Diagnosis of infertility

Since infertility can stem from disorders in the function of the reproductive system of either one or both spouses, both the man and the woman should undergo thorough examination. Anamnesis plays a crucial role in diagnosing infertility, so during the initial consultation with a reproductive specialist, it is necessary not only to provide detailed information about your problems but also to present, if possible, the results of analyses and examinations that have been conducted previously. The more complete the picture, the sooner the causes of reduced fertility will be identified, and an optimal course of treatment will be prescribed.

The diagnosis of infertility at the European Fertility Clinic is carried out using modern methods and diagnostic equipment.

Methods of examination in the diagnosis of infertility

Search for hormonal causes (the most common causes of female infertility: "insufficiency" of the second phase of the cycle, absence of ovulation, ovulation pathology)

To identify these causes, the following procedures are conducted:

• Monitoring of folliculogenesis in the natural cycle;
• Measurement of the patient's basal body temperature, from the fifth to the first day of the menstrual cycle (in the morning, in bed);
• Blood tests taken from a vein for testosterone, estradiol, free T4; FSH, TSH, LH, STG, DEA-S, GSPG (SHBG), cortisol, prolactin on the 3rd-5th day of the menstrual cycle, 17-oh progesterone.

The search for infectious causes, diagnosis of infertility, and its successful treatment are impossible without the elimination of infectious agents that exert their pathogenic effects on a woman's reproductive system and negatively affect her ability to conceive and give birth.

The group of infections collectively known by the abbreviation TORCH is relatively harmless for adults and children but extremely dangerous for pregnant women.

The letter "O" stands for "others," referring to infections that negatively impact the fetus. These include hepatitis C and hepatitis B, as well as chlamydia, gonococcal infection, listeriosis, and syphilis. Recently, chickenpox, enterovirus infection, and HIV infection have also been included in this list.

• T - toxoplasmosis,
• O - other infections,
• R - rubella,
• C - cytomegalovirus infection,
• H - herpes (herpes simplex virus)
• Bacteriological examination of the urogenital tract of the patient with subsequent identification of pathogens, among which Candida may be found
• Determination of sensitivity to antibiotics
• PCR of material from the patient's urethra and cervical canal for Mycoplasma hominis, Ureaplasma, Chlamydia, Mycoplasma, Gonorrhea, Trichomonas vaginalis, HSV 1.2, pathogenic strains of HPV
• Bacterioscopic examination of a native smear from the patient's urogenital tract discharge
• Analysis of venous blood for Listeriosis
• Determination of IgG avidity for Toxoplasma, CMV, rubella, HSV 1,2.
• ELISA of venous blood for rubella IgG, M; HSV 1 IgG, M; HSV 2 IgG, M; Toxo IgG, M; CMV IgG, M; Chlamydia IgG, M.

Exclusion of pathological processes that may decrease the chances of natural conception or successful IVF is achieved through pelvic examination of patients on days 3-5 and 19-21 of the menstrual cycle.

An important aspect in diagnosing the causes of infertility is determining the fertility of the patient's partner. A good semen analysis for the partner and a positive outcome from a consultation with an andrologist will contribute to the success of pregnancy.

In cases where male, endocrine, and infectious causes and factors are absent or corrected, additional invasive methods may be prescribed, which are used in operative gynecology (cervicohysteroscopy, hysterosalpingography, endoscopic examination of the pelvic organs). During these investigations, pathologies of the fallopian tubes, uterine cavity, and pelvic organs of the patient are excluded.

Often, invasive methods of investigation are prescribed by specialists at our center to determine the causes of infertility, with the most commonly used ones being cervicohysteroscopy and MLS (likely referring to magnetic resonance imaging, though contextually could be something else).

The list provided here serves as a general protocol for diagnosing male infertility. Naturally, the extent of recommended investigations is determined by the doctor on an individual basis. Depending on the circumstances, entire blocks of examinations from this list may be unnecessary.

To determine the scope and sequence of necessary investigations for you, it will be necessary to consult with a reproductive specialist.