Creating a family, each couple suggests the possibility of procreation - the birth of children and their upbringing. But a year or two passes, and pregnancy does not occur. If a couple leads a regular sexual life all this time and does not use any contraceptives, then after this period certain anxieties and worries about the possibility of conceiving a baby appear. There can be two reasons for this, and both relate to health - the health of a man and the health of a woman who wants to have a baby.
Let us leave for a while the topic of male reproductive health and talk about female.
According to medical statistics, in recent years there has been an increase in cases of infertility among girls who have reached reproductive age. Probably, for every girl, finding out about her inability to conceive and have a baby is the worst thing that can happen in life. The diagnosis of infertility does not allow one to experience the joy of motherhood. And for many women, the absence of a child is an incomplete family.
In this regard, it is very important to know the signs of possible infertility in a girl. This will allow to conduct a comprehensive examination in a timely manner, to prescribe and conduct the necessary treatment and medical procedures for reactivating the reproductive capacity of the female body.
What can cause infertility?
There are a number of reasons the presence of which can prevent the onset of pregnancy, bearing and having a baby:
- Hormonal dysfunction, manifested by a violation of the functioning of the ovaries and other organs responsible for the production of hormones - the pituitary, hypothalamus, adrenal glands and thyroid gland. Infertility in this case is inevitable.
- Endometriosis of the uterus. This disease is fraught with scarring. If signs of this disease are noticed in the internal organs of the patient’s reproductive system, then infertility should be feared.
- Symptoms of Infertility pathological changes in the uterus can also serve - such as polyposis, fibroids, uterine bicorn, or the presence of an intrauterine septum. All these pathologies can be congenital, but they can also arise in the process of life.
- Tubal obstruction - pipe infertility. It occurs due to the formation of adhesions in the fallopian tubes.
- The presence of adhesions in the pelvic area. Such commissures may form due to some kind of inflammation or surgical intervention. Such adhesions can occur between the fallopian tube and the ovary, which makes it impossible for the egg to enter the uterus for fertilization.
- Chromosomal pathology. This is a rather rare pathology, but, nevertheless, it leads to the sterility of a woman.
- Immunological factor. This type of infertility is also quite rare. With this type of violation, antisperm bodies are produced in the woman’s reproductive system, which prevents the penetration of sperm into the uterus, which makes it impossible to fertilize the egg.
- The psychological factor. Two reasons are related to this case - fear of pregnancy and childbirth, unwillingness to have a child from a specific sexual partner.
Types and degrees of infertility
There are two types of infertility - absolute and relative.
Absolute infertility is its most terrible variety, which is not treated. This type of infertility is caused by the abnormal development of the human body, for example, in the complete absence of any reproductive organ or its part (uterus, ovaries).
Relative infertility is not irreversible and after certain measures can be successfully overcome, which in turn will lead a normal lifestyle and have healthy offspring.
In addition to types of infertility, two degrees are also distinguished:
- primary infertility (first degree) - it happens with girls who have never been pregnant in their life,
- secondary infertility (second degree) - occurs in women who were pregnant and may already have a child, but currently have certain problems with conception. This type of infertility is diagnosed in approximately 45% of women who, as confirmed later, have various gynecological diseases, the result of which is usually the formation of adhesions. Often, the ability to conceive is influenced by previous operations on the internal genital organs (including artificial medical abortions).
Signs of infertility
The first symptoms of the possible development of infertility appear in girls as early as puberty (puberty), and the following symptoms include them:
- congenital disorders and dysfunctions of the genitals of a girl,
- the late onset of menstruation - the menarche at a very late age (after 16 years),
- meager menstrual flow
- long (long) menstrual cycle,
- irregularity of monthly bleeding,
- chronic diseases
- nervous system problems
- infectious diseases of the reproductive system.
Attention should be paid to the physical development of the girl. If she significantly lags behind (severe thinness - up to 45 kg) or ahead (overweight - over 90 kg) in the development of her peers, then in the future this can lead to infertility.
The main sign of infertility
If a girl of reproductive age, who has regular sexual contacts and does not use contraceptives, is not able to become pregnant for twelve months, experts say that this pathology is highly likely. However, despite this statement, other factors must be taken into account in order to establish a diagnosis. For example, after thirty years, the fairer sex is quite difficult to conceive a child.
This may require a sufficiently long period, even if a woman regularly practices unprotected intimate contacts and does not have health problems. How to understand that you are barren? Are there any clear signs of this condition?
