home Audience 2 Female infertility: causes, diagnosis and treatment. Immunological methods for diagnosing female infertility. Causes of female infertility

Female infertility: causes, diagnosis and treatment. Immunological methods for diagnosing female infertility. Causes of female infertility

The birth of a baby is the most an important event in family. But not everyone is able to have children due to illness. reproductive system. Modern medicine learned to overcome these problems, now doctors have a whole arsenal of remedies to drug therapy to "heavy weapons" in the form of auxiliary reproductive technologies. IVF procedures are not only a serious test for female body, but also a very expensive service. In pursuit of profit, many “fertility clinics” do not even try to use other treatment methods, immediately moving on to the most expensive service - IVF. Doctors at the Vitalis Clinic specialize in restoring reproductive function without in vitro fertilization. We try to use gentle methods of treating infertility and recommend that couples use ART only in cases where this is truly the only way to achieve pregnancy. Our doctors help couples cope with the diagnosis of infertility and become parents.

Factors influencing reproduction in men
Factors influencing reproduction in women

Diagnosis of infertility in men
Diagnosis of infertility in women

Treatment of infertility in men
Treatment of infertility in women

How common is the problem?

According to WHO (World Health Organization) criteria, there is a 15 percent rate of infertile couples reproductive age considered a threat to the country's national security. In Russia this figure is 17-20% and has a negative trend. This dry statistic means that every fifth family among our friends and acquaintances is faced with the problem of infertility.

When is infertility diagnosed?

The official WHO definition states: “Infertility is the failure of a sexually active, non-contraceptive couple to achieve pregnancy within one year.” Of course, there is a chance of getting pregnant later, but the highest chances of pregnancy are in the first year (provided that the couple is not protected), then the chances decrease every year. If you were unable to get pregnant in the first year, do not waste precious time and seek help from a doctor.

Causes of infertility

Although the wording of the diagnosis refers to the couple's inability to achieve pregnancy, it is a common misconception that the cause most often lies with the woman. This is not surprising, since 10 years ago even doctors did not consider the “male factor”. Medical centers Often, even now, the treatment of infertility refers to the treatment of women, and men make a direct connection between their “ male power"and the ability to reproduce (note, completely unfounded). According to the European Association of Urology, in 50% of cases, the absence of pregnancy is due to problems in the man. Therefore, it is better for a married couple to come to the clinic together for the first consultation. This will significantly reduce the time to find out the cause of infertility in your particular case.

What examinations are needed?

To choose the right tactics for the upcoming treatment, it is extremely important to find out the exact cause of infertility, for which it is necessary to conduct a diagnosis. Ultrasound examination of the reproductive system is usually used as a basic examination. hormonal tests blood, check for infectious diseases. However, a number of different laboratory and instrumental studies.

Get tested and pass everything necessary tests You can do it in our clinic. If you have the results of previous examinations, take them with you.

Infertility treatment

The method of treatment depends on the identified cause of infertility and can range from drug therapy to surgery and the use of ART. Correct diagnosis and correct established diagnosis allow you to choose the optimal treatment option for a given case and achieve the highest possible effectiveness.

It is also worth considering that treatment in men is a longer process than in women, which is associated with different durations of the maturation cycles of sperm and eggs (the process of spermatogenesis takes almost three months, unlike the usual 1 month for women).

The main task of the doctors at the Vitalis Clinic is to thoroughly understand the problem of a particular married couple and solve it in the most gentle way possible. People often come to our clinic with complex cases already have bad experience treatment and have gone through unsuccessful IVF attempts. We know how to cope with difficult tasks and are sincerely happy when we manage to help such families.

Doctors at the Vitalis Clinic specializing in the treatment of infertility

Cost of infertility treatment services at the Vitalis clinic

Specialist consultations

Content

Diagnosis of infertility includes examination of sexual partners for diseases of the reproductive system and involves the use of instrumental, laboratory, hardware, invasive surgical tactics. Thanks to modern methods The study is able to timely identify severe pathologies of the reproductive system: endocrine, congenital, infectious, genetic abnormalities. Diagnostic measures are aimed at choosing the optimal and quick option infertility treatment, following an individual approach.

When to see a doctor

Diagnosis of infertility, according to WHO standards, should be carried out within 3-4 months from the moment a couple seeks medical help.

