Infertility examination

Problems with conceiving a child now arise in many couples. Experts recommend starting the examination for infertility in a year of unsuccessful attempts. However, many problems can be identified at the planning stage of the child, which is becoming more popular. This will help to save time and nerves.

Infertility, the diagnosis of which includes a specific initial list of studies, is suspected in couples if, with regular unprotected sex, pregnancy has not occurred within a year. And it should be borne in mind that with age this period decreases. A woman after 35 should visit a doctor after six months.

Regular sex involves sexual acts 3 times a week, ideally every other day from 8 to 18 day of the cycle, with its standard duration. More frequent contacts are contraindicated because they impair sperm quality.

Examination of infertility is carried out in two ways. The first is a phased elimination of possible causes. The second strategy involves testing all factors at once. A phased option saves money, and the last one - time.

The problem is that finding one cause does not exclude the presence of another. In 30% of cases, there are problems for both men and women.

So, the examination for infertility includes the following studies:

• Analyzes for STDs;
• Spermogram and MAR-test;
• Measurement of rectal temperature;
• Ultrasound and folliculogenesis;
• Hormonal examination;
• Check the patency of pipes;
• Postcoital test;
• Hysteroscopy;
• laparoscopy.

The first two items apply to both spouses, the rest - only to the woman. Ideally, all these studies can be done in a couple of months, but in practice this sometimes stretches for years. With a not very good spermogram, men are additionally assigned:

• Hormonal examination (estradiol, FSH, testosterone, LH, prolactin,);
• TRUSI;
• Sowing on the flora of the juice of the prostate.

The examination for infertility necessarily includes tests for STDs. Today, PCR is used most often for this. This is a very sensitive method, allowing to identify even a few DNA in the preparation.

It is necessary to be examined for cytomegalovirus, herpes, HPV, chlamydia, trichomanada, gonococci. Also it is necessary to make crops with an antibioticogram on mycoplasmas, ureaplasmas and pathogenic microflora. A doctor's examination and general strokes also need to be completed. Women will not hesitate to do colposcopy and analysis for atypical cells.

Inflammations in the reproductive system not only have a detrimental effect on the ability to conceive a child, but also on the ability to take it out. This deteriorates the quality of cervical mucus, endometrium, sperm, impaired ovarian function and patency of pipes.

Spermogram is the key link in the survey of a man. It allows to reveal the percentage of mobile spermatozoa, their normal forms and their concentration. These factors significantly affect the fertilizing capacity of sperm. The MAR-test reveals the number of spermatozoa coated with antibodies.

It is desirable for a woman at least 3 months to measure rectal temperature. This will help evaluate the function of her ovaries, try to track ovulation and suspect some pathologies. In the second half of the cycle, the temperature should rise by 0.4 degrees.

Ultrasound can detect many pathologies of the uterus and ovaries that prevent conception. Folliculometry helps to track the maturation of the egg and confirm ovulation.

Hysteroscopy consists in examining the uterine cavity from the inside. This study can reveal many of its pathologies (polyps, synechia, septum). At a laparoscopy examine bodies of a basin outside, check patency of pipes. This manipulation can become an operative intervention. In this case, foci of endometriosis, adhesions, cysts are removed.

Most often first passability of pipes is checked with the help of GHA. The solution is entered into the uterus and an X-ray or ultrasound is done. If the substance is poured into the abdominal cavity, the tubes are passable.

At postokoitalnom test the woman during ovulation after sex comes to clinic. She takes cervical mucus and determines the amount of sperm in her. Thus, they check whether they can get into the uterus from the vagina.

Hormones must be surrendered on the days of the cycle. And it is better taking into account the measurements of the rectal temperature and the individual duration of the cycle. You need to know the level of prolactin, progesterone, LH, estradiol, FSH, testosterone, DHEA-C, cortisol. It is also desirable to check thyroid hormones and TSH.

So, a test for infertility is recommended for spouses trying unsuccessfully to conceive within a year. It is better to immediately make the necessary research for both, since problems in one do not exclude them from the other. If a step-by-step version is chosen, then first a man is examined, since this is simpler.