Recently, the number of infertile couples has been growing. Therefore, the urgent question is what tests to take to a woman to detect infertility, and how to diagnose the impossibility of conception in men. In modern medicine, there are a number of diagnostic measures that allow you to determine the pathology in both women and men. Consider the features of each procedure, how and where to do it, and whether there are effective methods of treating infertility (female and male).
What is infertility?
Infertility is diagnosed to a woman when, after a year of sexual activity without protection, conception did not occur. According to statistics, about 60% of infertile couples were able to become parents as a result of proper diagnosis and appropriate treatment. In this case, with pathology, it is important to conduct a study correctly in order to identify the root cause, which may depend on a woman or a man. After all, half of the couples cannot have children because of male infertility.
What does infertility statistics say?
- Such a pathology of reproductive function, as infertility, equally affects both men and women.
- Almost every 10 couple is faced with the impossibility of conception, and this figure is growing every year.
- A third of women under 35 experience infertility and every second after 40.
- Every fourth infertile couple has more than one factor causing infertility.
- In 40% of women, infertility is associated with obstruction of the fallopian tubes.
- In 10% of couples it is not possible to identify the reason that led to the impossibility of conception, they are diagnosed with infertility of unknown origin.
Signs and causes of infertility in women
A couple who has not been protected for more than a year during intercourse, and conception has not come, is infertile. Although this time period is very arbitrary, because the older the woman, the more time her body may need to conceive a baby. In half the cases, it turns out that conception does not occur due to male infertility. To begin with, tests for female infertility are given.
Most often, the pathology proceeds without pronounced symptoms. Although a woman may have abnormalities in the functioning of the reproductive or endocrine system. This can be expressed by frequent gynecological problems, hormonal imbalance or in the development of the pelvic organs.
The causes of female infertility can be inflammation of the internal genital organs, a genetic predisposition, congenital anomalies in the development of the pelvic organs, surgical intervention in the organs responsible for reproductive function, as well as age. It is proved that after 35 years, a woman's chances of conceive and make a healthy baby are significantly reduced.
Signs and causes of infertility in men
In men, as well as in women, there is no characteristic symptomatology indicating infertility. Pathology can be detected only by diagnostic methods.
Among the main causes of male infertility are:
- varicocele - in the spermatic cord and testicle, the veins are dilated, due to which there is too high a temperature that prevents the sperm from ripening normally (detected in 15% of cases);
- congenital anomalies - the absence of one or two testicles, improper location or underdevelopment of the genital organs;
- injury to the scrotum, frenulum or testicle - occurs in 10% of cases;
- genital infections
- inflammatory processes - prostatitis, urethritis;
- hormonal failure - is rare in men, most often diagnosed in women;
- taking medications that have an overwhelming effect on the production of the required amount of sperm.
Also, lifestyle is affected by vitality - bad habits, strong physical exertion, frequent visits to baths and saunas.
Types of Infertility
Before taking an analysis of infertility in women, a specialist studies her anamnesis. Pathology can be primary, when the representative of the fair sex has not yet given birth, and secondary (childbirth has already been), but conception this time does not occur. Most often, the cause of primary infertility is endocrine disease, the secondary - diseases or injuries of the genital organs.
Types of infertility:
- absolute - there are no organs responsible for reproductive function;
- relative - may be temporary, which can be treated, or permanent (for example, appears after an abortion);
- immunological - can be male or female, appears after previous or chronic diseases;
- pipe - about 66% of women in Russia suffer from obstruction of the fallopian tubes;
- endocrine - hormonal failure;
- uterine - malformations of the uterus, cervix or its abnormal location;
- polycystic, endometriosis - occurs only in 4% of women and is accompanied by menstrual irregularities;
- genetic - can be the cause of both female and male infertility;
- psychological - occurs after stress and occurs in 30% of couples.