Lack of pregnancy with active planning throughout the year when not used oral contraceptives And barrier methods protection becomes a reason to visit a doctor. The inability to conceive may not be accompanied by other symptoms, but most often women notice some clear or minor pathological signs.

It is necessary to undergo an examination for infertility if certain symptoms occur.

Irregular menstrual cycle, manifested by the onset of menstruation more often than once every 24-25 days or less than once every 35 days.
Scanty or excessively heavy painful menstruation.
Appearing in the middle menstrual cycle bloody discharge, and brown daub at the beginning of menstruation.
Excessive body hair growth, oily, problematic skin along with cycle disruption.
Appearance painful sensations during sexual intercourse (except for the ovulatory period).
Infectious and inflammatory processes of the genital tract, manifested pathological discharge With unpleasant smell, itching, worsening cystitis and urethritis. The discharge may be mucopurulent in nature and contain fresh or altered blood.
Release of milk from the breast.

Weakly positive tests and the subsequent onset of menstruation, a history of miscarriages, missed pregnancies are also considered reasons to consult a specialist.

In the process of diagnosing infertility, the following diseases can be identified:

bends of the uterus;
endometriosis;
ovarian cysts;
fibroids;
polycystic ovaries;
pathologies of the cervix (cervical stenosis, endocervicitis, dysplasia, polyps);
endometritis;
adnexitis;
hyperplastic processes in the endometrium;
adhesive process in the tubes and pelvis.

In the absence of detection of diseases of the reproductive tract in a man or woman, a diagnosis of “idiopathic infertility” or infertility of unknown origin is made.

A history of several cleansings, which could lead to damage to the basal layer of the endometrium, is also considered a reason to visit specialists and diagnose infertility.

Diagnosis of female infertility

Diagnosis of infertility in women includes a number of methods, the list of which is determined by the duration of the complaints, as well as the type of infertility. Highlight primary infertility, in which pregnancy never occurred, as well as secondary, when the facts of conception were present earlier.

In the primary form, studies are carried out as part of the diagnosis of infertility, aimed at identifying obvious pathology:

general examination and medical history;
examination of the cervix in the speculum, palpation of the uterus and appendages;
smears for genital infections, oncocytology;
colposcopy;
Pelvic ultrasound, including folliculometry and Doppler ultrasound;
blood tests for sex hormones.

If necessary, consultations are scheduled related specialists(endocrinologist, immunologist, therapist, surgeon). To a man within primary diagnosis for infertility, semen analysis and smears for sexually transmitted infections are prescribed.

If there is no pathology, the couple is sent for further planning, while vitamin therapy, diet, giving up bad habits, and measurement are prescribed or recommended. basal temperature to identify the most suitable days for conception.

Consultation with a gynecologist and medical history collection

Diagnosis of diseases of the reproductive tract in women with suspected infertility includes taking an anamnesis:

the duration of impossibility of conception in a particular marriage;
information on the number of marriages, presence and number of pregnancies;
methods of protection used;
presence of bad habits;
features of the menstrual cycle, its debut and duration of establishment;
family history on the female side;
the presence of diseases of the genital organs and extragenital pathologies;
analysis of previous treatment and diagnosis.

After receiving information about a woman’s reproductive status, the gynecologist forms a general picture of the situation, which allows him to optimally prescribe a list of measures for diagnosing infertility.

Physical examination

The collection of anamnesis during diagnosis ends with an examination of the woman and an assessment of external pathognomonic signs that indicate gynecological diseases.

Height, weight and BMI are subject to determination, which is normally 20-26. If the values are outside the acceptable intervals, find out the time of the beginning of the decrease or increase in body weight, the rate and possible reasons.
Assessment of the degree and nature of hair growth, the presence of stretch marks, acne.
Palpation of the mammary glands.
Examination of the cervical part of the uterus in speculums, diagnosis of pathologies using smears (microscopy and cytology) and colposcopy.
Ultrasound of the pelvic organs.

The initial appointment with a doctor ends with the appointment of more detailed studies for subsequent diagnosis of infertility.

Laboratory diagnostics

Laboratory methods for diagnosing infertility include testing for possible infections that affect reproductive status, as well as determining the level of sex hormones.

Diagnosis of endocrine infertility in women includes tests for:

first phase hormones (follicle-stimulating, luteinizing, estradiol);
second phase hormone (progesterone);
male sex hormones and metabolites (DHEA sulfate, 17-OH-progesterone, free testosterone);
egg reserve indicator (anti-Mullerian hormone, inhibin B);
prolactin;
hormones thyroid gland.