In addition to the absence of pregnancy, this pathology has no pronounced symptoms. And even the inability to conceive is not a basis for establishing a diagnosis. Indeed, there are often situations when it is not a girl who is infertile, but her partner. Therefore, both spouses should contact a specialist for advice on this problem. Do not postpone the visit to the doctor. After all, the earlier the examination will be carried out, the higher the chances of successful therapy and a positive result.
Common causes of infertility in women
How to understand that you are barren? Inability to conceive is not an independent disease. And the only sign of this condition is the absence of pregnancy for twelve months of regular intimate contact without contraception.
However, it should be remembered that infertility in girls is usually observed due to various disorders of the body, in particular, the genital area. It develops due to ailments of an inflammatory nature, genetic abnormalities or congenital defects of the reproductive system. Surgical interventions, hormonal imbalance, psychological overstrain and mechanical damage to the brain can also be factors that trigger the onset of this condition. After the age of thirty-five, all physiological processes in women proceed more slowly. It is much more difficult for them to conceive a child than younger women.
Varieties of pathology
How to understand that you are barren? This issue is relevant for those who for a long time cannot experience the happiness of motherhood, despite numerous attempts to conceive a child. It should be borne in mind that the signs of the pathologies that cause this condition are different and depend on the cause of the disease. Disorders of the body that contribute to the development of infertility are divided into several types:
- Infertility of a primary nature. They talk about him if the patient has never had a conception. Typically, the cause of this condition is an imbalance of hormones.
- Secondary infertility. This diagnosis is made in the situation when the patient already had at least one pregnancy, regardless of how it ended (interruption, delivery or death of the embryo in the womb). Often such infertility is observed after suffering inflammatory processes or infectious ailments of the reproductive system.
- Relative infertility. This condition is associated with the impossibility of conception as a result of dysfunctions that are reversible. After the detection and elimination of pathological processes, the girl’s signs of infertility disappear, and a long-awaited pregnancy occurs.
- Absolute infertility. It is due to anomalies that are not amenable to therapy. This, for example, the absence or defects in the formation of tubes, uterus, gonads. Previously, such pathologies made conception impossible. However, today, with the help of assisted reproductive technologies, women who have similar characteristics are given a chance to experience the happiness of motherhood.
- Immunological infertility. Such a violation is observed in patients of both sexes. The disorder is expressed in damage to male gametes with special antibodies that are formed as a result of acute infections or chronic diseases transmitted through sexual contact. In case of suspicion of such a pathology, the partners should undergo a comprehensive examination, including analyzes of biological material (seminal fluid, mucous membrane of the cervical canal and vagina).
Other diseases that prevent conception
How to understand that you are barren? Many ailments that interfere with the onset of pregnancy have pronounced symptoms. Their presence is impossible not to notice. Similar pathologies include:
- Adhesive processes, accumulation of fluid in the fallopian tubes. Adnexitis is often the cause of such phenomena (ICD code 10 70.0). This disease has an inflammatory nature, proceeds both in acute and in chronic, protracted form.
- Pathological processes in the uterus. These include excessive proliferation of organ cells (endometriosis), diseases of the cervical canal, various neoplasms (for example, fibroids).
- Oophoritis is an inflammation of one or two sex glands, which is characterized by an acute or chronic course.
To diagnose such disorders, the specialist conducts an x-ray of the fallopian tubes and a laparoscopic examination. Such procedures not only reveal pathologies, but also have a therapeutic effect.
This violation is observed in disorders of the pituitary gland, thyroid gland, adrenal glands or gonads. The substances necessary for the maturation of the eggs are not produced in this case. Therefore, the woman does not have ovulation. One of the signs of infertility in a girl, if it has a hormonal nature, is a stable schedule of basal temperature. It indicates the absence of the necessary conditions for conception. In addition, patients who have similar problems have excessive hair growth (especially in the shins, abdomen, chin), the appearance of acne on the face. In addition, the girl must pay attention to the nature of critical days. Any violation of the menstrual cycle (according to ICD 10 code 94.4 - 94.9) often leads to infertility. You should consult a doctor if the period between bleeding becomes too long, intense, prolonged, or, conversely, scanty and short-term (less than three days) discharge is observed.
One likely answer to the question of what can be infertility is an STI. Sometimes such pathologies occur without pronounced signs. In such cases, the spouses do not even realize that they are sick. And only the lack of conception for a long time forces them to turn to the doctor.
Infections transmitted through sexual contact adversely affect a woman's body, provoking pathological processes in the reproductive system that lead to adhesions.
Other factors that may interfere with conception
In some cases, infertility occurs as a result of the following reasons:
- Body mass deficiency. Lack of weight is typical for patients suffering from eating disorders, girls who have a meager and unbalanced diet. Excessive thinness interferes with the process of maturation of female gametes.