Where to start: infertility screening for women and men
Infertility can be associated with various disorders of the reproductive function of both men and women. Before conducting instrumental or ultrasound diagnostics of the internal genital organs, the doctor examines the history of each spouse. It is important to evaluate both a lifestyle that can affect the possibility of conception, as well as past illnesses or surgical intervention.
There is also such a factor as the incompatibility of partners. In order to determine whether this is the cause of infertility, the couple takes a post-coital test, as well as blood to determine the Rh factor.
Many people ask when to test for infertility in women. Experts are unanimous in this opinion and note that after a year of regular sexual activity without contraceptives and not the onset of conception, it is worth thinking about conducting a study. Although, according to the reviews of the women themselves, it is not necessary to be guided so much by precisely this time of 12 months.
Initially, a woman undergoes tests, including a smear on the flora, which can detect the presence of inflammatory processes, viruses or infections. Also, the fair sex is prescribed an ultrasound of the pelvic organs. Ultrasound can reveal pathologies in the development or location of the internal genital organs, especially the uterus and its appendages. If all these tests did not reveal any abnormalities in the woman’s health, then the sexual partner is diagnosed.
For men, it’s worth starting with sperm analysis. According to the reviews of women, men are reluctant to agree to the procedure, but with the help of this analysis it can be determined whether there are viable sperm and in what quantity.
Diagnosis of infertility in women
Ultrasound examination of the pelvic organs, as already mentioned above, are all women at the initial stage of infertility diagnosis. To obtain more accurate information, if this method was not informative, women are prescribed hysteroscopy. The essence of the method is that a hysteroscope (tube with a camera) is inserted into the uterine cavity, the resulting image is displayed on the screen. This allows you to examine the uterus and its contents in more detail, which is impossible using simple ultrasound.
A list of infertility tests in women.
- Tests for genital infections.
In some cases, infertility can cause inflammatory processes in the appendages, the presence of infection, which are asymptomatic.
- Analysis for sex hormones.
It is important to evaluate the hormonal background, since it directly affects the ovulation process, the possibility of not only conception, but also the bearing of the baby. To do this, TSH (checking thyroid function), FSH on different days of the menstrual cycle, LH (checking the ovulation process), as well as examining the levels of prolactin, estradiol and testosterone, are given.
- Analysis for the presence of antisperm antibodies.
Normally, they should not be in the body of a woman. Although even with their presence in the blood of a woman, conception can occur, although his chances are reduced by half.
- Tubal examination and laparoscopy.
It is necessary to check the patency of the fallopian tubes. In the vast majority of women, it is this factor that causes infertility. A special substance can be injected into the uterus, after which contrast pictures are taken. It is from them that you can determine obstruction zones.
Investigates for blood clots due to the density of blood or, conversely, its dilution. These factors can contribute to embryo death. According to reviews, the procedure is quite unpleasant.
Allows you to determine the function of a woman's ovaries, as well as their ovarian size. To do this, follicle-stimulating hormone is injected into the blood and monitoring of how it affects the woman's body is carried out.
A complex of tests for the diagnosis of infertility in men
The list of analyzes for infertility for men and women depends on the nature of the pathology, which is determined by a specialist. Diagnostic tests, as a rule, pass both partners at the same time.
In men, the reproductive system is much simpler, therefore, the number of their analyzes is insignificant in comparison with female diagnostics. Many couples, due to the ease and simplicity of determining male infertility, begin the diagnosis with a representative of the stronger sex.
List of tests for determining male infertility:
- spermogram - allows you to assess the number, motility and morphological composition of spermatozoa, as well as the presence of bacteria, fungi or the inflammatory process in sperm;
- bacteriological analysis;
- cytology - the prostate gland is examined;
- MAR-test - determines if the ejaculate has anti-sperm bodies.
The most informative method is the spermogram. Most often, she is the only analysis for the diagnosis of male infertility, which is carried out several times.
Also, representatives of the stronger sex can be prescribed a study of the hormonal background, screening methods (ultrasound of the scrotum to determine the structure of the testicles), TRUS (ultrasound of the prostate), genography (by introducing a contrast agent and X-ray, the narrowing of the seminal ducts is determined).
