The woman should do some tests for the following hormones between days 2 to 5 (day 1 is defined as the day of normal mestrual flow) of her cycle. At the same time she should do a vaginal ultrasound.
The hormones that the woman should do tests for are FSH, LH, E2, Prg, 17OH Prg, Testosterone, f-Testosterone, AMH, D4 androstendione, DHEA, DHEA-S, TSH, FT3, FT4, Anti-TPO, anti-Tg and prolactin.
Hysterosalpingography is a radiological examination that helps us to assess the patency of the fallopian tubes. It also helps to have an image of the endometrial cavity. This test is contraindicated in women who have passed pelvic inflammatory disease or endometritis. It is essential to have a vaginal and cervical swab before the test. It should be emphasized that it is painful and we recommend to take an analgesic eg Depon 1gr 1 hour before. For this reason, they prefer ultrasound Hysterosalpingography (HyFosy) today.
Ultrasound Hysterosalpingography (HyFosy)
It is an examination of the passage of the fallopian tubes. The woman does it in the doctor’s office using ultrasound. It does not hurt at all but an experienced gynecologist should do it. The examination is done by injecting a foam contrast agent with hypoallergenic action in the uterine cavity. At the same time, the doctor monitors its flow in the fallopian tubes. This shows us any abnormalities of the uterus and whether the fallopian tubes are open.
The main advantages are that:
At the same time, he performs a gynecological ultrasound (he doesn’t do it in the case of classical hysterosalpingography).
Today we have to slowly abandon the classic hysterosalpingography as it has been done for years abroad. HyFoSy is an easy, accurate and painless test and should be offered to all women.
It is a specialized diagnostic operation in which we examine in great detail the inside of the cervix and uterus. It is not a routine examination in the context of infertility research, but we must do it before any attempt at assisted reproduction. We do it with light intoxication or even without anything. That’s because it lasts a while and most women can stand it. We use a camera that enters the uterus and thus check for pathologies of the uterus such as polyps. Also, we check extent of known fibroids or the presence of signs indicative of chronic endometritis. We always perform an endometrial biopsy either for a simple histological examination or for endometritis control.
In case we observe a pathology that we could not solve in the diagnostic hysteroscopy (large polyp, fibroid that enters the cavity, adhesions) we must schedule invasive hysteroscopy which we do under general anesthesia.
Surgery performed through small incisions in the area around the navel. It allows us to enter the patient’s abdomen and check for various pathological conditions such as endometriosis. Its usefulness is based on the patient’s history.
Genetic testing of a couple
Any couple experiencing infertility should be screened with a simple pair karyotype. Karyotype is the recording of the number and structure of human chromosomes. in other words, it’s the genetic information that we hide in our genes. An example of a pathological karyotype is trisomy 21 or Down syndrome.
Another basic and mandatory genetic test that one of the 2 partners must do is cystic fibrosis. It goes without saying that if one carries a mutation, then we must test the other partner too. Cystic fibrosis is a genetic condition that causes systemic respiratory infections and gradually reduces the ability to breathe. 5% of the population are carriers.
More specific genetic tests are performed in women with premature ovarian failure (fragile X) and in men with azoospermia (micro chromosome deficiencies)