During diagnosis, it is advisable to take a cortisol test if there is an existing irregularity in the menstrual cycle.

In addition to hormones, when diagnosing infertility and suspected polycystic ovary syndrome, the level of insulin, glycated hemoglobin, and a glucose tolerance test are determined.

If immunological infertility is suspected, an antisperm antibody test is performed.

Diagnosis of the endocrine form of infertility allows us to determine hypothyroidism, hyperestrogenism, hyperandrogenism of ovarian and adrenal origin, ovarian wasting syndrome, and suspect polycystic disease - the most common reasons infertility in women.

Diagnosis of infections involves:

detection of the level of antibodies to cytomegalovirus, toxoplasma, rubella virus and herpes simplex viruses;
examination of vaginal smears using microscopy for the diagnosis of thrush, gonorrhea, trichomoniasis, gardnerellosis, degree of purity;
sowing the discharge onto nutrient media to detect the growth of opportunistic flora (diagnosis of dysbacteriosis);
smears from the urethra and cervical canal for the presence of chlamydial, mycoplasma and ureaplasma infections, genital herpes, cytomegalovirus, papillomavirus (PCR method).

When diagnosing infertility, vaginal microbiocenosis can be assessed using the Femoflor analysis.

Chronic genital tract infections are becoming one of the leading causes of female and male infertility.

Hardware diagnostics

The most effective and simplest method for diagnosing diseases of the genital organs is ultrasound. Ultrasound diagnostics allows you to detect fibroids various localizations, adenomyosis, ovarian cysts, large polyps, uterine anomalies (bicornuate, saddle uterus).

In order to diagnose endometrial hyperplasia, polyps, endometriosis, ultrasound diagnostics are carried out at the end of the menstrual cycle. It is advisable to diagnose other pathologies at the beginning of the cycle.

Diagnosis of cervical pathologies using extended colposcopy makes it possible to identify endocervicitis, pseudoerosion, dysplasia, leukoplakia, and erythroplakia. The surface of the neck is treated with solutions acetic acid and iodine.

Thanks to an iodine-based reagent, it is possible to determine the boundaries of the junction of two types of epithelium, the transformation zone. Iodine does not stain the columnar appearance of the epithelium in Brown color, so the doctor can easily visualize the boundaries and state of the tissue transformation zone.

Acetic acid affects the vessels of the cervix, leading to their short-term spasm. Normally, capillary spasm gives the surface of the cervix temporary pallor. But with dysplasia, leukoplakia, and cancer, acetowhite epithelium is noted - a prolonged spasm of the capillaries, as well as mosaic and punctation ( pathological changes vascular pattern), atypical tortuous and corkscrew-shaped vessels.

Diagnosis of cervical diseases makes it possible to identify the cervical form of infertility.

Hardware diagnostic methods also include MRI of the sella turcica to detect pituitary microadenoma, a sign of which is considered to be an increase in prolactin.

Surgical examination

At the second stage of diagnosing infertility, when attempts to become pregnant have not been successful and the couple has applied for re-examination, the gynecologist must prescribe invasive instrumental methods to the woman.

Examination for infertility in women at the second stage includes diagnostic hysteroscopy and laparoscopy.

Surgical diagnostic methods allow a detailed examination of intrauterine formations and pathological processes in the pelvis.

The hysteroscope is equipped with a video camera and during its insertion into the uterine cavity it is possible to detect conditions not visible on ultrasound, in particular, adhesions and polyps.

In addition, invasive diagnostics of intrauterine pathologies makes it possible to determine:

the state of the entrance to the lumen of the pipes, their patency;
the presence of adenomyosis;
endometrial hyperplasia of a diffuse and focal nature;
submucous fibroids;
Uterine anomalies: saddle-shaped, bicornuate uterus.

In the process of diagnostic hysteroscopy, the removal of pathological formations that initiate infertility is carried out in parallel.

After a successful hysteroscopy, pregnancy occurs within six months.

In addition to hysteroscopy, if obstruction is suspected fallopian tubes perform two more studies:

hysterosalpingography;
echohysterosalpingoscopy.

The first method for diagnosing tubal infertility in women involves the use of X-rays and a radiopaque substance that is injected into the tubes. Considering the radiation exposure, specialists are increasingly resorting to a diagnostic method such as echohysterosalpingoscopy, which means introducing an echo contrast agent (Furacilin, distilled water, saline solution) into the tubes, then performing an ultrasound.

