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Clearing the Way to Motherhood-Fertility Evaluation

fertility evalutation
We love helping women get ready for fertility treatments.

If you are dreaming of expanding your family and welcoming a little one into the world, it’s important to know about potential obstacles within your body that could delay conceiving.

Many couples who have trouble conceiving begin intrauterine insemination (IUI) or in vitro fertilization (IVF) treatments before getting evaluated thoroughly by a GYN surgical specialist. After spending hundreds or thousands of dollars for these treatments, some couples discover that a condition exists that needs to be treated or removed before proceeding with additional treatments.

Ljubica fertility evaluation
Ljubica, a few weeks before welcoming Aleksandra

We recently featured Ljubica and her daughter Aleksandra in Fertility Surgery: A Love Story, which focused on two procedures with CIGC. The first was the removal of a fibroid that appeared after hormone therapy for fertility treatment, and the second was the removal of a uterine polyp. After these procedures with Dr. Paul MacKoul, Ljubica was actually able to conceive naturally.

We also featured The Fibroid-Fertility Connection, going more in-depth on how removing fibroids increases fertility rates, and our minimally invasive LAAM procedure helps women recover faster.

In addition to fibroids and uterine polyps, other conditions exist that can block any of the pathways to conception (sperm to egg, or embryo to uterus), or create an inhospitable environment for an embryo to attach to the uterine wall, resulting in possible miscarriages.

Understanding How the Pathway to Conception Can Be Blocked

Hydrosalpinx is a fluid-filled fallopian tube: A normal tube will push an embryo toward the uterus but a hydrosalpinx has abnormal flow. This increases the chance for the embryo to implant within the fallopian tube, resulting in an ectopic pregnancy. This can be a life-threatening situation for a woman.

In addition, it is thought that the inflammatory fluid can flow into the uterus, causing a hostile environment for an embryo and limits the potential for implanting. Presence of a hydrosalpinx was associated with a 50 percent lower success rate among women undergoing IVF.

TREATMENT: A hysterosalpingogram can evaluate whether the tubes are open and assess their overall shape. Dilated or abnormal tubes can be evaluated at the time of laparoscopy. Hydrosalpinges can be removed laparoscopically and is the treatment of choice for women who will undergo IVF.

Uterine septum is a wedge-like wall at the top of the uterus, which protrudes into uterine cavity: Women with a uterine septum are at a significantly higher risk for miscarriage and infertility. If an embryo is able to successfully implant, the septum is usually unable to support the growing embryo with adequate blood supply and nutrients, resulting in early pregnancy loss.

TREATMENT: Uterine septum can be removed hysteroscopically. Hysteroscopic procedures do not require any incisions, and most women are able to return to work the following day.

Adhesions are organs or structures within the pelvis that are stuck together: Pelvic adhesions can simply be two structures adherent to one another, or they can be bands of adhesions between two structures. Intrauterine adhesions are usually the result of uterine trauma (such as dilation and curettage (D&C), myomectomy, cesarean delivery) or pelvic infection. Adhesions can vary widely in severity.

Adhesions surrounding the ovary may impair the ability of an egg to reach the tube after ovulation. Adhesions of the tube can prevent the sperm from reaching the egg, or an embryo from reaching the uterus.

TREATMENT: Depending on the type and severity of the adhesions, hysteroscopy, laparoscopy or a combination of both may be used in treatment. DualPortGYN is a procedure developed by the surgeons at The Center for Innovative GYN Care, and can be used to safely and effectively remove pelvic adhesions.

Fertility evaluation
Emily and her Daughter, 2 years after treatment at CIGC

Fertility Evaluation

Women who have had trouble conceiving with IUI or IVF treatments should consider getting an evaluation with a GYN surgical specialist. The advanced trained surgical specialists Paul MacKoul MD and Natalya Danilyants MD at The Center for Innovative GYN Care have designed minimally invasive procedures to diagnose & treat possible causes of infertility, with the shortest recovery time, to help you start your family sooner.

You can learn more by watching our new videos on Infertility, the LAAM myomectomy (removal of fibroids), DualPortGYN, and also watch Emily’s story.


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Surgical specialists can often see patients sooner because they are focused entirely on surgery. Each patient gets detailed, in depth attention from Dr. Danilyants and Dr. MacKoul. This personalized care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD or Natalya Danilyants MD.


Vitals, RateMDs, Google Plus, WellnessUCompareHealthCare.

Vitals, RateMDs, Google Plus, WellnessUCompareHealthCare.


CIGC travel program

Even if you are not from the DC area, many patients travel to The Center for Innovative GYN Care for our groundbreaking procedures. We treat women from around the world who suffer from complex GYN conditions.

Learn more in our travel program.