Gynaecological Consultations

Gynaecological Consultations – all our consultants are fully trained in general gynaecology and they run busy clinical services in their NHS hospitals.  They all have extensive experience in looking after women with common gynaecological problems such as menstrual problems and pelvic pain.  In addition to being able to identify the causes, our consultants can also advise on a wide range of the available treatment options.  In women with pelvic tumours it is important to determine whether the swelling is benign or malignant in nature. Malignant tumours require immediate treatment by cancer specialists. In women with benign tumours the choice of treatment depends on women’s symptoms, type of the lesion and the chance of the swelling growing larger in the future.  Our consultants are experienced in the management of all types of benign pelvic swellings and are able to provide women with information and advice to help them to choose between surgical and non-surgical treatment. 

Gynaecological Consultations

Two of our consultants are fertility specialists and they are able to meet with women and couples who have concerns about their fertility or wish to discuss fertility preservation. They are able to arrange all necessary investigations and outpatient treatment if required. We do not provide IVF treatment in our Centre and women who require more complex treatment would be given a choice of visiting one the several leading IVF units in London.

In women presenting with bleeding after menopause or irregular bleeding whilst taking hormone replacement therapy (HRT) our consultants are trained to identify the cause of bleeding and advise women on the need for additional treatment. They can also provide general advice on HRT and help women to choose preparations, which are safe and are associated with a lower risk of causing irregular bleeding.

All our consultants are experts in managing early pregnancy complications. In women who suffer miscarriage or ectopic pregnancy they can help women to make an informed choice between a non-interventional approach (i.e. pregnancy resolving naturally), medical treatment and surgery.  They can also discuss causes of pregnancy losses, additional investigations and risks of similar problems occurring in the future.  We are also able to provide contraceptive advice to women who wish to postpone or prevent future pregnancies.

Have questions?
Is it possible to diagnose ectopic pregnancy on the scan?
Experienced operators are able to detect almost all ectopic pregnancies measuring more than a few millimetres in size on ultrasound scan. It is important to emphasize; however, that ectopic pregnancies tend to develop more slowly than intrauterine pregnancies and it often takes them longer to grow to the size which makes them visible on the scan. Most women with a positive pregnancy test in whom ultrasound cannot identify a pregnancy have either normal pregnancies which are younger than expected from the date of their last period or they have already suffered a miscarriage. A small proportion of these women; however, may develop small ectopic pregnancies. A blood test is usually arranged in these cases to measure the levels of pregnancy hormones in women’s blood. Based on the result of the blood test we can advise women on the likely outcome of their pregnancy and on the need for further follow up.
Experienced operators are able to detect almost all ectopic pregnancies measuring more than a few millimetres in size on ultrasound scan. It is important to emphasize; however, that ectopic pregnancies tend to develop more slowly than intrauterine pregnancies and it often takes them longer to grow to the size which makes them visible on the scan. Most women with a positive pregnancy test in whom ultrasound cannot identify a pregnancy have either normal pregnancies which are younger than expected from the date of their last period or they have already suffered a miscarriage. A small proportion of these women; however, may develop small ectopic pregnancies. A blood test is usually arranged in these cases to measure the levels of pregnancy hormones in women’s blood. Based on the result of the blood test we can advise women on the likely outcome of their pregnancy and on the need for further follow up.
When can you see the baby’s heartbeat?
The earliest ultrasound can confirm the presence of a heartbeat is two weeks after a missed menstrual period or four weeks after conception. In women who conceive after IVF the heartbeat can be seen four weeks after the day of oocyte collection. Again, in order to avoid coming for the scan too early it is best to delay the attendance until two and a half to three weeks after the missed period or four and a half to five weeks after conception/oocyte collection.
The earliest ultrasound can confirm the presence of a heartbeat is two weeks after a missed menstrual period or four weeks after conception. In women who conceive after IVF the heartbeat can be seen four weeks after the day of oocyte collection. Again, in order to avoid coming for the scan too early it is best to delay the attendance until two and a half to three weeks after the missed period or four and a half to five weeks after conception/oocyte collection.
How soon after a missed period can pregnancy be seen on the scan?
A normal intrauterine pregnancy can be first seen on the scan three days after a missed menstrual period. In women who fall pregnant after fertility treatment such as ovarian stimulation the pregnancy can be seen 17 days after ovulation. In women who conceive after IVF the pregnancy can be seen 17 days after the day of oocyte collection. There are, however, small variations in the timing of conception and women who wish to confirm that their pregnancy is located within the uterus are advised to delay their attendance until a week after the missed period (or three weeks after conception) to avoid coming for the scan too early. This is particularly important in women with uterine abnormalities such as fibroids or adenomyosis, which make it harder to see the pregnancy and sometimes the diagnosis may be delayed for several days.
A normal intrauterine pregnancy can be first seen on the scan three days after a missed menstrual period. In women who fall pregnant after fertility treatment such as ovarian stimulation the pregnancy can be seen 17 days after ovulation. In women who conceive after IVF the pregnancy can be seen 17 days after the day of oocyte collection. There are, however, small variations in the timing of conception and women who wish to confirm that their pregnancy is located within the uterus are advised to delay their attendance until a week after the missed period (or three weeks after conception) to avoid coming for the scan too early. This is particularly important in women with uterine abnormalities such as fibroids or adenomyosis, which make it harder to see the pregnancy and sometimes the diagnosis may be delayed for several days.
Is it safe to have a scan in early pregnancy?
There is no evidence that ultrasound scans can harm pregnancies. It is important to ensure, however, that the energy of ultrasound beam is kept low. Use of pulsed Doppler devices to measure blood flow should be avoided in the first weeks of pregnancy as their energy output is higher compared to the ultrasound beam used for standard imaging. Our equipment is fully compliant with the international standards for safe use in pregnancy and the machine energy output is continuously monitored during the examination.
There is no evidence that ultrasound scans can harm pregnancies. It is important to ensure, however, that the energy of ultrasound beam is kept low. Use of pulsed Doppler devices to measure blood flow should be avoided in the first weeks of pregnancy as their energy output is higher compared to the ultrasound beam used for standard imaging. Our equipment is fully compliant with the international standards for safe use in pregnancy and the machine energy output is continuously monitored during the examination.
Is it possible to detect ovarian cancer on the scan?
Ovarian cancer can be accurately diagnosed on ultrasound scan. The best and most accurate way to diagnose ovarian cancer is by an expert performing a systematic and detailed examination of the tumour and the adjacent structures in the pelvis and abdominal cavity. The advantage of this approach is that it provides the information about the nature of the tumour instantly in the vast majority of cases, without the need of additional blood tests such as CA125 or MRI.
Ovarian cancer can be accurately diagnosed on ultrasound scan. The best and most accurate way to diagnose ovarian cancer is by an expert performing a systematic and detailed examination of the tumour and the adjacent structures in the pelvis and abdominal cavity. The advantage of this approach is that it provides the information about the nature of the tumour instantly in the vast majority of cases, without the need of additional blood tests such as CA125 or MRI.
Can you see Fallopian tubes on the scan?
Normal Fallopian tubes are very thin and they cannot be routinely seen on the scan. If the tubes are damaged, they tend to fill with fluid which makes it possible to see them. Tubal patency can be tested using a procedure called HyCoSy which is described in the section on the services we offer to women with concerns about their fertility.
Normal Fallopian tubes are very thin and they cannot be routinely seen on the scan. If the tubes are damaged, they tend to fill with fluid which makes it possible to see them. Tubal patency can be tested using a procedure called HyCoSy which is described in the section on the services we offer to women with concerns about their fertility.