Ovulation (Egg release) is checked with a blood test for Progesterone (a week before the expected date of the period) i.e. day 21 of a day 28 cycle. The Progesterone hormone level should be over 30. If low then treatment with Clomid tablets (an anti oestrogen) from days 2 to 6 of the menstrual cycle is often successful. This is monitored with a pelvic scan between days 10 to 14 to count the number of Follicles (egg sacs) that are growing.
A blood test between days 2 to 5 for hormones FSH, LH Thyroid function, Prolactin, and Rubella antibodies. The tubes should be checked with either a HSG (X ray of the tubes in which dye is injected through the cervix without a general anaesthetic) or an ultrasound scan of the pelvis combined with an injection of ultrasound dye (HYCOSY), or a Laparoscopy (see later) where the condition has the chance to be repaired.
Fluid Ultrasound picture of fluid injected into the lining of the womb to confirm that a polyp exists, outlined by the black fluid outline. This is a simple office based procedure.
In this procedure a small probe about the size of a tampon is inserted into the vagina with an empty bladder. This will identify ovarian cysts, (unusual collections of fluid or solids in the ovaries), Polycystic ovaries, Uterine fibroids and endometrial polyps (small extra pieces of tissue in the womb lining that do not come away with the period). If endometriosis (a condition where the lining of the womb grows outside the womb and causes regular monthly internal bleeding) affects the ovaries by producing cysts (internal monthly bleeding into the ovary giving a chocolate appearance) then these are also seen on ultrasound. These conditions are optimally treated by laparoscopy (See later).