- The presence of excess kilograms. Obese patients are not able to have a baby due to hormonal imbalance.
- Problems of a psychological nature. This is a strong desire to conceive or fear of pregnancy.
To identify the cause of the problem, you must contact a medical institution. What tests pass for infertility? Specialists recommend patients the following types of examinations:
- Magnetic resonance imaging of the brain.
- Assessment of the state of the organs of the reproductive system using ultrasound.
- X-ray of the uterus and fallopian tubes.
- Laboratory tests of biomaterial to detect infections and determine hormone levels.
- The study of the cervical canal.
- Inspection of the gynecologist.
After diagnosing female infertility and identifying the causes of infertility, the specialist selects treatment methods. Depending on the factors preventing the onset of conception, the doctor recommends the necessary means to eliminate them.
Some patients are prescribed drugs to relieve inflammation, others are given antibiotics, and others are given medicines containing hormones. Sometimes the situation is so serious that you have to use assisted reproductive technologies. Such methods as in vitro fertilization, artificial insemination, the use of donor biomaterial or the services of a surrogate mother allow many women to make the dream of having a baby a reality.
Signs and causes of male infertility
Male reproductive problems are caused by health problems:
- prostate fibrosis,
- genital injury
- potency disorders
- infectious and inflammatory diseases of the genitourinary system.
The consequences of the ailments are the violations listed below, which lead to a man's inability to conceive a child:
- Lack of sperm in the ejaculate, their low activity and viability.
- Violation of sperm synthesis.
- High reduces sperm motility.
- The complete absence of sperm in the ejaculate.
- Pain in the lower abdomen after minor physical exertion.
- Frequent false urination.
- Disorders of the endocrine system.
- The formation of lumps or threads in the ejaculate.
- A small amount of sperm or its complete absence.
Before you learn how to check a man for infertility, you need to know how to properly prepare for the study in order to get reliable results. To do this, you must:
- abstain for two or three days from sexual intercourse,
- refuse to use drugs a week or two before the study,
- stop drinking alcohol and smoking one to three months before diagnostic measures,
- overheating of the testicles should be avoided
- remove coffee, sweet and sodas from the diet.
If a man fixes one of the listed signs of infertility, it is necessary to consult a specialist.
However, not every couple knows where to check for infertility to a man and which doctor to consult. To do this, you need to seek help from a urologist or andrologist in a specialized medical institution or a special department of the clinic.
The examination takes place in several stages.
Stage 1 examination
Checking for infertility in men in the first stage includes a clinical and laboratory study. The minimum price of this stage is 8000 rubles. and more, depending on the place of residence and the number of requests.
A clinical trial includes:
- Survey of the patient, the study of his physique, weight, height, age and more.
- A full medical examination, a visit to a therapist, sex therapist and genetics is mandatory.
- Screening for the presence of pathologies and diseases of the genitourinary system.
Laboratory research includes a spermogram
Laboratory research includes tests such as:
- Spermogram. The main analysis, on the basis of which a further examination is prescribed. It is necessary to study sperm quality, sperm count, their activity and appearance. The state is studied in dynamics, so you need to pass the analysis several times.
- The MAR test does not help establish the number of non-viable sperm in the ejaculate.
- An enzyme-linked immunosorbent assay (ELISA) indicates in the blood.
- Cytological analysis helps to obtain information about the condition of the seminal vesicles, urethra and excreted fluid.
- Additional laboratory tests: bacteriological analysis of the prostate, general and biochemical analysis of blood, general analysis of urine.
2 stage examination
If the studies carried out at the first stage did not give a specific result: infertility is established, but its reason is not found, how else can a man be checked for infertility? To do this, you must go through the second stage of the examination, which includes:
- A hormonal blood test, with the help of which it is possible to accurately determine whether a man’s sperm are present and mature, as well as possible violations of this process.
- Ultrasound examination of the genitals, in order to determine pathological conditions.
- TRUS is a method by which changes in seminal vesicles are investigated.
- Doplometry helps to study the blood vessels of the pelvic organs and establish the presence of varcocele.
- Genetic research.
- Sperm centrifuge analysis.
- Testicular biopsy is necessary to obtain sperm for IVF.
Based on the results, the attending doctor diagnoses infertility and the type described below:
- The secretory form implies low sperm activity. It is the most common.
- The obstructive form occurs in men after pelvic injuries, with inflammatory or infectious diseases of the genitourinary system. Obstacles arise in the way of sperm cells that do not reduce their speed or completely impede their exit.
- The immunological form is the most poorly studied, since with this pathology, the man’s immunity independently suppresses sperm production and reduces their viability. With this type of infertility, the male body contains a high level of sperm.
