HYCOSY

(HYSTEROSALPINGO-CONTRAST-SONOGRAPHY)

It is not unusual for a couple to take up to a year to conceive naturally.

However after this time some baseline investigations to make sure that there is no underlying problem may be advised. There may be some fairly strong indicators as to the source of the difficulty. For example very irregular periods are often associated with a failure to ovulate every cycle, while a previous history of pelvic infection may predispose to tubal pathology.

For many the reassurance that there is nothing significantly wrong is all that is required.

Investigating subfertility

An ultrasound scan is an extremely helpful initial step in the investigation of subfertility. Performed at the appropriate time of the cycle it can check for abnormalities of the uterus, ovaries and fallopian tubes as well as comment on the function of the ovaries and endometrium (womb lining). Swabs can be taken to check for previous infection at the time of a scan and any blood tests organised to check for ovulation. In this way many of the causes of subfertility can be diagnosed or excluded in one visit.

Your IVF or Fertility Specialist may want you to have the patency of your tubes checked. Hysterosalpingo-Constrast-Sonography or HyCoSy is the first line non-invasive ultrasound-based technique which can determine tubal patency. At OMNI in St Leonards and Penrith we perform outpatient HyCoSy (Hysterosalpingo-Contrast-Sonography), assess the position of the ovaries for egg retrieval as well as evaluating ovarian morphology; all important information in the work up of the sub fertile couple.

Conceiving with a fertility treatment

All women who conceive following fertility treatment should have an early pregnancy scan to locate the pregnancy because of the increased risk of ectopic pregnancy. Different fertility treatments include ovulation induction or ovarian stimulation, IVF, ICSI and GIFT. Heterotopic pregnancy occurs when there is a simultaneous intra- and extra-uterine pregnancy. The rate in natural pregnancies is very rare indeed (1 in 30,000 pregnancies); but with IVF the rate can be as high as 1 in 35 to in 1 in 100 pregnancies. Again ultrasound can help in the diagnosis.

OMNI Ultrasound & Gynaecological Care

Condous performs Advanced Endosurgery procedures for women needing intervention for pelvic masses, adnexal pathology, severe endometriosis or hysterectomy. He also runs ‘Hands on’ Live Sheep Laparoscopic Workshops for gynaecologists at Camden Veterinarian School.
Having completed an undergraduate degree with the University of Adelaide, he left Australia in 1993 and moved to London where he completed his training in Obstetrics and Gynaecology. From 2001 to 2003 Condous worked as a Senior Research Fellow at St George’s Hospital, London. At St George’s he set up the Acute Gynaecology Unit, the first in the United Kingdom. It was also during this time that he developed an interest in Early Pregnancy and especially the management of pregnancies of unknown location (PULs). Condous has developed many mathematical models for the prediction of outcome of PULs which have been featured in numerous peer review journals. In 2005, he returned to Australia where he completed his Laparoscopic Fellowship at the Centre for Advanced Reproductive Endosurgery, Royal North Shore, Sydney.

Condous was appointed as a Consultant Gynaecologist and Senior Lecturer at Nepean Hospital in 2006 and soon was made Associate Professor. In 2010, he was made Departmental Head of Obstetrics and Gynaecology at Nepean Hospital. He obtained the MRCOG in 1999 and was made FRANZCOG in 2005. In 2009, he was awarded his Doctorate in Medicine (MD), University of London, for his thesis entitled: “The management of pregnancies of unknown location and the development of new mathematical models to predict outcome”.

Condous has edited three books including the “Handbook of Early Pregnancy Care”, published over 100 papers in international journals and is internationally renowned for his work in Early Pregnancy. He is the Associate Editor for Gynaecologic Obstetric Investigation, which is a European based journal, as well as the Australasian Journal of Ultrasound in Medicine (AJUM). He is on the organising committee and is an invited speaker at the International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) Scientific meeting in Sydney 2013. His current research interests relate to the management of ectopic pregnancy, 1st trimester growth, PULs and miscarriage and the use of transvaginal ultrasound (in particular sonovaginography, to predict posterior compartment deep infiltrating rectovaginal endometriosis).Condous is also actively involved with post-graduate education including the annual running of the Early Pregnancy and Gynaecological Ultrasound Interactive Courses for Sonologists, Radiologists, Sonographers and Gynaecologists in Australia.