Preparing for a procedure can be a confusing and anxiety provoking experience. Our physicians and staff at the Johns Hopkins Fertility Center excel in the diagnosis and treatment of fertility issues, and want you to be comfortable with your treatment alternatives. To this end we have prepared a list of different procedures and the recommended preparations. Please call if you have any questions, as telephone numbers are listed next to each procedure.
An HSG is a radiographic evaluation of the uterine cavity and the fallopian tubes. An iodine contrast dye is used, except if you are allergic to iodine or shellfish (if so, we can pre-medicate you but you will need a prescription from your physician). The test is performed at the Johns Hopkins Outpatient Center, in the radiology department (601 N. Caroline Street, 4th Floor).
Preparation: The HSG may cause some discomfort, so you can take Ibuprofen 400 mg or Acetaminophen (Tylenol®) 500 mg a half hour before and one hour after the procedure. There are no dietary restrictions.
The endometrial biopsy is taken 2-3 days before your expected menstrual period. The biopsy will be used to determine:
- the presence of abnormal cells
- the cause of abnormal menstrual bleeding
- if your hormones (estrogen and progesterone) are causing the natural changes to the endometrium throughout the menstrual cycle.
A tiny sample of the endometrium (inner lining of your uterus) is taken and is sent to the pathologist for examination. The test is done at the clinic office (10753 Falls Road, Suite 335).
Preparation: A urinary pregnancy test will be done before you undergo the biopsy. The biopsy will be cancelled if you are pregnant. You may experience slight discomfort, so you can take ibuprofen (Advil® or Motrin®) a half hour to an hour before the test. You may temporarily experience the feeling of menstrual cramping afterwards.
Please tell the physician if you have had a recent gynecological infection, and refrain from using vaginal sprays, powders or tampons 24 hours before the biopsy.
Post Coital Test
For some patients the doctors want to determine what happens to the sperm once they are inside the vagina. Sometimes patients who are taking Clomid® have a disruption to their cervical mucus. The physician will take a small sample of cervical mucus (painless) and analyze it under the microscope anywhere from six to twelve hours after you have intercourse. The doctor will be able to give you immediate results.
Preparation: Have intercourse the night before the post-coital test and avoid the use of lubricants.
The semen analysis enables the physician to know the sperm count, motility (activity), shape of the sperm (normal or abnormal), and volume. You must have no more than 4 days’ interval of sexual abstinence before the procedure. We also perform sperm cryopreservation services wherein the sperm is frozen for future use for our fertility patients. You need a doctor’s order for the test. We will also need a current HIV test result.
Sperm Cryopreservation for Cancer Patients
Our Hopkins family of patients who will undergo cancer treatment and who wish to preserve their fertility options can also have their sperm cryopreserved. Your oncology physician needs to call 410-583-2753 to make the necessary arrangements. We will need a current HIV test result. Please have your physician fax it to 410-583-2767.
Surgical Outpatient Procedures
Hysteroscopy is a study of infertility, recurrent miscarriage or abnormal uterine bleeding due to fibroids, scarring, polyps, and congenital malformation. A narrow lighted instrument is inserted through your cervix and into the lower end of the uterus. This is an outpatient surgery and is performed under anesthesia.
A laparoscopy is also an outpatient procedure done under the benefit of anesthesia. The abdomen is filled with carbon dioxide gas which pushes the internal organs away from the abdominal wall. The laparoscope (a long, thin instrument that mimics a telescope) is then inserted through a very small incision so the surgeon can see your reproductive organs. This procedure helps the physician to diagnose or treat certain conditions such as endometriosis, uterine fibroids, ovarian cysts, ectopic pregnancy, scar tissue and chronic pelvic pain.
Your recovery from these procedures is 2-4 days for hysteroscopy and 5-7 days for laparoscopy. You will have weight-lifting restrictions for one week for outpatient procedures.
Surgical Inpatient Procedures
A laparotomy is a surgical procedure whereby an abdominal incision is made to gain entry to the reproductive organs. Most often the incision is below your navel but above the pubic bone.
The myomectomy allows the surgeon to remove fibroids from the uterus, and allows the surgeon to reconstruct the uterus to preserve your fertility options.
Although the laparotomy and myomectomy are two separate procedures, they are often done during the same surgical procedure. You will remain in the hospital for 2-3 days after the surgery, and you will have a 4-6 week recuperative period with weight-lifting restrictions. You must use mechanical contraception for about three months to allow yourself to heal. Sometimes pregnancies must be delivered by C-section after myomectomy.
Preparation for inpatient or outpatient procedures:
To schedule the HSG, please call 410-583-2750 or email email@example.com on Day 1 of your menstrual period. To schedule surgery with Dr. Garcia or Dr. Kolp, please call 410-583-2750 or email firstname.lastname@example.org on Day 1 of your menstrual period. To schedule surgery with Dr. Wallach or Dr. Zacur, please call 410-583-2751 or email email@example.com on Day 1 of your menstrual period.
We need to know:
- Your full name
- Your physician’s name
- Your date of birth
- Your phone numbers (home, work, cell)
- Day 1 of your period (red flow)
- How many days you have a menstrual flow
- The interval from one menstrual cycle to the next (i.e., 28, 30, 32, 60-90 days)
- Allergies to anesthesia or medicines (hives, breathing problems, etc.)
- Any prior reaction to anesthesia
- Notable surgical history (prior gynecological surgery, organ transplant, colostomy, etc.)
- Let us know of any health issues, such as diabetes, coronary problems.
Preoperative Visit: Call 410-616-7140 to schedule your preoperative visit which will include a physical, possibly some blood tests, and a review of the risks/benefits with your surgeon. You will also be asked to review and sign some surgical consent forms.
Dietary Restrictions (surgeries only) – Nothing to eat or drink from midnight the night before your procedure. If you take medications, bring them with you. The OR staff will advise what you can take.
Postoperative Visit – Call 410-616-7140 to schedule these visits. You will be discharged with instructions to make an appointment to see your surgeon 7-10 days after your outpatient procedure; or at 2 weeks and 4 weeks after your inpatient procedure.
Emergency Contact Numbers
|After-hours, weekends or holidays ||410-955-4331|
(Ask to speak to the reproductive endocrinologist on-call.)
|Fertility Center Nurses||410-847-3650 |
Support Staff Phone Numbers For Non-Emergency Calls
|Dr. Garcia||Laura||410-583-2753 ||firstname.lastname@example.org|