A qualified specialist will prescribe a treatment that includes one or more methods
Treatment and prevention
Which doctor. Of course, it is necessary to apply for treatment to a urologist or andrologist who prescribed the study and deciphered their results.
Treatment is prescribed only by a qualified specialist, which includes the use of one or more techniques in combination:
- Conservative drug treatment is aimed at maintaining immunity, eliminating inflammatory and infectious processes, as well as normalizing the work of the endocrine system. For this they use drugs: vitamin-mineral complex, immunosuppressive therapy, herbal remedies, as well as antibiotics.
- Surgical intervention is necessary when pathologies of the structure of organs, as well as neoplasms, are found in the male genital organs and are aimed at eliminating them.
- Assisted reproductive technologies. The method of IVF and ICSI is widely used when a viable sperm is selected in the male body and is inserted into the female egg in vitro or endoscopically.
- Treatment with folk remedies, in combination with medication.
It is also important to prevent infertility. To do this, you must:
- Regularly checked by a urologist, in order to timely identify possible problems and eliminate them.
- It is necessary to lead a healthy lifestyle: give up bad habits, play sports, eat right.
- Have sex regularly. If you want to get pregnant, unprotected sexual contact should be 3-4 times a week on ovulation days.
- Use underwear only from natural materials. This will help to avoid overheating of the scrotum.
- During the treatment of other diseases, it is worth asking the doctor to prescribe medications that are least harmful to the male body. and find out how experts recommend treating.
According to the World Health Organization, up to 20% of families around the world cannot have children. About ten percent of couples fail to conceive a child in a natural way. Moreover, in half the cases, a woman does not manage to become pregnant due to the infertility of her partner, therefore the question of how to check a man for infertility is especially relevant. Male infertility or impaired reproductive function in men is associated with a change in the qualitative and quantitative composition of sperm (a small number or insufficient activity of sperm). Today, inability to conceive and childlessness is not a sentence at all: modern medicine provides a chance to become parents of almost every married couple. A man who wants to become a father needs to contact the family planning center and undergo an examination with an andrologist.
A man and a woman should sound the alarm if pregnancy does not occur within a year of regular sexual activity (intimate relationships at least twice a week) without the use of contraceptive methods and methods.
The first step is to consult a reproductologist who will refute or confirm that the man is impotent and cannot have children. But doctors of this specialization rarely conduct receptions in small towns. In the absence of a reproductologist, contact the gynecology and urology department. Gynecologists and urologists also specialize in reproductive health issues for men and women.
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A comprehensive examination of a man includes a medical history, visual and manual examinations, and analysis of seminal fluid. To prescribe effective treatment and identify etiology, the patient undergoes the following types of diagnostics:
A comprehensive examination is best done in the largest centers of family planning and reproduction, located in the Leningrad, Moscow, Omsk, Nizhny Novgorod, Ryazan regions, the Republic of Tatarstan and the Krasnodar Territory. Testicular biopsy will cost the most: from three to ten thousand rubles.
Sexually active does not mean healthy
The absence of problems with an erection and a strong sex drive is also found in infertile men. Dispel all doubts will help the passage of the spermogram procedure. A laboratory study of the ejaculate allows you to establish the ability to conceive and identify possible diseases of the reproductive system in men. For accurate confirmation of the diagnosis, several spermograms should be taken.
The reliability of the results depends on the observance of the rules when passing the semen analysis. For several days before the test, a man should not enter into an intimate relationship, take medications (the exception is vital), and drink alcoholic and caffeinated drinks.
Features of spermogram delivery:
- The biomaterial is collected in a sterile plastic container and transferred to the laboratory assistant. The quantity, density, shape, speed of sperm is estimated.
- The laboratory checks the concentration of sperm (above or below twenty million sperm per ml of ejaculate). Today on sale appeared a home test of male fertility. It can be carried out at home.
- With a small number of sperm, additional tests are prescribed to accurately check the impotent man or not. The doctor needs to know the level of prolactin, testosterone and follicle-stimulating hormone that affects the functioning of the gonads.
- A urinalysis reveals the most common infections in guys. Using it, you can diagnose a disease such as spermaturia (the presence of seminal fluid in the urethra).
Classification of Infertility in Women
There are two main types of this problem: the first type is primary infertility, which is diagnosed in women in situations where pregnancy does not occur within a year of active sexual activity, provided that there are no contraceptives. This type of infertility occurs in two situations: with malformations of the uterus (saddle or two-horned uterus, underdevelopment of the uterus, abnormal anatomy of the organ), in violation of the normal functioning of the endocrine system. Secondary infertility is diagnosed in the presence of at least one pregnancy in the past (even if the child has not yet been born). This can happen for the following reasons: due to injuries of the pelvic organs, abortions or other types of operations, tumor processes that occur in the reproductive system (this can be myoma, endometriosis, hay fever), inflammatory diseases of the female reproductive system, and hormonal disorders background, which occurred due to diseases of the endocrine system with incompatibility of partners.
