In order to make a treatment plan you’ll need to have transvaginal ultrasound scans (internal scans of the vagina), urine tests, a postcoital test and a sperm test. Your consultant will discuss these in more detail with you.
Transvaginal ultrasound scan
On day one of your period, book an appointment for a transvaginal ultrasound scan for between day two and five of your cycle. Make sure your bladder is empty before you have the scan. The size of your ovaries will be measured and their appearance assessed and after the scans, you may have blood taken to measure different hormone levels: follicle stimulating hormone (FSH), luteinising hormone (LH), thyroid stimulating hormone (TSH) and prolactin (PRL).
You may also need a blood test to confirm you are immune to rubella (German measles). If you’re not immune, you’ll need to be vaccinated before any treatment. Other blood tests that may be required include full blood count, blood group, antibody screening and haemoglobin electrophoresis (blood test that detects different types of haemoglobin).
For more information, and if you have any queries, speak to your consultant.
Your next appointment will be about a week later for another transvaginal ultrasound scan. The purpose of this scan is to look for follicles growing in your ovaries, as the oocytes (eggs) develop in these follicles. Depending on the rate of growth of the follicles, another scan may be done a few days later.
When the follicles are showing satisfactory growth, you will be asked to start testing your urine each morning to detect the LH surge. The sudden increase in luteinising hormone will trigger ovulation (release of the eggs).
On the morning you detect the LH surge, arrange to have a postcoital test (PCT) for the following morning, and have sex that night. Don’t have a bath before coming to have the PCT, but you can have a shower.
During these weeks, whilst your cycle is being monitored, your partner will need to have his semen analysed.