Diagnostic laparoscopy is a method of examining the pelvic cavity using endoscopic equipment. Diagnostics female infertility Using laparoscopy, you can detect:

tubo-peritoneal infertility;
obstruction of the fallopian tubes;
endometriosis of the peritoneum, ovaries;
intramural and subserous fibroids.

During the operation, formations are removed and adhesions are dissected. A few months after diagnosis and treatment by laparoscopy, many women experience natural pregnancy.

Using Functional Tests

Tests functional diagnostics in case of infertility they are used to evaluate hormonal regulation in a woman's body. Tests are used for self-administration and outpatient testing. Women can assess whether they are ovulating by measuring their rectal temperature for at least three consecutive cycles.

Measuring basal temperature is considered a simple and effective test for home use, allowing you to determine the right time for conception.

Doctors use several tests to diagnose the cause of hormonal imbalance.

Progesterone test. If after its administration a woman begins uterine bleeding, confirm the insufficiency of the second phase as the cause of infertility.
Test with estrogen and progesterone. Both drugs are administered sequentially to a woman; when a menstrual-like reaction appears, the test is considered positive, which means ovarian failure and excludes uterine pathology as a possible cause of infertility.
Dexamethasone test to diagnose the source of increased levels of male sex hormones. If after administration of the drug there is a decrease in the level of 17-ketosteroids, hyperandrogenism is adrenal in nature, if 17-KS increases - ovarian.
Ovulation stimulation test using clostilbegit. If there is no result during the diagnostic process, anovulation is of a hypothalamic-pituitary nature.

After finding out the character hormonal disorders appropriate infertility treatment is prescribed.

Diagnosis of male infertility

Tactics diagnostic measures When determining the cause of infertility in men, it comes down to a survey, laboratory and instrumental studies, the main role in which is played by the spermogram.

List of studies for diagnosing male infertility:

STI tests;
Ultrasound of the prostate;
determination of the level of sex hormones;
detailed spermogram;
MAP test of sperm (for immunological infertility);
Kruger sperm analysis;
tests for chromosomal abnormalities of sperm (FISH analysis, Y-chromosome integrity);
analysis of prostatic juice.

When diagnosing male infertility using the Kruger analysis method, they rely on a standard of more than 4%.

The norm for the MAP test is considered to be less than or equal to 30%; other results serve as a reason for establishing a diagnosis of “immunological infertility.”

If MAP analysis values are more than 30%, it is advisable to carry out IVF with the mandatory use of ICSI. Thanks to this procedure, the optimal sperm is selected and artificially introduced into the egg.

Examination of a couple for infertility

Infertility due to the female factor is registered in 45% of cases, due to the male factor - in 40%, the rest of the causes of infertility are due to both male and female pathologies.

If an infertile couple comes to see a reproductologist, a specific diagnostic algorithm is prescribed:

the man is prescribed a sperm analysis and, in the absence of pathology, no other measures are taken at this stage;
postcoital test (diagnosis of the immune form of infertility);
two-stage examination of a woman.

At the first stage, methods are used to eliminate three common female diseases: ovulation disorder, tubo-peritoneal factor, infectious and inflammatory processes of the reproductive tract. This diagnostic stage consists of a standard set of minimally invasive techniques.

Primary diagnosis of infertility in women, the stages of which are divided into blocks, includes:

Study of anamnesis and clinical data.
Infectious screening: vaginal smears for purity, bacterial culture, PCR examination of a cervix smear for chlamydia, urea and mycoplasma, herpes simplex, CMV, HPV, as well as blood for antibodies to toxoplasma.
Hormonal screening: on day 2 with short cycles, on days 2-5 (with a 28-32 day cycle), on days 6-9 (with a cycle length of 35 days) donate blood for sex hormones, including FSH, LH, estradiol, free testosterone, prolactin, DEA sulfate, 17-OH-progesterone. To determine the level of progesterone, blood is examined on the 7th day after ovulation proven by ultrasound.
Ultrasound diagnosis of diseases of the mammary glands, pelvic organs, thyroid gland, adrenal glands.

In the absence of menstruation, blood is donated for hormones any day.

Primary diagnosis and treatment of infertility identified by the results of a study in women implies normalization hormonal balance, removal of pathological formations, vitamin therapy.