How to determine infertility? To do this, you need to contact a specialist who knows what are the main signs of such a problem as infertility in women.
The main signs of infertility in women
How to determine infertility? The most common signs by which a specialist can detect infertility are as follows:
- late onset of menstruation. It should be noted here that according to medical standards, the cycle should begin in the interval that begins at 11 and ends at 13 years. However, there are cases of early onset of menstruation, for example, at 9 years old,
- the abnormal duration of the menstrual cycle, which in normal situations should last 28-30 days. Here everything is calculated strictly individually, so sometimes this period can take 35 days or so,
- amenorrhea, that is, the complete absence of menstruation, which may be associated with gynecological, neurological or endocrine disorders,
- violation of cyclicity, which is one of the most common gynecological problems of our time. It can be observed for various reasons. For example, due to stress, infection that affects the pelvic organs, hormonal disorders, childhood diseases (in particular, rubella), and so on,
- insufficiently plentiful discharge, the volume of which should normally be from 50 to 100 ml per one taken cycle. However, this value also varies depending on various factors of an individual order,
There are other signs of infertility in women, however, the above are most often found in women.
Diagnosis of infertility in women
Many novice doctors wonder about how to determine infertility in women. In fact, this is a lengthy process that is notable for its complexity. To determine the presence of infertility in a woman, a survey is carried out, conducted simultaneously in several directions. First, the specialist needs to determine whether a woman who is a patient has acute and chronic diseases. After this, an examination of the organs is carried out using ultrasound equipment. This is necessary in order to completely exclude developmental pathologies and determine the degree of maturation of the uterine epithelium in accordance with the phases of the menstrual cycle. Then, the degree of patency of the fallopian tubes is revealed in women and a thorough study of the functioning of the endocrine glands is carried out (this is especially important when the first and second phases of the cycle go). Next, a post-coital test is performed. This is then necessary to exclude immunological incompatibility, which quite often is the cause of infertility in women.
The most common causes of infertility in women
One and most common causes of infertility – these are problems that arise in a girl with ovulation. Sometimes the duration of their menstrual cycle is less than the due period or, on the contrary, longer than it. For this reason, the risk that the egg will not have time to mature or be unable to fully function, becomes quite high. Based on the information presented, the question arises of how to determine infertility? Reproductive health experts respond that the following symptoms are observed with this problem: ovulation is absent, as are mature eggs, which are not capable of producing mature follicles.
Another common cause of infertility in a girl is ovarian dysfunction, which is diagnosed in 20% of cases that are considered in practice. The essence of the problem lies in the fact that the specialized hormones responsible for regulating the menstrual cycle and the formation of sex hormones cease to be produced in sufficient quantities. The main signs: sharp pains of a piercing nature, severe pain, a feeling of numbness, which is felt in the lower abdomen, located in close proximity to the internal genital organs, increased irritability, changes in behavior. The third reason that infertility is diagnosed is hormonal disruption, which, in fact, is one of the varieties of ovarian dysfunction. The main symptom observed in a girl who wants to determine the causes of infertility is the complete absence of menstruation, which occurs due to non-maturing of the egg.
The main methods of treatment of infertility
When choosing a method for the treatment of infertility, the specialist focuses on why this problem arose. For example, if a couple cannot conceive a child due to problems with ovulation, then a treatment method called “classical ovulation induction” is prescribed. Its essence is to restore normal ovarian function due to insignificant hormonal effects, which is necessary for egg maturation. This will help eliminate infertility, later conception will occur in a natural way. If the cause of infertility lies in hormonal disruptions, then doctors prescribe a certain therapy that helps to normalize hormonal disruption, and therefore, eliminate infertility.
A marriage is considered to be sterile, in which, during the 1st year of sexual life without contraception, a girl younger than 35 years old does not get pregnant. If the age of the girl is more than 35 years, then this period decreases to six months.
Photo: Infertility - an occasion to see a doctor
It is best to consult two doctors: the local gynecologist who will begin the examination and the gynecologist doctor - the reproductologist, more a narrow professional working on problems.
Research methods include:
- Ultrasound of the abdomen of the pelvis,
- hormonal analysis,
- blood coagulation testing and other important procedures.
Only the friendly interaction of these doctors will give a solution to your problem as quickly as possible.
