Today we will talk about the basic concepts associated with the examination of a woman for fertility, if such prerequisites exist for a long period of time. A woman who wants and decided to become a mother, but cannot get pregnant in any way, should take this problem seriously and start with the diagnosis of her body. If the conception of a child does not occur, there are certain reasons for this. The purpose of diagnosis is to find out these causes, in order to then eliminate them and select a treatment aimed at restoring reproductive function.
The examination always begins with in this case it is a gynecologist-reproductologist – a specialist in the treatment of female infertility. At the appointment, the doctor takes an anamnesis and elaborates:
• the presence of genetic diseases in the family, whether the woman had earlier infections of the urogenital area, miscarriages, miscarriages;
• the age of the patient, the presence of concomitant pathologies and bad habits;
• if the couple has a second marriage – did the husband have children from the first marriage;
• whether the woman notes a number of symptoms indicating endocrine disorders: increased body hair, increased excitability, irascibility, anxiety, apathy, heart palpitations, weight loss or unreasonable weight gain;
• whether the patient has complaints indicating organic lesions of the reproductive organs and the growth of neoplasms in them: intermenstrual bleeding, heavy menstruation, lengthening of the menstrual cycle, its irregularity, pain in the lower abdomen, etc.
At the reception, the reproductologist usually does an ultrasound.
Ultrasound of the pelvic organs
This is one of the simplest, safest and most affordable diagnostic procedures. With the help of ultrasound, pathologies of the reproductive system of an organic nature are revealed:
1. adhesive process;
2. cicatricial changes;
3. foci of endometriosis;
4. myoma nodes;
5. hypo- and hyperplasia of the endometrium and polypous growths;
6. hypoplasia of the uterus and ovaries;
7. depletion of the follicular reserve;
8. ovarian cysts and uterine cavity;
10. cancer processes;
11. anomalies in the development of the uterus, etc.
Next, the doctor directs the woman to take tests. Tests for hormones and infections are of paramount importance in the diagnosis of infertility.
Tests for hormones
Violations of the hormonal nature most often do not have visible morphological changes in the pelvic organs, but make the process of conception and maintaining pregnancy impossible. Usually women need a definition of:
• the level of hormones that form the ovulatory cycle – FSH, LH, estradiol, testosterone;
• the level of hormones responsible for the onset and maintenance of pregnancy – prolactin;
• ovarian follicular reserve – AMH;
• levels of TSH and T4 – thyroid hormones that affect fertility.
A blood test for hormones should be taken in the first phase of the menstrual cycle – for 2-3 days.
Screening for infections
It is extremely difficult to identify infections such as cytomegalovirus, chlamydia, herpes virus: often the causative agents of these diseases persist (stay for a long time) in the body, without showing themselves in any way, until pregnancy occurs. After conception, immunosuppression (decreased immunity) occurs and infections can worsen.
Some viruses are teratogenic to the fetus. The bacteria can infect the baby through the placenta or during childbirth. In addition, some pathogens can disrupt the patency of the fallopian tubes and provoke infertility.
Polymerase chain reaction (PCR) is used to diagnose most genital and TORCH infections. The essence of the method is the repeated duplication of a piece of DNA with the help of enzymes.
All of the above tests allow you to determine the cause of infertility in most cases. But there are situations when the obtained data is not enough, and additional research is required. Among them:
4. genetic research;
5. endometrial biopsy and others.
If you feel that there is a problem or it may arise due to the presence of factors leading to infertility, including your age and state of your health, we recommend that you immediately contact a competent doctor to minimize and prevent the risks associated with the occurrence of diseases leading to infertility.
If you feel psychological uncertainty and discomfort on this issue and you have no one to discuss this problem with, we can organize an individual free seminar with you on any topic that interests you with the participation of a reproductologist. To do this, just write to us by mail with a request to help or simply choose one of our reproductive coaching programs that are interesting for you and your family.
Stay healthy and always sure of love, kindness and every goodness in your life!