Diagnosis at the second stage is always individual. The set of methods usually includes studies based on identified pathologies during the first stage of infertility diagnosis, and also includes:

tests that detect genetic abnormalities (karyotypes, determination of HLA compatibility of partners);
blood tests for hemostasis mutations, thrombophilia, antiphospholipid syndrome;
instrumental diagnostic methods (MRI of the sella turcica, laparoscopy, hysteroscopy, hysterosalpingography).

48% of infertile women are diagnosed with 1 infertility factor, and 52% have more than two.

When identifying diseases that cannot be fully cured during the diagnosis of infertility, for example, ovarian wasting syndrome, severe endometriosis, asthenozoospermia, false aspermia, azoospermia, bilateral adhesive process in pipes, couples are offered IVF or artificial insemination.

Conclusion

Diagnosis must be consistent and time-limited. Each of its stages must be directed towards completing a specific task in order to assign optimal treatment. If there are no results of diagnosis and treatment of infertility in men and women within a year, it is necessary to seek a second consultation. It is considered advisable to change the clinic or specialists.

Diagnosis of infertility in the whole family is a proven process. Since, as a rule, the woman is the first to show concern, it is gynecologists who have developed plans for a step-by-step diagnosis of infertility.

The first stage of the examination includes studies that allow you to pay attention to all aspects of fertility in both women and men. Further, in-depth examination depends on the identified features.

Screening for sexually transmitted infections and bacterial flora.
Blood hormones: prolactin, testosterone, AT-TPO, T4 St. , TSH, AT-TG, DHEA, LH, FSH. Read more about this in the article “We take hormonal tests"
A man must have his sperm analyzed.

In addition to those listed, the doctor may prescribe other tests and studies, depending on the general health of the spouses and the disorders identified in them.

IN last decades examination of men is given first place. The reason is simple: men account for the same number of cases of infertility as women, and at the first stage the man is only required to submit sperm for analysis. The test procedure is simple and painless (masturbation), the result is obtained in 1-2 hours, the spermogram is very informative.

If abnormalities are detected in sperm, men undergo further examination and treatment parallel with your wife, which allows you to speed up the onset of pregnancy.

Compatibility test sperm and cervical mucus(postcoital test). The test is carried out to identify the CERVICAL FACTOR of infertility, when normal sperm is immobilized in the cervix. 5-6 hours after intercourse, mucus is taken from the woman’s vagina and cervix. Sperm motility is determined under a microscope. If they are less mobile in the cervix than in a regular spermogram given men, then draw a conclusion about negative impact cervical mucus.

In addition to the studies described, doctors usually refer the patient for an ultrasound examination ( Ultrasound). This very technically complex and very simple in appearance study allows you to see with your own eyes many disorders of the structure of the genital organs. Using ultrasound, you can identify congenital abnormalities of the structure of the uterus, fibroids, endometriosis, the presence or absence of pregnancy in the uterus, ectopic pregnancy, structural abnormalities of the ovaries, the presence and size of the follicle and egg. Ultrasound is harmless and can be performed regularly if necessary. Modern devices and the use of a vaginal sensor allow you to avoid the unpleasant detail of preparing for an ultrasound - bladder overflow.

Laparoscopy - modern operation, without which many achievements in the fight against infertility would be impossible. During laparoscopy abdominal cavity a thin needle is inserted through which a flexible probe equipped with optics is passed. The uterus, tubes and ovaries are examined through the probe. outside, can carry out surgical intervention- dissect adhesions, remove the capsule from the ovaries, remove uterine fibroids (there are cases when fibroids weighing more than 2 kg were removed by laparoscopy!).
At the same time, complications are practically excluded, patients gain working capacity in as soon as possible and minimal internal damage.

X-ray of the skull and sella turcica. This study is carried out if the doctor suspected the presence of a pituitary tumor or received high levels of the hormone prolactin in blood. Prolactin is produced by the pituitary gland and is responsible for milk production in breastfeeding mothers. At present, such a study is almost never carried out, since changes in the pituitary gland occur against the background of a large tumor. Initial changes are determined more in a modern way - computed tomography.

The studies described can only be the beginning a long process, as a result of which the cause (or causes) of infertility in this couple will be established.

Starting an examination for infertility, spouses should think about the fact that the years go by, the age increases, the chances decrease. Long-term diagnostics, carried out in fits and starts in different medical institutions, no plan, no consideration individual characteristics reduces the chances of successful subsequent treatment.

