Diagnostics

The aim of the examinations is to find out the causes of infertility as well as its subsequent elimination or treatment. Both partners are always examined. However, in some couples even after undergoing all possible examining methods the cause of infertility is not detected (so-called idiopathic infertility). Due to improving the diagnostic process a number of such couples has gradually been declining.

Examination of a woman

Baseline examinations:

  • Interview with a patient (course of the menstrual cycle, past medical history, already performed examinations and previous infertility treatment, etc.) and baseline pelvic examination (through palpation and using speculum, including cervical oncocytology).
  • Ultrasound examination (basic and folliculometry – evaluation of follicular growth in the course of menstrual cycle).
  • Vaginal and cervical bacteriology (collection of cervical and vaginal specimens in order to determine the presence of infection) (aerobic and anaerobic bacteria, chlamydia, ureaplasma and mycoplasma infections).
  • Blood testing for sexually transmitted diseases.
  • Blood testing on the 3rd day of the menstrual cycle for hormonal levels.
  • Laparoscopy (LSC = operative procedure under general anaesthesia) or hysterosalpingography (HSG = ambulatory X-ray procedure with a contrast medium) in order to evaluate the condition of internal sex organs (uterus, ovaries, oviducts, along with evaluation of their patency, if appropriate removal of adhesions, endometriosis lesions, etc.).

Examinations referring to points 1-5 are possible to perform with a general gynaecologist, who subsequently refers the patient with her results to a centre for assisted reproduction.
Examination referring to point 6 is performed by departments of gynaecology in the respective catchment area or by physicians in a centre for assisted reproduction.

Additional examinations:

  • Hysteroscopy (diagnostic or also operative procedure, mostly performed under general anaesthesia in order to evaluate the condition of the uterine cavity, uterine mucosa and openings of the oviducts).
  • Postcoital test (evaluation of mucus quality, sperm count and motility after a normal sexual intercourse).
  • Genetic testing (suspicion for genetically conditioned infertility disorders).
  • Examination for detecting the presence of diseases causing higher blood coagulation resulting in higher likelihood of miscarriage.
  • Immunological examination (presence of antibodies against sperm and eggs).
  • Psychological and sexuological examinations (difficulties during a sexual intercourse, psychoreactive disorders, etc.).

Examination of a man

Baseline examinations:

Spermogram
Basic male fertility testing is a spermogram (semen analysis). For a semen analysis it is necessary to bring or hand in the ejaculate directly at our Centre. Semen analysis is carried out according to the 2010 WHO Guidelines.

Before a semen analysis sexual abstinence is advised during the previous 3 days.

A male comprehensive examination includes also an examination of man’s hormonal profile, test for sexually transmitted infections and assessment of erectile ability.

Additional examinations:

Urological examination.

  • Blood testing for sexually transmitted diseases.
  • Genetic testing (suspicion for genetically conditioned fertility disorders, serious disorders of semen analysis, or before an attempt of surgical sperm retrieval).
  • Hormonal levels testing (in serious disorders of semen analysis).
  • Psychological and sexuological examinations (impotence, insufficient erection, absent ejaculation, etc.).


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