A 24-year-old female unable to conceive since 15 months, Previously she had recurrent pelvic inflammatory disease, normal menses, normal vaginal and cervical examination.What is the next line investigation here?: (A) HSG, (B) AMH, (C) Hysteroscopy, (D) CA 125
Answer is A. History of recurrent PID is suggestive of tubal infeility and warrants investigation for tubal patency. Tests for Tubal Patency HSG: Cavity of the uterus and fallopian tube patency can be checked As it does not require anesthesia, it is the First-line investigation for checking tubal patency. Laparoscopy with chromopeubation with methylene blue dye: Best investigation, as tubal patency can be confirmed under vision AMH- Test for ovarian reserve. Hysteroscopy- Evaluates any Uterine cavity factors (septum, endometrial polyps, submucosal fibroids, intrauterine adhesions). CA 125 is a marker for ovarian malignancy, may be raised in tuberculosis, endometriosis, liver disease