At the MAMA Clinic you can undergo full examination to find out the causes of infertility or clarify the diagnosis. You can discuss the required scope of examination with the Clinic’s doctor at your initial appointment.

Take the first step - make an appointment!

Infertility still remains actual problem V medical practice. Every year doctors identify various shapes This disorder affects thousands of people. In most cases, impaired fertility is temporary, but in some cases, dysfunction of the reproductive system may be due to dangerous diseases. Diagnosis of the causes of infertility in our clinic is carried out by highly qualified and other specialists.

Causes

Diagnosis of infertility makes it possible to detect a variety of factors that negatively affect the condition. reproductive organs in men and women. It can be chronic diseases, congenital anomalies, as well as bad habits. Sometimes for staging accurate diagnosis required to carry out a large number of tests, since the cause of the disease may be hidden.

Common reasons:

Infection genitourinary system;
Vascular disorders. Thus, in men, varicocele is often found, which negatively affects testicular tissue, as a result of which sperm become inactive and immature;
Anatomical disorders that complicate sexual intercourse and fertilization. Examples include obstruction of the fallopian tubes in women and obstruction of the vas deferens in men;
Functional disorders: erectile disfunction, ejaculation disorder;
Malignant neoplasms genitals;
Diseases endocrine organs;
Anomalies in the development of the genital organs;
Genetic diseases;
Taking certain medicines and performing surgical intervention in the pelvic area;
Immunological factors in which the body's defense systems damage its own germ cells. (Immunological infertility is more common in women).

Also, the diagnosis of infertility should be made after identifying risk factors. Impaired fertility can occur with obesity, chronic stress and bad habits.

Forms of the disease

Diagnosis and treatment of infertility depend on the form of fertility disorder. The classification of this disease is usually based on etiological factors and the patient's individual history.

Basic forms:

Primary infertility. Such a diagnosis is made if the couple has never had pregnancies, that is, the reproductive function has never been realized.
Secondary violation fertility, as a rule, occurs after the birth of a child or good luck with your conception. Diagnosis secondary infertility often due to acquired diseases, age-related changes.

Female infertility increasingly occurs when a woman has bad habits and against the background of taking hormonal drugs, while infertility in men in most cases is due to chronic diseases, bad habits, nutrition, stress.

Examination of men

If there is a male factor of infertility, the patient needs to consult a urologist-andrologist. The doctor will take a medical history initial examination and will appoint necessary methods diagnosis of infertility.

Basic examinations:

, allowing to study the morphological and functional parameters of the ejaculate. In particular, the number and concentration of germ cells, their mobility, structure (morphology), whether there are inflammatory changes, antisperm antibodies are determined;
Ultrasonography testicles, epididymis, seminal vesicles and prostate gland. This test detects tumors vascular disorders and inflammatory changes;
Blood test for the concentration of sex hormones that play important role in the formation and maturation of sperm;
Blood test and urethral swab to detect infections affecting reproductive functions;
Genetic research;
Study immune system;
Microsurgical testicular biopsy in the absence of sperm in the ejaculate.

Diagnosis of male infertility can be successfully made after several tests, but the scope of research depends on the individual patient's medical history.

Examination of women

Diagnosis is carried out by gynecologists and reproductive specialists. A thorough examination of the genitourinary, endocrine and other body systems is necessary.

Diagnosis of infertility in a woman includes:

General and instrumental gynecological examination. The doctor can immediately detect signs of pathology;
Assessment of ovarian reserve;
Assessment of fallopian tube patency;
Blood test for concentrations of sex hormones. It is important to carry out such analysis during one menstrual cycle;
Various microbiological studies to exclude bacterial, fungal and viral infections;
pelvic organs;
Genetic research and other tests as indicated.

The diagnosis of infertility in women is often associated with menstrual irregularities. Our doctors will be able to offer an effective and safe treatment regimen to solve this problem.

results

The diagnosis of infertility with clarification of the cause of the disorder can be made within a few days. The duration of the examination depends on the specific medical history. Our laboratory has modern equipment that allows us to quickly and accurately conduct examinations.

It has been scientifically proven that a period of 12 months is sufficient to determine the level of fertility of almost any couple, provided that this couple lives a regular sex life. According to statistics, with systematic unprotected sexual intercourse, pregnancy occurs in 30% of couples in the first 3 months, in 60% of couples within six months, and in 10% in the first year.

