Infertility assessment: what is it?


Infertility assessment: what is it?

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After one or two years, depending on the case, couples who have not been able to conceive consult a gynaecologist. He may prescribe an infertility check-up. A first step necessary to determine the causes of this difficulty. Here is how it works.

  1. Medical issues
  2. Infertility examinations in women
  3. Male infertility reviews

The first consultation of your infertility assessment takes place as a couple. Infertility can come from a malfunction in women, men, or both. To find the most effective treatment, it is, therefore, necessary for the doctor to meet with both partners.

The doctor will start by asking the couple about their history, their lifestyle (tobacco, alcohol, stress, weight), their hobbies (sport), working hours and of course their sex life. How often report? Regularity is of major importance in conceiving a baby. The ideal is to make love at least every other day. He will also ask if there are problems with impotence or vaginismus (closing of the vagina preventing penetration).

Medical issues

The doctor will question the man on the age of his first ejaculation, on possible infections of the genital organs but also on the state of his testicles (descended or not) or his state of health. It is, of course, important to report any history of radiotherapy or chemotherapy.

The woman is questioned about the regularity of her cycles, about the genital infections that she may have had and about possible surgical procedures. The doctor must know his medical history before concluding or not to additional examinations.

Infertility examinations in women

First, there is the basic exam: the temperature curve (measured every morning by the anal route). It makes it possible to check the presence or not of ovulation over three to four cycles. It is accompanied by a dosage of hormones carried out by several blood samples at specific times of the cycle. These two examinations determine whether or not an ovulation disorder, the most common cause of infertility (more than 30% of cases).

With the Hühner test, also called post-coital, we check the quality of the cervical mucus (a white liquid) and its reaction to contact with the sperm. The examination consists of taking cervical mucus in the ovulatory phase about ten hours after intercourse. The number and mobility of sperm are analyzed under the microscope.

A pelvic ultrasound can visualize the condition of the ovaries and the uterus in the days around ovulation. In 25% of cases, infertility comes from a blockage of the fallopian tubes. This examination can be supplemented by hysterosalpingography. A contrast agent is injected into the tubes, X-rays are then taken to see if the fluid is progressing correctly.

Male infertility reviews

In all cases, a spermogram is normally carried out. This involves analyzing the sperm obtained after masturbation in a laboratory. We can thus analyze possible defects in spermatogenesis (mobility, number, morphology). The sperm contains between 20 and 400 million sperm and if there are less, we speak of "oligospermia".

We also observe whether they are mobile enough to reach the oocyte released in one of the tubes and ensure fertilization. Insufficient sperm mobility is called "asthenospermia". Finally, the analyzes relate to their morphology. If more than 45% of them are abnormal, we speak of "teratospermia".

If the spermogram shows anomalies, additional examinations will be necessary. The sperm culture verifies the presence of infectious disease, the biochemistry of the sperm detects a dysfunction of the genitals of the man. There may be a testicular ultrasound as needed to highlight a malformation, blood tests to check hormone levels and genetic tests.

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