An appropriate, balanced level of sex hormones present in the female body is crucial for ovulation, fertilization and pregnancy. Cyclic hormonal changes in a female organism are a basic prerequisite for conception. Measuring the hormonal levels in specific phases of the cycle will show whether the hormonal functions work properly. Examinations are usually performed on the third day of a menstrual cycle by taking a blood sample. Different hormones than those listed below can also be tested if there are any additional concerns. Tests of hormonal functions can also be performed.
Semen analysis serves as a basic examination of male fertility. After 3 – 5 days of sexual abstinence, a man provides a semen sample into a sterile vial by masturbation and brings it to the center for further testing. An immediate testing of fresh ejaculate is the best way to analyze the semen. If a patient is unable to provide a sample while in our reproductive medicine center, he can do so at home. However, a fresh ejaculate must be brought to the center within an hour of ejaculation. Otherwise, the results of the test can be affected by temperature changes (lower than 37° C).
Postcoital Test (PCT) is one of the oldest tests used in infertility diagnostics. It is performed after a sexual intercourse with ejaculation into the uterus during the female’s ovulatory phase. If the test is performed too soon or too late in the cycle, the results will be abnormal because during this time the cervical mucus is too dense and hard for the spermatozoa to pass through. Optimal conditions allowing the spermatozoa to pass through the mucus so that the PCT can be performed occur only during the ovulation phase.
Endometrial Biopsy is an examination that helps determine if the thickness and the structure of the endometrium is suitable for an egg implantation. This examination is not extensively used today, although sometimes it is indicated for patients with regular menstruation and repeated miscarriages. During endometrial biopsy, the physician takes a small tissue sample from the uterine cavity which is then sent to the lab for further analysis. The sample is taken with a small thin device inserted through the cervical canal.
Hysterosalpingography (HSG) is a radiologic examination of the shape and passage of the uterine canal and the fallopian tubes using a radiographic contrast medium. It is used to reveal uterine congenital defects or fallopian tubes obstruction. HSG is done after menstrual bleeding in the first half of a menstrual cycle. A contrast medium is injected into the uterine cavity via a special device called the Schultze’s cannula, which caulks the cervix. Passing of the contrast medium through the patient’s internal reproductive organs is then monitored and analyzed.
Hysteroscopy is an endoscopic inspection for possible abnormalities in the cervix and the uterine cavity. These could be polyps, myomas, endometrial inflammation or growth defects. It also allows for treatment of such abnormalities by removing polyps, myomas, uterine septum, small adhesions or by gathering endometrial samples for further examinations. Hysteroscopy is usually indicated based on results of ultrasonography, hysterosalpingography or sonohysterosalpingography examinations, or it can be indicated as a substitute for these other methods.
Laparoscopy is a minimally invasive surgical examination. The abdominal cavity is stretched out using carbon dioxide, which is inserted inside through a small incision above the navel via a small, blunt needle. Then, a special device called a laparoscope is used to examine the inside of the abdominal cavity. This surgery can serve a diagnostic purpose and can determine the cause of infertility, such as fallopian tubes patency problems, severe adhesions, myomas, uterine abnormalities or can be used therapeutically to treat these problems – remove adhesions, myomas, cysts, endometriosis, etc.