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Ultrasound technology has made dramatic advances in recent years, and now tests have been described which allow the doctor to use ultrasound to assess tubal patency. Basically, these involve passing a fluid into your tubes through the uterus; and the gynecologist can see the passage of the bubbles into the tubes and out into the abdomen. Since this test ( sonosalpingography) can be done in the doctor's clinic itself, and does not involve X-ray radiation, it has advantages - especially for documenting that the tubes are normal. However, the gold standard for tubal testing remains HSG (hysterosalpingography, an X-ray of the uterus and tubes) and laparoscopy today, because it provides us with a "hard copy" image which can be critically examined.
Doppler: The newer ultrasound machines have Doppler attachments which allow the doctor to judge the flow of blood in the blood vessels. Colour Doppler allows the doctor to "see " the blood flow in the pelvic blood vessels, mapped in color on the monitor. While still a research tool, it may provide important information for assessing the infertile patient in the coming years.
Three - dimensional ultrasound. Using sophisticated microprocessors, the newest ultrasound machines allow the doctor to reconstruct the image, so that he gets a three dimensional view. While this provides excellent pictures, the true value of this technique for infertility still has to be evaluated. It can be useful in assessing women with uterine anomalies, because it helps the doctor to differentiate between a septate uterus and a bicornuate uterus.
Ultrasound now also offers infertile patients newer treatment options not available before. Modern surgical techniques have progressively become less and less invasive - all to the patient's benefit ! From laparotomy to laparoscopy , and now to ultrasound guided procedures, we are witnessing a change in the gynecologist's armamentarium from the knife to the endoscope to the guided needle !
The benefits to the patient of "minimally invasive surgery" are many and include : reduced costs; reduced hospitalisation ; reduced risk of complications; and better preservation of fertility, with increased chance of conception for the future.
Ultrasound-guided procedures can be used to treat a variety of problems seen in the infertile woman:
The scope of ultrasound guided procedures has increased dramatically in the last few years; and with further improvements in technology, we can expect this list to become even longer, and doctors become more versatile with using this technology.