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Ad Astra Per Aspera | To the Stars through Difficulties

Ad Astra Per Aspera | To the Stars through Difficulties

astra fertility diagnostic services female

Second Line Investigations / Female

Antisperm Antibody Testing

In some instances, a woman’s cervical mucus can develop antibodies to her partner’s sperm. It is believed that antisperm antibodies in the cervical mucus may account for as much as 40% of unexplained infertility in couples.

Office Hysteroscopy

Office hysteroscopy is an office procedure that does not require anaesthesia. During this procedure, normal saline is used to distend the uterine cavity to allow for a very thin telescope to enter the uterine cavity for direct visual assessment. Subtle lesions that are frequently missed on ultrasound or X ray will be clearly diagnosed and readily treated with the hysteroscope. We are the only clinic in Ontario that offers office hysteroscopic assessment to patients whenever indicated and without delay. We also offer a ‘see and treat’ approach in the same setting, often helping to avoid an operation under general anaesthesia. In experienced hands, office hysteroscopy is significantly more comfortable than sonohysterogram.

Transvaginal Hydro-Laparoscopy (THL)

Transvaginal Endoscopy (TVE), a combination of hysteroscopy and transvaginal hydro-laparoscopy, is a revolutionary technique used for the direct visualization and assessment of the entire female reproductive system. The procedure is done under light sedation with only one needle puncture to enter the pelvic cavity through the vagina and behind the uterus. A normal saline solution, instead of CO2 gas, is used to visualize the entire female pelvis directly. Post-operative recovery is fairly quick, with most patients feeling back to normal within hours. This is in contrast to diagnostic laparoscopy, which involves abdominal incisions, general anaesthesia, and longer recovery time.

It is important to note that subtle uterine and pelvic pathology can only be diagnosed under direct visualization. Ultrasound imaging, despite its simplicity and non-invasiveness, is not sensitive enough to show us endometriosis or adhesions. This can lead to missing the diagnosis of pelvic factors that can contribute to infertility in a significant proportion of patients who are otherwise labeled as having “unexplained infertility” (basically, a diagnosis that is reached when physicians run out of answers to explain the real cause of infertility). Remember, having a real diagnosis is the most important step in managing fertility patients.


Laparoscopy is a surgical procedure in which a telescope is inserted inside the abdomen through a small cut inside the navel, to facilitate direct observation of the pelvic organs. It is done under general anaesthesia. A laparoscopy can lead to the diagnosis and treatment of many problems that can cause infertility, including damaged tubes, endometriosis, adhesions and tuberculosis. For therapeutic purposes, up to 4 incisions in total may be required depending on the complexity of the pelvic pathology. Recovery usually requires a few days of rest.