Video: Female infertility, cause, diagnosis
Today, reproductologists work in Eco hospitals. Actually, therefore, for diagnosis, an IVF hospital should be contacted immediately, as soon as you realize that you have problems conceiving. Going to an IVF hospital does not mean that fertilization is definitely advised to you.
On the contrary, a large number of patients with infertility can be cured without resorting to artificial methods of fertilization. But this is only possible if the diagnosis of infertility in women is observed in a timely manner and effective treatment is started
Goals for early admission to the hospital
- 1st - the appointment of the survey program,
- 2nd - the implementation of those research procedures that cannot be completed in consultation,
- 3rd - obtaining an opinion,
- 4th - drawing up an effective treatment program.
The determining value in the research depends on the consultation of a specialist andrologist, his qualification level and interpretation of the survey data. Diagnosis is carried out according to the following scheme:
- A fertility map is compiled, which includes the collection of all general tests, the appointment of treatment
- Sperm quality study,
- MAR test
- Ultrasound scrotum,
- Examination of the prostate gland.
What is dangerous prolonged examination of a couple?
The main danger is an increase in the age of the girl. The fact is that at the age of a girl of 25-30 years, the effectiveness of the treatment of infertility is 54 - 80%, and at the age of 36 - 40 years it is 21 - 26%, after forty years, only 11 - 15% of marriage couples have a chance to get pregnant.
Another danger is the sensory exhaustion of the couple, caused by a long unsuccessful visit to various doctors, the repeated passing of heterogeneous tests, often of little information. Finally, the financial costs of the couple will increase, the longer the examination lasts.
Infertility Diagnostic Methods
An in-depth examination of both spouses should not exceed 4 months.
Methods of research for a couple suffering from infertility:
- Conversation of the state of health, past illnesses, operations, bad habits, occupational hazards.
- Gynecological examination.
- Subjectively, according to the evidence, consultations of other doctors can be prescribed: an endocrinologist, a neurologist. therapist and others.
- For the health of the unborn baby, spouses need to have blood tests: for tocosplasmosis, sexually transmitted diseases, various infections, HIV.
- Sound examination of the pelvic organs.
- To control ovulation, a study is made of the schedule of changes in the base temperature for three monthly cycles.
- A sign of the reproductive function of the male reproductive system is sperm analysis.
- Sample for compatibility. Biological or immunological incompatibility of a couple can lead to infertility of an absolutely healthy couple. Это обследование проводится за два дня до допускаемой овуляции и не позднее, 6 ч после полового акта.
- Гормональное исследование на определение уровня мужских и женских гормонов, а также пролактина, кортикостероидов и т. д.
- Гистеросальпингография. It determines the severity of adhesions in the fallopian tubes, in the ovary area, detects endometriosis and more.
- X-ray of the uterus and tubes. Allows you to determine pathological changes in the uterine region, detect nodes, polyps and much more.
Video: Methods for the diagnosis and treatment of infertility partners
Dreams of pregnancy for many couples remain dreams. Unfortunately, the number of men and women who have problems conceiving is increasing every year. Therefore, the question of infertility tests, the causes of this phenomenon and methods for its correction remains very relevant. Modern scientific medical technology helps to cope with most varieties of infertility. But before embarking on any therapeutic measures, it is necessary to diagnose the problem. Where to check for infertility for men and women?
Specialists in reproductive medicine argue that the issue of infertility needs to be raised only a year after unsuccessful attempts to become pregnant. In this case, sexual activity should be regular, and no contraceptive methods should be used. Such recommendations are explained by statistics that claim that in the first month pregnancy occurs in twenty percent of cases. The total number of pregnant women in three months of active attempts is fifty-seven percent. For six months, up to seventy-five percent of future couples become future parents. Eighty-five percent of women become pregnant in six months of active attempts.
In many ways, the probability of the onset of conception depends on age indicators, so at the age of twenty-five years, seventy-five percent of couples achieve such a result in six months, and only forty-two percent at forty.
Where to check for infertility?
If you suspect infertility, it is advisable for the couple to make an appointment with a special doctor in the antenatal clinic, who is responsible for family planning. After collecting an anamnesis, the doctor will advise the necessary studies and refer both a man and a woman to an additional specialist.
It is important that both partners come to the doctor, since infertility can be both male and female. According to statistics, the likelihood that the problem in the fair sex is almost fifty percent. The chances are that the man is the “culprit” of the situation.
