The function of the fallopian tubes is to transfer the egg from the ovary to the uterus, where fertilisation of the egg by the sperm generally occurs. Tests can be performed to ensure the fallopian tubes are functioning correctly. These tests are:
- Hysterosalpingogram (HSG)
- Sonosalpingogram (SSG)
- Diagnostic Laparoscopy and hysteroscopy
HSG AND SSG procedure
A HSG is an x-ray procedure to determine if the fallopian tubes are open and the shape of the uterine cavity is normal. A SSG is similar to a HSG but is an ultrasound.
HSG and SSG is performed on day 5-12 of the menstrual cycle when menstruation has ceased and ovulation has not yet occurred, so early pregnancies are not disturbed. The procedures require an insertion of a vaginal speculum is inserted (the same as a cervical screening smear smear) and a fine tube in inserted through the cervix and into the uterus to allow dye to be passed into the uterus and the tubes.
If you chose an HSG you can choose between a water soluble iodine containing contrast or a water soluble iodine containing an oil based solution called Lipiodol. A study reported in 2017 has shown that Lipiodol has improved live birth over the ensuing six months and possibly even longer in couples with fertility. Use of Lipiodol incurs extra costs.
If you chose a SSG the dye is a solution of sugar like molecules known as ExEm Foam.
Diagnostic Laparoscopy
Diagnostic laparoscopy is keyhole surgery to examine the abdominal and pelvic cavities. The procedure performed under general anaesthesia, and you can generally go home that day.
Compared to HSG and SSG, diagnostic laparoscopy is a more comprehensive procedure as endometriosis can be diagnosed or scar tissue around the tubes detected. It does have more risks (injury to other structures for example) and is more inconvenient. Lipiodol can be inserted at the time of the laparoscopy.
Is HSG or SSG uncomfortable?
Both procedure are associated with mild or moderate uterine cramping for about 5 minutes after the procedure and sometimes during the procedure. Occasionally, women experience cramps for several hours. These cramps can be reduced with non-steroidal anti-inflammatory drugs.
Are there any serious risks of an HSG or SSG?
The most serious risk is infection and can occur if the fallopian tubes were previously damaged. To avoid infection, you may be asked to take antibiotics the day before and the day of your procedure. Tubal infection is uncommon.
Anti-Mullerian Hormone (AMH) is a hormone measured in the blood which indicates the number of immature eggs a woman has left in her body. It is not an exact test but is a good indicator of the number of eggs a woman will have collected during an IVF cycle. As the number of eggs in a woman’s ovary reduces the AMH reduces as well.
Who is AMH best suited for?
AMH measurement is not 100% reliable and can be artificially lower in women who are very young, who are taking the contraceptive pill or who are very lean exercisers or those with pituitary problems.
When can the test be performed?
It can be collected at any time of the menstrual cycle.
Does AMH predict if you’ll have a baby?
AMH is not a predictor of whether a woman will have a live birth. Age is the best predictor of whether a woman will have a live birth or not. AMH indicates the quantity of eggs remaining in a woman’s ovary and does not indicate the quality of the eggs in the ovary.
AMH costs
It is not funded by Medicare and costs between $80 and $90.
Male factor infertility accounts for approximately 40% of those couples failing to conceive. Therefore, despite its well‐known limitations a detailed semen analysis is an essential step in diagnosing the cause of infertility as well as providing information on the most appropriate treatment options for a couple trying to achieve a pregnancy.
It is important to remember that even with very low sperm counts it is possible to achieve a pregnancy following sexual intercourse.
What does a Sperm Test actually test?
Normally men produce approximately 1,000 sperm every second, but the sperm count can vary noticeably in both fertile and sub‐fertile individuals. To make an accurate assessment of sperm quality scientists take a semen sample and analyse it under a microscope. From these samples they can then estimate:
- the concentration of sperm
- the total sperm count
- the percentage of motile or moving sperm
- how well the sperm can move
- how much they stick together
- the number of sperm that have a normal appearance (morphology).
What does the procedure involve?
- The seminal sample is delivered in a special container provided by Care Fertility following collection either at home or at Care Fertility Andrology rooms.
- Care Fertility scientists analyse it under a microscope.
What is the Semen sample procedure?
- Before doing the test, you should abstain from sexual intercourse, or ejaculation, for two or three days before providing a semen sample, but no more than 5 days.
- The semen sample can be collected at your home if you have less than one hour’s travel time from your home to Care Fertility. The anticipated time of delivery of the sample should be arranged with the scientific staff of Care Fertility. There is also a private Andrology room that you can book with Care Fertility.
- The entire ejaculate should be collected by masturbation into the container provided (withdrawal intercourse or lubricants should not be used).
- The lid should be secured firmly in place, the label completed with the man’s name and date of birth and signed. The sample jar should then be placed in the ziplock plastic bag provided, kept at room temperature, kept upright and delivered to Care Fertility within one hour of collection.
- Book with Care Fertility for the semen sample to be processed at the time of delivery.
- The request form from the doctor should be brought with the semen sample and the middle section of the form should be completed by the man providing the sample.
- It may be necessary to complete a form at the reception area of Care Fertility before the sample can be received.
The cost of having a Semen Analysis
The cost of having a semen analysis performed by Care Fertility is $130 (price subject to change without notice so please contact Care Fertility reception for confirmation of price) and the reception staff will be able to provide information on the Medicare rebate for the service.
Semen collection methods
Collection of sample by masturbation
This is the preferred method. You will receive a container with your full name, date of birth, partner’s name and time of collection. Unlabelled specimens cannot be used and another sample will need to be collected.
Collection of sample by sexual intercourse
This requires the supply of a special condom (free of lubricants and other chemicals which are toxic to sperm) obtained from the scientific staff of Care Fertility. The ejaculate should be contained within the condom and the sample together with the condom placed in the labelled specimen jar for delivery to the laboratory at Care Fertility.
Freezing of semen samples
If the male has a poor sperm count or anticipates difficultly producing semen on the day it is required semen can be frozen. Generally this is performed at least three weeks prior to the date the semen is likely to be required. Semen quality is reduced by freezing and thawing and fertilisation and pregnancy cannot be guaranteed. Costs are incurred for the freezing of each sample and for the ongoing storage of the samples. Often more than 2 or 3 ejaculates are required. Please discuss this with your doctor if you wish to freeze semen.
Difficulties obtaining the semen sample
When men have difficulty producing a sample or are anxious about quality of sample a couple of hours break (e.g. a walk or watching a movie) may help. Please inform the staff of Care Fertility so the scientists schedules can be readjusted.
If you anticipate having difficulties producing a semen sample on the day or have difficulty getting or maintaining an erection please discuss this with your doctor well in advance of the anticipated egg collection so appropriate treatments can be instituted.