If, after the allotted period, pregnancy has not occurred, there is every reason to consult a doctor. A comprehensive examination for infertility is the most correct solution in this situation, as it will determine the presence or absence of a reason that is preventing you from conceiving a child. Optimally, contacting a specialist should be carried out at the child’s stage, which will help eliminate possible risks birth of defective children (with congenital diseases and anomalies), complications during pregnancy and childbirth.

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When should you see a doctor?

A woman who wants to get pregnant should also think about visiting a gynecologist if she has the following signs:

hyperprolactinemia ( increased level prolactin in the blood, which causes menstrual irregularities);
a sharp decrease in body weight;
the complete absence of a woman's menarche;
the hair in the genital area is located in an abnormal pattern (vertically directed, excessive, insufficient);
underdevelopment of the mammary glands;
spontaneous miscarriages and miscarriage in history;
absence .

The above symptoms of infertility are quite common, so it is important to pay attention to them as early as possible.

Female infertility: examination stages

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The diagnostic process in case of suspected infertility in the family should begin with an examination of the future father. today it occurs with the same frequency as in women. If the examination did not reveal causal factors from the husband’s side, then they begin to diagnose the woman. It includes many points, starting with a survey and ending, if necessary, with laparoscopy.

Taking an anamnesis is the first stage of diagnosing infertility

Consulting a gynecologist is very important at the beginning of an examination for infertility. It allows the doctor to assess the overall picture of the problem and identify possible causes of infertility.

When assessing the gynecological health of the patient, the doctor asks her about the following points:

Symptoms that bother you ( general health, duration of absence of pregnancy, pain “before” and “during”, sudden weight loss or weight gain, discharge from the breast and vagina).
Family history (presence gynecological pathologies mother, relatives, age, Rh factor and husband’s health, bad habits).
Disease history ( surgical interventions, infections that the woman had previously suffered from, injuries, gynecological and other diseases).
Menstrual function (age of first menarche, regularity, duration, pain of menstruation, amount of discharge).
Sexual function (onset of sexual activity, methods of contraception used, regularity of sexual intercourse, number of marriages and partners, libido level, presence of orgasm, discomfort during sex).
Fertility (number of pregnancies and living children, spontaneous and induced abortions, course of previous pregnancies, complications during childbirth).
The results of examinations and treatments that were carried out earlier.

Objectively, the gynecologist evaluates general state female patients:

body type;
condition of mucous membranes and skin;
nature of hair growth;
development and condition of the mammary glands.

He also palpates thyroid gland, abdominal area, takes into account the figures of the woman’s blood pressure and body temperature.

Special gynecological examination for suspected infertility

It is carried out using gynecological mirrors on a chair. During the procedure, the doctor assesses the condition and degree of development of the genital organs (internal and external), the type of pubic hair, the appearance of discharge and its nature. The presence of abnormalities in the structure of the genital organs may be a symptom of infantilism and other congenital anomalies reproductive system.

Excessive hair growth male type indicates hormonal problems. Discharge is a sign of inflammatory or other pathological process in the vagina, which requires additional tests to identify the pathogen.

Functional tests

An examination for infertility also necessarily includes functional tests, which provide information about the nature of ovulation, level female hormones, the presence of antisperm bodies.

The following are used:

Cervical index. This study reflects the quality of cervical mucus, expressed in a scoring system. It assesses the level of estrogen saturation in the female body.
Basal temperature. Based on daily temperature measurements in anus a curve is constructed. Its analysis gives a picture monthly cycle, confirms the presence or absence of ovulation and ovarian activity.
Postcoital test. It is performed to study in more detail the activity of sperm in the mucus on the cervix.

Necessary tests for infertility

The most informatively valuable studies are tests for hormone levels, for which urine and blood are taken from a woman.

To diagnose infertility, the following are indicated:

Important: V All these studies should be carried out some time after gynecological examination and sexual intercourse, given that the levels of certain hormones may vary.

Instrumental and hardware diagnostics of infertility in women

These examination methods include:

They are resorted to if available uterine form infertility. Surgical diagnostic technologies are very highly informative and also low-traumatic.

Most often this is used:

Hysteroscopy is a procedure for examining the uterine cavity through optical device, which is inserted into the uterus through the external os - the cervix. It is performed under general anesthesia in the hospital. The doctor can not only examine the condition of the uterus from the inside, but also identify and immediately remove pathological formations(cyst, polyp).