If you are thinking about where to go to a private clinic or a public institution, the choice of treatment location depends solely on your personal preferences and financial capabilities. In small cities, it often turns out that the same specialists work in these structures, just on a different schedule. Analyzes are carried out in the same laboratories. As for the unambiguous advantages of private medical institutions, one of those is a more attentive attitude of the doctor to his patients, due to unlimited time for admission. Accordingly, in such a clinic you have more chances that they will listen to you in detail and take into account all, even the smallest nuances.
Nevertheless, government offices of reproductive medicine also provide fairly qualified assistance at a very decent level.
First of all, women who suspect infertility should undergo an examination with a gynecologist. This study will help to assess the general condition of the genitals, and detect any obvious problems. In addition, the doctor carries out biomaterial sampling to search for various infections and inflammatory processes. One of the first diagnostic measures is also an ultrasound scan, it shows how correctly the genitals are developed. Also, with its help, you can see various pathological conditions, for example, cysts, fibroids, adhesions.
Going to the first appointment with a gynecologist, a woman should make a schedule of basal temperature. To get the most clear picture, temperature data should be recorded for several months. Such a schedule will help the doctor evaluate how well the reproductive system works, whether ovulation occurs, etc.
A study of female infertility can also include hysteroscopy, a special study that makes it possible to determine the condition of the uterine cavity, as well as see some abnormalities. This procedure involves the introduction into the uterus of a special device - a hysteroscope, it is equipped with a video camera and transmits the picture to the monitor screen. The specialist can refer the patient to determine the patency of the fallopian tubes, which is called hysterosalpingography. For its implementation, a special component is introduced inside the uterus, after which, using a special apparatus, contrast images are taken, which make it possible to assess the patency of the tubes.
Necessary studies are also hormonal analysis, laparoscopy, determination of the level of blood coagulation, etc.
As for male infertility, the specialist first sends the patient to a spermogram that shows motility, as well as the cellular composition of sperm, determines their morphology and quantitative indications. In the future, bacteriological examination, cytology and blood tests may be needed.
Based on the results of all these studies, the doctor may prescribe some additional diagnostic measures. In some cases, such manipulations are sufficient to select the appropriate treatment options.
Signs of Male Infertility
How to find out if a man can have children? All symptoms can be divided into two large groups of symptoms. The first is external manifestations, the second is subjective internal sensations, allowing to suspect a malfunction in the body. The symptomatology of male infertility in the vast majority of clinical pictures for a long period of time goes unnoticed. As a rule, until all attempts to get pregnant do not end with the desired result.
It is worth knowing: for the fertility of men, sex hormones and organs of the reproductive system are responsible.
With the development of hormonal imbalance due to a disease, external symptoms are often manifested. Some diseases of the reproductive system leading to impaired fertility are also visually distinguishable. However, the presence of an external clinic is not always indicative of infertility.
The diagnosis is made solely on the basis of laboratory and instrumental diagnostics.
How to determine if I can have children? It is recommended to pay attention to signs of infertility of an external nature:
- Body type atypical for a man. If a representative of the stronger sex has a tendency to anatomy to a figure of a female type, this is an occasion to suspect problems with fertility. The symptoms are most pronounced in men against the background of Klinefelter's syndrome - a congenital disease. In the puberty, there is an accumulation of fatty tissue at the waist, insufficient hair on the body, high growth in combination with narrow shoulders, enlargement of the mammary glands, small and dense testicles.
- Strong sex, having a "beer" belly or obesity, runs the risk of being infertile. An excess of fatty components in the body leads to the development of azoospermia - a pathological condition due to which there are no sperm in the seminal fluid. Pathology is diagnosed in 25% of men among all cases of morbidity.
- The answer to the question of how to find out that you are infertile will be a careful study of your scrotum. Normally, both testicles are the same size. One may be located somewhat lower than the other - a variant of the norm. If there is an increase in the scrotum from one or two sides, an atypical structure is present, the shade of the skin is altered - signs of infertility.
- Failure to testify one testicle or both testicles indicates impaired fertility, since full spermatogenesis cannot be carried out in the abdominal cavity. Most often, this pathology is diagnosed in infancy.
- Asymmetric view of the scrotum. The formation of a hernia leads to an increase in the scrotum in size. In everyday life, pathology rarely worries representatives of the stronger sex, since it does not have the property to manifest itself as a pain syndrome. But the danger is that the growth of the neoplasm provokes compression of the blood vessels that nourish the soft tissues of the testicles, respectively, spermatogenesis is disrupted. Asymmetry of the scrotum can provoke a varicocele disease - the expansion of the veins of the spermatic cord.
- How to find out if a man is infertile? You can suspect a violation if there is an insufficient amount of seminal fluid after ejaculation. A small amount of seed for a mature man after 55 years old, a variant of the norm, but not for a young man in 20-35 years old.
