What type of examinations are carried out in a sterility study?

When a couple has problems getting pregnant, the fear of suffering some kind of sterility problem becomes very real. Despite the fact that specialists have established, in patients under the age of 35, a time margin of one year of unprotected sexual intercourse before considering that there is a fertility problem, doubts and fears are inevitable.

Once the time comes to carry out a sterility study, our specialists do not limit themselves to analysing the particular case of each of the members of the couple, but also analyse family history, as well as environmental and occupational factors or personal habits that may affect fertility.

At Eugin we recommend carrying out the sterility study on both partners, and therefore we have the necessary resources for both men and women to be able to undergo the tests prescribed by the specialists. In the case of women, the tests they can undergo may include a transvaginal ultrasound, a hysterosalpingography, a hysteroscopy or an endometrial biopsy. In addition, a karyotype study and an anti-Müllerian hormone (AMH) analysis will also be performed.

Men can also undergo a karyotyping and hormone analysis, which can be supplemented by a seminogram, a sperm capacitation test (MSR), bacteriological and biochemical examinations, or a testicular biopsy or epididymis puncture.

The diagnosis consists of looking for the causes of the sterility in both members of the couple, as the analysis of only one of its components may be insufficient to issue a diagnostic orientation. These tests form part of a protocol that, once concluded, allows the specialist to orient the diagnosis and the possibilities of pregnancy with respect to the proposed treatment.

The first step in the first visit is to draw up a detailed clinical history, taking into account personal and family background, as well as those environmental or work factors and toxic habits that can influence fertility.

We will also carry out a basic blood analysis on both members (group and Rh factor, biochemical and coagulation, serology to rule out infectious diseases…).

Transvaginal ultrasound: An ultrasound examination providing vital information on the morphology of the uterus and the ovaries that allows us to see the changes to the ovaries and the endometrium during the ovarian cycle. It also gives us information about the patient’s ovarian reserve.

Anti-Müllerian hormone (AMH): This is a hormone that is analysed after a blood test and allows us to assess the patient’s ovarian reserve at any time during the cycle.

Hysterosalpingography: This is a radiological test involving a contrast liquid being injected into the neck of the uterus and which allows us to evaluate the uterine cavity and the permeability of the Fallopian tubes. A blockage in both tubes would impede the process of natural fertilisation. This test takes place after menstruation but before ovulation. It is a very important test especially before artificial insemination is carried out.

Hysteroscopy: A hysteroscopy is an endoscopic examination where an optical tube is inserted through the neck of the uterus in order to visualise the uterine cavity (hysteroscope = mini camera), and provides a direct and precise view of both the cervical canal and the inside of the uterus.

A hysteroscopy is carried out in order to diagnose possible alterations to the inside of the uterus and in some cases it explains why the embryos do not attach to the uterus, or the reason for repeated miscarriages.

Biopsy of the endometrium: This is carried out through aspiration of the endometrial mucous using a tube which is inserted unto the uterus via the cervical canal. It is sent to the laboratory and studied to see if there are any infections or anomalies of the endometrium.

Karyotype: This can reveal chromosome anomalies and explain sterility or infertility. It is done through a blood analysis.

Seminogram (analysis of the semen): Due to its simplicity, this is the first test carried out on the couple. The seminogram evaluates the production of sperm in the seminiferous tubules of the testicle. In the seminogram the parameters of quantity (concentration), quality (motility) and morphology are studied.

Capacitation test (or MTC): This is a study which is complementary to the seminogram and consists of “washing away” all the fluids and substances from the semen and leaving only the sperm, which is then put in a medium rich in nutritional substances. The number of motile sperm obtained (MSC) in this test allows us to know the quantity that will be viable to use in Assisted Reproduction techniques.

Bacteriological and biochemical examinations: A more detailed examination (semen culture or blood analysis) to detect infections which alter the quality of the semen.

Testicular biopsy or epididymal punction: These techniques are used to collect the sperm found in the testicles. They are used when the semen cannot be obtained by ejaculation.

Hormonal: Used to detect anomalies in hormone levels using blood analysis (FSH, LH, testosterone).

Karyotype: This can reveal chromosome anomalies or damage and thereby explain sterility or infertility.

Infertility is one of the greatest fears of couples wishing to have children and is estimated to affect about 10-15% of couples of childbearing age.

In some cases, both the male and female partners may be infertile, and the couple’s difficulty in conceiving arises as a combination of these medical conditions. In other cases, the suspected cause is genetic; both may be independently fertile but the couple may not be able to conceive together without assistance.

In these cases, and when it comes to undertaking assisted reproduction treatment, it is important to carry out a sterility study on both partners to find out what is causing the infertility. Thanks to these tests, the specialist can direct the diagnosis and assess the chances of pregnancy with regard to the available treatments.

At Eugin, many of these medical tests are carried out for women as well as for men on the first visit, in a single day and at a reduced price in order to start treatment without delay and in an affordable way.

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