Many couples have problems conceiving a baby today. Experts recommend starting a fertility examination after a year of unsuccessful attempts. However, many problems can be identified at the planning stage of the child, which is becoming increasingly popular. This will help save time and nerves.
Infertility, the diagnosis of which includes a specific initial list of studies, is suspected in a couple if pregnancy does not occur during a year with regular unprotected sex. Moreover, it should be borne in mind that with age this period decreases. A woman after 35 should visit a doctor in six months.
Regular sex involves intercourse 3 times a week, ideally every other day from 8 to 18 days of the cycle, with its standard duration. More frequent contacts are contraindicated because they impair sperm quality.
An examination for infertility is carried out in two ways. The first is to phase out possible causes. The second strategy involves checking all factors at once. The phased option saves money, and the latter saves time.
The problem is that finding one cause does not exclude the presence of another. In 30% of cases, both men and women have problems.
So, an infertility test includes the following studies:
- tests for STDs;
- spermogram and MAR test;
- rectal temperature measurement;
- Ultrasound and folliculogenesis;
- hormonal examination;
- pipe cross check;
- post-coital test;
- hysteroscopy;
- laparoscopy.
The first two items apply to both spouses, the rest - only to the woman. Ideally, all of these studies can be completed in a couple of months, but in practice, sometimes this 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 prostate juice.
Infertility screening necessarily includes tests for STDs. Today, PCR is most often used for this. This is a very sensitive method that allows even a few DNA to be detected in a preparation.
Be sure to be tested for cytomegalovirus, herpes, HPV, chlamydia, Trichomonas, gonococci. It is also necessary to make crops with an antibioticogram for mycoplasmas, ureaplasmas and pathogenic microflora. A doctor's examination and general smears also need to be passed. Women can benefit from colposcopy and atypical cell analysis .
Inflammations in the reproductive system not only adversely affect the ability to conceive a child, but also the ability to bear it. At the same time, the quality of cervical mucus, endometrium, sperm is deteriorating, ovarian function and tube obstruction are impaired.
Spermogram is a key link in the examination of men. It allows you to identify the percentage of motile sperm, their normal forms and their concentration. These indicators significantly affect the fertilizing ability of sperm. The MAR test reveals the amount of sperm coated with antibodies.
It is advisable for a woman to measure a rectal temperature for at least 3 months . 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 allows you to detect many pathologies of the uterus and ovaries that prevent conception. Folliculometry helps to track egg maturation and confirm ovulation.
Hysteroscopy consists in examining the uterine cavity from the inside. This study allows us to identify many of its pathologies (polyps, synechia, septum). When laparoscopy examines the pelvic organs from the outside, check the patency of the pipes. This manipulation can become an operative measure. In this case, foci of endometriosis, adhesions, cysts are removed.
Most often, pipe patency is first checked using GHA. A solution is injected into the uterus and an x-ray or ultrasound is done. If the substance is poured into the abdominal cavity, then the pipes are passable.
In a post-coital test, a woman comes to the clinic during ovulation after sex. She takes cervical mucus and determines the number of sperm in it. Thus, they check whether they can enter the uterus from the vagina.
Hormones must be given on a cycle day. Moreover, it is better taking into account measurements of rectal temperature and individual cycle duration. You need to know the level of prolactin, progesterone, LH, estradiol, FSH, testosterone, DHEA-C, cortisol. It is also advisable to check thyroid hormones and TSH.
So, the examination for infertility is recommended for spouses who are trying to conceive unsuccessfully for a year. It is better to immediately do the necessary research for both, since problems in one do not exclude them in the other. If a phased option is chosen, then the man is first examined, because it is easier.