The same diagnostic methods cannot be applied to all patients. After conducting an extensive interview and taking into account the patient personal characteristics, the doctor will assess which are the most appropriate examinations for each case
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It is considered appropriate to study further if pregnancy has not been achieved after one year of sexual intercourse without the use of any contraceptive method. This period may be shortened to 6 months in certain cases, such as when the woman's age exceeds 35 years, or even earlier, when the medical history of the couple is associated with high risk of infertility. In any case, it is advisable to have an interview with a Fertility Specialist before even starting the search for pregnancy in order to receive the correct information on family planning focused on improving fertility.
The basic tests for the correct diagnosis of infertile couples consist of the elaboration of an exhaustive medical history that includes family and personal background as well as gynaecological and andrological history, life habits, etc., followed by a medical examination and completed with:
- Hormonal test in women. It consists of measuring the hormones that regulate ovulation. Currently, to know the ovarian reserve in most patients it is not necessary to perform it on a certain day of the cycle.
- High resolution or 3D vaginal ultrasound scan: It provides a detailed study of the ureter, ovaries and pelvis. It is essential to know uterine abnormalities and malformations, the presence of tumors and cysts, both in the uterus and in the tubes and ovaries. On some occasions, it could be completed with:
- Hysterosalpingography — to rule out if the tubes are blocked. This examination avoids carrying out radiological tests with the use of contrast, eliminating both the use of radiation and the risks of using contrast techniques. In addition, three-dimensional technology allows us to rule out small malformations or uterine abnormalities during the same examination.
- Spermiogram: it is the analysis of semen and it evaluates the characteristics of the seminal plasma and the quantity of sperm, their mobility, vitality and their shape.
You can learn more in the section: fertility clinic: first visit.
The whole process lasts a very short time. It usually doesn't take more than 2 weeks from the first interview until patients receive the study results and can start the treatment.
Sometimes the test results are completely normal. In fact, this occurs between 20% and 30% of the couples studied. In these cases, we speak of unknown cause of infertility. It does not mean that there is no problem, but only that it is yet to be found and it will require the help of the IVF laboratory. The causes could be related to the quality of the oocytes, embryonic development, the sperm / oocyte ratio, among others.
When the test report is submitted, the Specialist gynecologist explains the results in detail and in an understandable manner. At the same time, the doctor informs you of all the treatment options that may be reasonable in your case. In that visit, and after knowing the opinion of the patients, the treatment strategy is designed.
In practically all cases, the scheduling of the treatment is defined starting this in the next menstruation cycle, if that is the patients wish.