Fertility Assessment & Tubal Evaluation in Dubai

International guidelines recommend seeking a fertility evaluation if you are under 35 and have not conceived after 12 months of regular, unprotected intercourse, or after 6 months if you are over 35. However, you should seek earlier assessment if you have known risk factors such as irregular periods, a history of pelvic infections or endometriosis, prior ectopic pregnancy, or PCOS. At DCDC, our gynecologists can help determine whether evaluation is appropriate for your situation and guide you through the process efficiently.

A comprehensive fertility workup typically includes a detailed medical history and physical examination, pelvic ultrasound to assess the uterus, ovaries, and follicle count, blood hormone testing (FSH, LH, AMH, estradiol, prolactin, progesterone, and thyroid function), and hysterosalpingography (HSG) to evaluate fallopian tube patency and uterine cavity shape. Your gynecologist may also recommend a semen analysis for your partner, as male factors contribute to approximately 40% of infertility cases. Additional tests may be ordered based on your individual clinical picture.

Blocked fallopian tubes can result from several causes. Pelvic inflammatory disease (PID), often caused by untreated chlamydia or gonorrhea, is one of the most common causes. Endometriosis can create adhesions and scar tissue around or within the tubes. Prior abdominal or pelvic surgery, including appendectomy or ovarian cyst removal, may lead to post-surgical adhesions. Ectopic pregnancy and its treatment can damage tube structure. In some cases, the cause is unknown. HSG is the primary diagnostic tool for identifying tubal blockages, and your gynecologist will explain the findings and treatment options clearly.

In some cases, yes. The treatment approach depends on the location, extent, and cause of the blockage. Proximal blockages near the uterus can sometimes be opened with selective tubal catheterization, a minimally invasive procedure. Laparoscopic surgery can address distal blockages, remove adhesions, or treat endometriosis-related tubal damage. The HSG procedure itself can sometimes clear minor blockages or mucus plugs. However, if tubes are severely damaged or if surgery is unlikely to restore function, IVF may be recommended as it bypasses the fallopian tubes entirely. Your gynecologist at DCDC will discuss all options based on your specific findings.

A complete fertility evaluation typically takes one to two menstrual cycles to complete. The initial consultation can be scheduled at any time. Some blood tests need to be drawn on specific cycle days (for example, FSH and estradiol on day 2-3, progesterone on day 21), and HSG must be performed between day 7 and 12 of your cycle. At DCDC, we coordinate all tests efficiently to minimize delays. Once all results are available, your gynecologist will schedule a follow-up consultation to review findings and discuss your treatment plan, usually within 4-6 weeks of starting the workup.

Success rates vary depending on the underlying cause, the treatment approach, the woman's age, and other individual factors. For couples where a treatable cause is identified, such as ovulation disorders or mild tubal issues, cumulative pregnancy rates can be quite favorable with appropriate treatment. Ovulation induction combined with timed intercourse may achieve per-cycle pregnancy rates of 10-20%. IUI success rates are typically 10-15% per cycle. IVF success rates vary by age but can range from 30-50% per cycle for women under 38. Your DCDC gynecologist will provide realistic expectations based on your specific diagnosis and treatment plan.

Yes, HSG and pelvic ultrasound provide complementary information. Ultrasound is excellent for evaluating the uterine structure, measuring the endometrial lining, assessing ovarian reserve (antral follicle count), and detecting ovarian cysts, fibroids, or polyps. However, ultrasound cannot reliably assess whether the fallopian tubes are open. HSG specifically evaluates tubal patency by tracking the flow of contrast dye through the tubes. Together, these two investigations provide a comprehensive picture of the anatomical factors affecting your fertility. Your gynecologist may recommend one or both depending on your clinical situation.

Blood tests are an essential part of the fertility workup but cannot tell the whole story on their own. Hormone testing can reveal ovulatory disorders, diminished ovarian reserve, thyroid dysfunction, elevated prolactin, or hormonal imbalances that affect conception. However, structural issues such as blocked fallopian tubes, uterine fibroids, polyps, or adhesions require imaging studies like HSG and ultrasound to detect. A comprehensive fertility evaluation at DCDC combines blood tests with imaging to ensure no significant factor is overlooked.