- Hyperemia or swelling of the scrotum. These signs indicate an inflammatory process. In the absence of timely treatment, the reproductive function of men is impaired. As a rule, additional symptoms are present. This is an increase in body temperature, pain in the perineum, general malaise, swollen lymph nodes.
How to determine if a man can have children? Unfortunately, it is difficult to visually identify the pathology even to the most qualified specialist. You can only suspect any disease or a malfunction in the body yourself. In 90%, symptoms of external infertility are not manifested. Sometimes the presence of pathology can be suspected of internal discomfort. Many diseases of the reproductive system are accompanied by various symptoms. This is pain in the groin, discomfort during ejaculation, impaired erectile function, tingling in the anus, etc.
Description of methods for determining infertility
How to determine infertility in a man? To do this, you need to go through the diagnosis. The examination algorithm includes a collection of medical history and patient complaints. The doctor studies the existing pathologies of a chronic nature, surgical interventions in the anamnesis. Be sure to be interested in the number of sexual partners, the presence / absence of pregnancy, the method of contraception. Information about work is also important, because a profession related to chemicals can impair fertility.
Important: at the first visit to the doctor, a visual examination is performed. The doctor evaluates the degree of development of secondary sexual characteristics, palpates the testicles of the scrotum, the expansion and tortuosity of the veins of the spermatic cord. A rectal examination of the glandular organ is carried out to confirm or refute the presence of inflammatory processes.
An important step in the diagnosis is the assessment of reproductive and sexual function. The doctor clarifies the number of sexual contacts per week, the hardness of the penis during an erect condition, the nature of ejaculation - early, normal or delayed. Then it is recommended to make a spermogram. To do this, a man passes seminal fluid to the laboratory. To date, a spermogram appears to be the most informative diagnostic method. Sperm testing helps determine the following abnormalities:
- Small amount of active sperm,
- The absence of sperm in the seminal fluid,
- Reduced viable sperm count,
- Low sperm count
- Leukocyte jump (infection or inflammation),
- A large amount of seminal fluid
- The presence of 50% defective sperm, for example, having a doubling of the head, a change in structure, shape, etc. indicators.
If there is a suspicion of a sexually transmitted infection, additional tests are prescribed. These include a smear from the urethral canal, PCR diagnostics to establish the appearance of a specific pathogenic microorganism. Bacterial seeding of seminal fluid is also carried out (if bacteria or a large number of leukocytes are found in semen), prostatic juice is examined.
How to check infertility in men? Often, disorders are associated with hormonal imbalances in the male body. Hormonal studies are conducted to determine the concentration of testosterone, FSH, LH, prolactin, estradiol. The content of free radicals is estimated - excessive production contributes to damage to the sperm membrane, violates their mobility, which reduces the fertilizing ability.
For information: an important step in the diagnosis of male infertility is the study of the acrosomal reaction - when sperm comes into contact with an egg, chemical transformations are observed on its head, which allow it to dissolve the egg membrane and, accordingly, penetrate inside. Acrosomal reaction occurs exclusively in sperm with normal morphology.
Electron-microscopic examination of spermatozoa and cytogenetic analyzes can detect pathology of the structure of sperm, evaluate the contents of the plasma of seminal fluid, determine the qualitative and quantitative characteristics of chromosomes. If chromosome abnormalities are found, a genetic consultation is required to understand the cause of infertility.
How to check for infertility? In addition to the tests described above, a man is recommended instrumental diagnostics:
- Ultrasound of the thyroid gland.
- X-ray of the skull, Turkish saddle (manipulations are necessary to exclude the tumor process in the pituitary gland).
- Ultrasound transrectal and transabdominal way. The structure and consistency of the testicles, appendages, glandular organ, condition of seminal vesicles, and vas deferens are assessed.
- Dopplerography of the scrotum.
- Thermography of the scrotum (determines varicose veins).
- Testing of biopsy specimen from testis. Such manipulation is carried out against the background of an idiopathic decrease in active sperm with a normal testicle size and concentration of FGS.
If an immunological type of male infertility is suspected, a study of antisperm bodies is performed. Their presence indicates that the immune system produces specific antibodies that take germ cells for foreign objects. Additional tests include Shuvarsky analysis (helps to determine the immune conflict at the level of the cervical canal) and the Kurzrock-Miller test.
A few years ago, California scientists developed a home infertility test for men. It is presented as a sperm chip. It has "bridges" of electrodes that are filled with liquid. A few drops of seed should be placed on the chip. After that, the device monitors each sperm "floating under the bridge", then determines their number. The price of such a novelty varies from $ 50 to $ 80.