Diagnosis is the key stage of infertility treatment.

Its results help to indicate reasons for conception problems.

What is more, infertility diagnosis largely simplifies finding the best treatment method with the precise identification of causes of the problem. Let us remember that preliminary examination should involve both partners for the optimal determination of therapeutic procedures.

Diagnosis of infertility

Diagnosis of infertility

When is infertility diagnosis appropriate?

If after one year of regular efforts to have a baby (without contraceptives), a woman is still unable to get pregnant, it is definitely a signal to start the treatment.

If the woman is 35, it is recommended to begin infertility diagnosis earlier. In which cases? When one of the below was observed during previous interviews:

  • Oligo/amenorrhea bleeding disorders
  • Uterus, fallopian tubes pathology
  • Endometriosis
  • The occurrence of a serious male factor.

How to start?

Infertility diagnosis in 3 steps.

Step 1

Medical history which is a comprehensive health condition analysis

Diagnosis of infertility

The assessment mainly involves measuring the effectiveness of male and female reproductive cell production. It is also important to assess the reproductive potential of the partners, which is the proper forecast concerning conception on the basis of the woman’s monthly cycle.

Medical history is the early stage of infertility diagnosis: identification and diagnosis of potential diseases which have a direct or indirect cause of the problem.

  • Woman’s age
  • Previous fertility
  • Time trying to have a baby
  • Intercourse frequency and intensity
  • Concomitant diseases
  • Use of stimulants
  • Eating habits

Step 2

Detailed physical examination

Diagnostyka nieplodnosci

Gynecological examination is of high importance in this case. The main focus is on the following examinations:

  • Woman’s age
  • Ultrasound, the so-called USG, which is usually done via the intravaginal route
  • Hysterosalpingography, HSG
  • Contrastive hysterosalpingography, HyCoSy
The aim of the above examinations is to correctly determine the anatomy and the functionality of ovaries and fallopian tubes (with the special emphasis on the ductility of the ducts), the uterus and the endometrium.
Laparoscopy may be the examination of equal importance in the infertility diagnosis. It is recommended, first and foremost, when the patient has undergone a surgery (such as surgeries on reproductive organs or appendicitis surgery) or in case the appearance of adhesion or endometriosis is suspected, and inflammation of reproductive organs occurred in the past.

Step 3

Additional tests

These tests help determine the causes of conception problems. The tests include:

  • semen analysis (seminogram)
  • Computer sperm analysis (SCSA)
  • hormonal test
  • Ovarian reserve assessment (AMH)
  • Immunological tests
  • Genetic test
  • Bacteriological tests
  • other (PCT test / post-intercourse)
  • USG 3D

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Factors supporting female fertility:

  • avoiding stress
  • relaxation
  • Appropriate body weight
  • Taking vitamin C, E and B group
  • Diet rich in zinc, iron copper and magnesium

Factors supporting male fertility:

  • active lifestyle
  • low-fat diet rich in fruit and vegetables
  • taking vitamin A, C, E and zinc

Infertility diagnosis

Procedure scheme

for infertile couple at IVITA

Definition

Infertility- no pregnancy despite regular sexual intercourse (3-4 times per week) maintained in the course of over 12 months, without contraceptive and with the parallel lack of known pathology.

In the case of predisposing infertility factors (eg. period disorders, former pelvic inflammation conditions, aged over 36) early start of diagnosis is permitted.

Male patient

Detailed interview during the visit.
Semen analysis – before the test, one should abstain from sexual activities for 3 to 5 day before the test. The waiting time for the result is approx. 3-4 hours from the time of material submission (for the basic test), and approximately 24 hours for the extended test. The correct result does not require verification. In the case of abnormal result:

  • lifestyle risk factors assessment
  • potential urological consultation or genetic test

Female patient

Detailed interview during the visit.

Physical examination and ultrasound during the visit.

Confirming ovulation – hormone test and possible ovarian reserve assessment + AMH test (determination of the Anti-Mullerian hormone in venous blood, helpful in the assessment of female fertility) in the course of the a monthly cycle (approx. 28-32 days)

Uterus and fallopian tubes assessment:

  • If there are no risk factors and for the age of 35, Sono HSG examination is performed. It is a safe and effective method to assess uterine cavity and fallopian tubes, which involves the administration of physiological saline with the use of a catheter, under continuous ultrasound control. The aim of the examination is to detect potential abnormalities in the shape of the uterus and the blockage of fallopian tubes. The test is performed in the first phase of the monthly cycle – the result is obtained the same day.
  • If there are risk factors (eg. past inflammations, surgeries, positive Chlamydia trachomatis test (bacterial species, the treatment lasts approx 1-2 months)) suspicion of endometriosis (endometriosis- the presence of uterine mucosa outside the uterus) – laparoscopy and hysteroscopy.
Abnormality in Sono HSG result or a suspicion of other pathology – laparoscopy and hysteroscopy.
Correct Sono HSG or laparoscopy – intrauterine insemination (IUI) with the partner’s or a donor’s sperm in the case of male infertility. The insemination can be performed in the same cycle.
The occurrence of ovarian factors, endometriosis, advanced age of the female patient, low ovarian reserve, low sperm parameters or the unexplained infertility ineffectively treated with previous methods (2-3 IUI cycles), in-vitro fertilization including oocyte donation procedure.

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