The purpose of the examination is to discover the cause of infertility and then choose adequate treatment. Both partners are always being examined. In some couples, the cause of infertility (idiopathic sterility) is not revealed even after using all the examination methods..
In the diagnostics, we distinguish initial and special (complementary) examinations. Based on the results of initial examinations, the physician will decide whether any special examinations are necessary.
Examination of the woman
- Having an interview with the female patient (the course of her menstrual cycle, diseases overcome, examinations already performed and previous treatment of infertility, etc.) and the basic gynaecological examination..
- Monitoring the spontaneous menstrual cycle and follicle growth without taking any hormonal drugs. The first examination is performed on one of the first three days of menstrual bleeding and consists of collecting blood for hormonal examination and in the ultrasound examination. Two more blood collections and ultrasound examinations are also performed between the 12th to the 14th and the 20th to the 22nd days of the menstrual cycle.
- Microbiological examination of the vagina and uterine cervix and blood collection for the examination of sexually transmitted diseases. These examinations may also be performed at your gynaecologist’s.
- Hysterosalpingography (an outpatient X-ray exposure with an X-ray contrast substance). This is performed for the assessment of any eventual ovarian duct obstruction.
- Laparoscopy (surgery in general anaesthesia). This allows one to assess the condition and function of the internal genital organs (uterus, ovaries, ovarian ducts) and, if necessary, to perform surgical procedures (e.g., removing the adhesions, endometriosis foci).
- Hysteroscopy (a diagnostic or surgical procedure, mostly performed in the general anaesthesia) is used to assess the condition of the uterine cavity, uterine mucosa, ovarian ducts orifice.
- Post-coital test (assessment of the cervical mucus quality, the quantity and movement of the sperms after a normal sexual intercourse); recently it has been barely used.
- Genetic examination (for suspected genetic disorders of fertility).
- Immunological examination (for the presence of antibodies against sperms and ova).
- Psychological and sexuological examination (for difficulties in the sexual intercourse, psychoreactive disorders, etc.).
Examination of the man
- Spermiogram – the volume of the ejaculate, the number of sperms, proportion and quality of their mobility, proportion of pathological (abnormal) forms of the sperms, presence of other cells are determined from the ejaculate obtained by masturbation after three to five days of sexual abstinence; where appropriate, microbiological examination shall be made to detect the agent of the infection present.
- Blood test for the presence of sexually transmitted diseases.
- Urological examination (for inflammatory diseases or after injury to sexual organs).
- Genetic examination (for suspected genetic disorders of fertility, severe spermiogram disorders, or surgical sperm retrieval).
- Examination of hormonal levels (in case of severe spermiogram disorders).
- Psychological and sexuological examination (in case of impotence, insufficient erection, missing ejaculation, etc.).