtc@dh.gov.hk), patient should be able to:

  • Produce HKID/ valid passport
  • Produce Marriage Certificate
  • Sign relevant consent forms

before starting of any fertility treatment

4DHyCoSy - (4-dimensional hysterosalpingo-contrast sonography) - Patient’s Fact Sheet

What is 4DHyCoSy - (4-dimensional hysterosalpingo-contrast sonography)?

HyCoSy (Saline Infusion Sonohysterography) consists of imaging the uterus, uterine cavity and fallopian tubes using ultrasonography while sterile ultrasound contrast medium is instilled into the uterine cavity.  The purpose of sonohysterography is to detect abnormalities of the uterus, endometrial (uterine) cavity, and patency of fallopian tubes.

Why is 4DHyCoSy performed?

The usual indications for HyCoSy are infertility; abnormal uterine bleeding; recurrent spontaneous miscarriage; congenital abnormalities of the uterus; suspected blockage of fallopian tube(s); preoperative and postoperative evaluation of the uterine cavity; suspected intrauterine adhesions (synechiae or scar tissue); and further evaluation of uterine abnormalities suspected during routine ultrasonography.  HyCoSy should not be performed in women who are pregnant or who are suspected to be pregnant.  4DHyCoSy should also not be performed in women with an active pelvic infection or unexplained pelvic tenderness.

How is 4DHyCoSy performed?

HyCoSy is usually performed in the first part of the menstrual cycle after menstruation.  The procedure begins with a transvaginal ultrasound examination.  After this is completed, a narrow tube is placed through the cervix into the uterine cavity, and the ultrasound examination is continued while ultrasound contrast medium is instilled into the uterine cavity.  The uterine cavity is filled with ultrasound contrast medium in order to improve detail of images of the uterine cavity and automated 4D volume acquisation allows easy visualization of the contrast medium's flow throughout the entire Fallopian tubal length.  Space-occupying abnormalities such as endometrial polyps and intracavitary fibroids are usually very well visualized with this technique.

What are the risks and complications?

A 4DHyCoSy is a very safe procedure.  It may cause mild cramping, spotting, or discharge.  Some women may experience cramps for several hours.  The most common serious complication with 4DHyCoSy is pelvic infection; however, this occurs less than 1% of the time and usually occurs in the presence of preexisting tubal disease.  If spasm occurs during the examination, a false tubal patency result may be given, and that will be reconfirmed with a x-ray hysterosalpingography.  You should call your doctor if you experience pain and/ or fever within one or two days of the 4DHyCoSy.  Some physicians will prescribe pain medication and/ or antibiotics before the procedure.


Figure 1 - 4DHyCoSy illustrating a defect in uterine wall.

Figure 2 - 4DHyCoSy illustrating free spill of contrast indicating tabal patency.

Figure 3 - 4DHyCoSy illustrating a normal uterine cavity and a blocked Fallopian tube.

 

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