A 29-year-old woman presents with primary infertility and regular cycles. Her hysterosalpingography reveals bilateral tubal blockage. Which investigation should be prioritized next for management?
Diagnostic laparoscopy with chromopertubation
Hysterosalpingography (HSG) suggesting bilateral tubal blockage can be a false positive due to tubal spasm, so the finding must be confirmed before deciding treatment.
Diagnostic laparoscopy with chromopertubation (passing methylene blue dye through the cervix while viewing the pelvis) is the gold standard to confirm tubal patency or block, and it also detects endometriosis and pelvic adhesions — guiding the choice between tubal surgery and IVF.
With regular cycles, ovulation is likely normal, so thyroid tests or an endometrial biopsy for luteal phase assessment are not the priority; transvaginal ultrasound cannot assess tubal patency.
Hence, Diagnostic laparoscopy with chromopertubation.
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Important Questions from Midwifery and Obstetrical Nursing
During infertility assessment, a female is diagnosed with Asherman's syndrome. What is the primary mechanism by which this condition causes infertility?
Which hormone fluctuation is primarily linked to premenstrual syndrome symptoms?
A 30-year-old pregnant woman with hyperemesis gravidarum is at risk for Wernicke's encephalopathy. Which vitamin supplement is essential in her treatment plan?
During assessment, a midwife observes a blood-tinged mucus discharge, known as the 'show,' in a pregnant woman. What is the significance of this finding?
Effective maternal–infant bonding in the immediate postnatal period primarily helps the mother to achieve which of the following?
