The fertility diagnostics of a couple is complex process, which has its rules and contributes to revealing the true cause of infertility.
After finding the cause the treatment is decided which is individual for every patient. Some cases are diagnostically easier while others require complex and elaborate examination.
By evaluation of higher amount and variety of examinations we are able to acquire more complex overview of possible cause of infertility. After this step, we can suggest optimal and most economical treatment.
We always recommend diagnosing the couple in order to find the cause – both man and woman.
The initial examination of man is very simple and fast (spermiogramme).
The basic examination of woman is thorough gynecological examination by a specialist and examination of blood.
Spermiogramme examinations – basic and thorough (for pathological values)
If spermiogramme values are pathological, following examinations are needed:
Sperm Flow Test – examination of sperm acrosome integrity, intracromosile protein, sperm lifespan
Palpation gynecological examination – routine part of basic examination for evaluation of small pelvis organs.
Ultrasound examination of small pelvis
Basic examination consists of performing transvaginal or abdominal ultrasound examination of small pelvis (uterus, ovaries and their surroundings) with respect to menstruation cycle. Ultrasound examination can evaluate the size and shape of uterus, presence of pathological formations (myoms), height and quality of endometrium. It provides information about the state of ovaries, follicle growth, presence of cysts and in some cases about the endometriosis.
Blood examination during the 2. - 4. day of menstruation provides us with information about the state of ovaries, their ability to create sufficient number of oocyte and possible answer to stimulation treatment.
The level of follicle stimulation hormone (FSH), luteinization hormone (LH) and Anti-Müllerian hormone (AMH) as basic indicators of ovarian reserve are being examined. Important part of hormonal examination is determining the level of prolactine (PRL) and thyroid gland hormones (TSH, FT3, FT4).
RTG uterus and fallopian tubes examination
Hysterosalpingography (HSG) – out of date examination, almost not performed nowadays.
Ultrasound uterus examination
Substitutes HSG, the contrast agent is applied under the ultrasound control into the uterine cavity while its penetration into fallopian tubes is being watched. It’s called HyCoSy (hysteron-salpingo-contrast-sonograpfy).
Hysteroscopy is a method which allows visualization of uterine cavity and performance of various operations in the cavity and cervix (membrane biopsy, polyps and adhesions removal, etc.). Examination is done with use of special device – hysteroscope. Hysteroscopy is either diagnostic – possible without anesthetics or surgical – with anesthetics.
Laparoscopy is examination method, which allows examination of abdominal cavity and tubal patency. It’s one of so called methods of minimal invasive surgery – it is possible with the use of special tools and few punctures to display abdominal cavity and perform desired surgical operation without the need of opening the abdominal cavity. Laparoscopy is diagnostic or treatment method, both require anesthetics.
This is chromosome examination by special techniques, which provides us with information about patient’s genetics. Abnormal findings could be one of the infertility causes, could lead to treatment failure and often lead to recurrent miscarriages. Men with pathological genetic finding can suffer from sperm production and development disorders.
Immunological examination is another important woman examination. Sperm, oocyte, embryo and antiphospholipid antibodies are being examined. In some cases (recurrent miscarriages, recurrent unsuccessful treatment, etc.) the examination of cell immunity is performed.
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