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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) and laparoscopy today, as described in chapter 12.
The newer ultrasound machines have Doppler attachments that allow the doctor to judge the flow of blood in the blood vessels. The most exciting advance is that of Color Doppler, where the blood flows can be 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.
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.
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 are many and include: reduced costs; reduced hospitalization, 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.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