Postcoital test
Where to take tests for infertility of men and women, as well as which ones, is determined by the doctor. Diagnostics can be done in a private clinic or public health facility if you have the necessary modern equipment.
Rather common in Russia, but considered ineffective in European countries, is a postcoital test. The method can identify the causes of infertility in both men and women. Its essence lies in the study of mucus under a microscope, the collection of which is carried out several hours after intercourse. The study can determine if a woman has enough mucus after intercourse, its quality, as well as the presence of live sperm in it. If the sperm count is insufficient or most of them are “immobilized”, this may indicate poor sperm quality.
Recently, there are many methods and invasive techniques that are used instead of the post-coital test as an analysis of infertility in women and men.
Reviews
According to user reviews, the onset of the desired pregnancy begins after a comprehensive diagnosis, as well as competent therapy. It is important to choose a clinic according to the recommendations. Often, to identify the impossibility of conception in a woman, not the whole complex of diagnostic measures is carried out. Also, patients note in the reviews that it is worth to be patient and undergo an examination together with a partner. More than half of couples diagnosed with infertility could become parents only with the help of IVF after laparoscopy.
Also noted in the reviews is the importance of informing patients about the side effects of each method of diagnosing infertility. This often applies to laparoscopy and other instrumental techniques, which are fraught with consequences. Some women noted that after such a diagnosis, they started to bleed and had to be treated first, and then return to infertility therapy.
The usefulness of some diagnostic studies
Very often, when it is impossible to conceive and study reproductive function, a large number of different tests are prescribed. Some may harm the organs that are responsible for conception, not to mention the significant costs.
The most traumatic are considered invasive methods as tests for infertility in women. For example, hysterosalpingography, hysteroresectoscopy, or even simple hysteroscopy, that is, diagnostic curettage, can cause a number of complications. This can be endometritis or dysfunction of the uterine receptor apparatus, which will affect the reproductive function in the future.
Since female infertility is much more difficult to detect, it is better to start with a man. It is enough for him to pass a spermogram, which is the most informative method. Although, if it is impossible to conceive in a couple, both partners should be examined in parallel.
It is worth understanding and weighing the risks, since some procedures for women can be quite traumatic and fraught with infectious complications. How are women tested for infertility, says a specialist. It is important to adhere to certain rules in order to avoid negative consequences. Also, it is not necessary to carry out similar manipulations, for example, hysteroscopy and hysterosalpingosonography. These methods are absolutely identical in terms of informativeness and specificity of conducting, but hysteroscopy is considered a less invasive technique and with a minimum risk of possible infection.
Infertility treatment
The first condition that the doctor recommends when impossibility of conception is lifestyle correction. It is necessary to exclude all adverse factors. Further treatment is based on which of the partners is responsible for the impossibility of conception.
With poor sperm quality in a man, vitamins and special medications are prescribed for him. Varicocele and azoospermia are treated with surgery, and immune infertility with drugs.
Treatment of infertility in women begins with a search for the cause. Therapy can be carried out both conservatively and surgically. It is important to restore normal hormonal levels in endocrine diseases, normalize weight (the larger and heavier the woman, the less chance she has to conceive and bear a baby). Perhaps the appointment of physiotherapy or laparoscopic surgery to restore patency of the fallopian tubes.
If none of the methods helps either men or women, the couple is offered an IVF procedure, that is, artificial insemination. For this, the husband’s liveliest spermatozoa are selected by laboratory method and then planted in the uterine cavity. The procedure is quite expensive and requires a long preparation of a woman, including taking hormonal drugs, but effective.
Conclusion
Problems with conception are identified in every tenth couple dreaming of a baby. It is important to pay attention to the diagnosis of both male and female infertility in the early stages. A large half of couples with this diagnosis successfully become parents. Modern medicine can easily determine the root cause of the pathology and choose the appropriate treatment.