Infertility examination
When a couple complains about the inability to have children, they are first asked about the conduct of full sexual intercourse. Even in our time, there are cases when the spouses do not know about what and how to do for conception. The time of intimacy and the technique of sexual relations are discussed. Typically, the specialist is interested in the history of the sexual life of the spouses, the presence of pregnancies in the past, miscarriages and abortions, previous diseases and infections, the use of drugs and alcohol, the development of genitals and the conduct of operations on them;an assessment is made of the health status of partners.
To determine the causes of infertility, a thorough examination of both partners is necessary. Since quality control of male seed is not difficult, this research is carried out in the first place. When analyzing sperm, the amount of seed, its consistency and condition, the number of live spermatozoa, their ability to move, the presence of leukocytes are estimated. Usually, one analysis can not determine the fertility( fertility) of a man, and repeated tests are required after a while.
In the future, attention is focused on the examination of a woman. She is invited to pass urine and blood tests to identify possible infections and hormonal imbalances, a gynecological examination is performed, an analysis of the cervical mucus is done to determine if ovulation has occurred.
Basic research in infertility:
1. A complete study of male ejaculate obtained as a result of masturbation.
2. Postcoital test, usually performed 6-18 hours after intercourse. It involves the study of mucus taken from the uterine canal to determine the survival of spermatozoa in the vagina and cervix.
3. Scraping of the mucous membrane of the uterus to analyze its readiness for the implantation of a fertilized egg.
4. Hysterosalpingography - X-ray of the uterus and fallopian tubes after the administration of contrast medium.
5. Rubin test( "purging") - the introduction of carbon dioxide into the fallopian tubes to examine their patency and / or to remove possible obstacles.
6. Ovulation test - daily measurement of progesterone levels in the blood or urine and measurement of basal temperature.
7. Laparoscopy - the introduction of an optical instrument into the abdominal cavity for the study of the uterus and fallopian tubes. This procedure is usually combined with the introduction through the cervical canal and the uterus of the blue coloring fluid to determine the patency of the fallopian tubes.
Tests are continued throughout the entire monthly cycle, including blood tests to detect the dynamics of the level of various hormones, biopsy of the endometrium( mucous uterus) on the eve of menstruation, a special test is performed after sexual intercourse to determine the ability of sperm to pass through the mucous plug in the cervix.
Days of the monthly cycle, most favorable for conception. If a woman has a regular 28-day cycle, the most favorable days for conception is the period from 11 to 16 days of the cycle.
If the cycle time varies within the range of 27-35 days, conception is more likely if proximity occurs on the five specified days, starting from the 13th day of the cycle.
The woman is given the task to measure and record the basal temperature every morning. The chart helps to determine the presence of ovulation by raising the temperature( the absence of a temperature shift is a sign that ovulation has not occurred).
The listed studies in 50% of cases is sufficient for the appointment of a successful treatment.
In case of need of further examination, procedures are appointed whose purpose is to determine the patency of the fallopian tubes and the features of the structure of the uterus. This X-ray and endoscopic examination of the uterus, ovaries and fallopian tubes, ultrasound diagnosis, laparoscopy for inspection of reproductive organs through the abdominal cavity, hysterosalpingography, checking the patency of the fallopian tubes. Men are given a testicular biopsy( a piece of tissue is taken for microscopic examination).Sometimes it may be necessary to study the chromosomes of both partners to identify possible genetic disorders that cause anomalies in the sex cells.