The same diagnostic methods are not applicable to all patients. After a detailed consultation and according to personal characteristics, the doctor will assess the most appropriate examinations to be performed in each case.
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It is advisable to undertake a study if pregnancy has not been achieved after a year of sexual relations without the use of contraception. This period of time may be reduced to 6 months in some cases, such as when the woman is older than 35, or even earlier when any aspect of the couple’s medical history is associated with a sterility risk. In any case, it is advisable to see a doctor specialized in fertility even before seeking pregnancy to receive correct information on pro-fertility family planning.
- Female hormone analysis involves taking a blood sample during the first days of the cycle (sometimes also at the beginning of the period). This gives information regarding the functioning of the ovarian reserve.
- Hysterosalpingography. This is a special ultrasound examination that enables us to rule out blockage of the fallopian tubes. This examination avoids the need for X-rays with contrast, eliminating the need for radiation and the risks involved in the use of contrast. Furthermore, the use of three-dimensional technology enables us to rule out a malformation of the uterus during the same examination.
- Semen analysis. Also known as a seminogram or a spermiogram, this analysis is used to evaluate aspects that we know to be influential in order to achieve pregnancy. Basically, we study sperm count, motility and morphology.
Many tests are available which may be useful for specific cases, but they are not performed as a matter of course for all patients. These are known as complementary tests and they are required after the first consultation when a specific pathology is suspected or to clarify the results of the basic tests.
The process from diagnosis to commencement of the treatment takes very little time. In general, patients receive the results of the study no more than 2 weeks after the first consultation.
Sometimes, the results of the tests are completely normal. In fact, this happens with approximately 20% to 30% of couples studied. In these cases, the cause is said to be unknown. This does not mean that there are no problems, but that after using all the reasonable means of diagnosis none could be identified. The fact that the root of the issue cannot be specified does not preclude the use of treatment and, in general, the possibilities of success are the same.
When giving the test report to patients, the gynecologist will explain the results in detail and in an understandable manner, explaining at the same time all the alternative treatments that may be reasonable in each case. On this visit, and after considering the opinion of the patients, a strategy is defined.
In practically every case, the treatment can be scheduled immediately, beginning in the woman’s next cycle.