The results of the baseline examination do not always reveal the cause of the infertility of a married couple. In this case, both the man and the woman may be assigned additional tests, as well as other methods of hardware diagnostics. Thus, it is possible to form a complete picture of the state of the reproductive health of the spouses. Based on the data obtained, reproductologists prescribe the appropriate treatment for infertility.
Additional examination for women
Sometimes the results of the diagnostics performed are not enough to find out the reasons for the decrease in fertility in women and issue an opinion for IVF. In such a situation, a specialist can prescribe additional types of tests and examinations to the patient.
Blood test for hormones
The range of hormonal examinations is extensive, so the reproductologist prescribes certain types of tests based on previously obtained data. The hormonal background of a woman reflects the functional state of the reproductive system, therefore this type of diagnosis is used most often.
The analysis can be performed to determine the concentration in the body of the following types of hormones:
- follicle-stimulating - a low concentration of the hormone leads to dysfunction of the gonads and insufficient production of progesterone and estrogen;
- luteinizing - an increased content of the hormone often signals the development of endometriosis and the syndrome of depletion of the gonads;
- anti-Müllerian - a low content of the hormone indicates depletion of the ovarian reserve of the ovaries;
- progesterone - insufficient body production affects the readiness of the endometrium for embryo implantation into the uterine wall;
- estrogen - affects the menstrual cycle, as well as the development of eggs in the follicles;
- testosterone - excess content increases the risk of miscarriage in early gestation.
In addition to sex hormones, it may be necessary to donate blood to determine the level of hormones of the thymus gland and adrenal cortex in the body. Changes in the concentration of bioactive substances can lead to delayed ovulation and insufficient production of cervical mucus.
Genetic analysis
For the analysis, venous blood is taken. According to its result, the likelihood of miscarriage is assessed, and pathological changes in the genes of the blood coagulation system are determined.
Endometrial biopsy
For histological and histochemical analysis, the specialist takes tissue samples from the uterine mucosa. With the help of a minimally invasive procedure, intrauterine diseases are detected:
- endometrial hyperplasia;
- hypoplasia of the uterine mucosa;
- malignancy of endometrial cells;
- atrophy of the uterine mucosa;
- inflammation of the endometrium, etc.
The examination is most often prescribed for amenorrhea of unclear etiology, uterine bleeding and menstrual irregularities.
Tumor markers
A blood test for tumor markers reveals tumor processes in the body. When a positive result is obtained, the woman is prescribed additional types of examination to determine the localization of neoplasms.
Hysteroscopy
Minimally invasive intervention is carried out to examine the uterine cavity and identify diseases such as:
- synechiae;
- abnormal development of the uterus;
- endometriosis;
- endometrial polyps;
- hyperplasia of the uterine mucosa, etc.
Hardware examination is recommended during the follicular phase, i.e. in the interval between 6 and 13 days of the menstrual cycle.
Colposcopy
This diagnostic method involves examining the vagina and its walls for tissue inflammation and the formation of tumor formations inside the organ. In the process of diagnosis, the specialist evaluates the structure of the mucous membrane, its color, shape, and also the vascular pattern.
Cytogenetic study
Karyotyping allows you to identify chromosomal abnormalities that can lead not only to a decrease in fertility, but also to the development of chromosomal diseases in the fetus:
- Down syndrome;
- Edwards syndrome;
- Klinefelter's syndrome;
- Patau syndrome, etc.
When identifying quantitative and numerical anomalies, the specialist assesses the likelihood of developing serious illnesses in the child.
Additional examination for men
The accuracy of the diagnosis is determined by the quality and quantity of the examination methods performed. If, after passing the basic tests, it is not possible to establish the reasons for the violation of fertility, the patient is prescribed additional types of examinations.
Genetic testing of ejaculate and blood
An extended spermogram is prescribed when abnormalities in the quality of semen are detected. Within the framework of genetic research, the DNA of germ cells is studied, the degree of their mobility and morphological changes are analyzed. A special blood test is used for male infertility of unclear etiology, as well as frequent miscarriages in a spouse or pregnancy fading.
Semen biochemistry
During the examination, a specialist examines the composition of the ejaculate. According to the results of the analysis, one can judge the functional state of the prostate, epididymis and vas deferens.
Sperm culture
If, during the basic examination, pathogenic bacteria or leukocytes are found in the ejaculate, the patient is additionally prescribed semen culture. According to the results obtained, one can judge the presence of inflammatory processes in the reproductive organs, in particular in the prostate-vesicular complex.
Study of sperm morphology
An in-depth study of the structure of the sperm allows you to assess the quality of the ejaculate and the reproductive potential of the patient. During the study, the probability of penetration of male gametes into the egg is determined.
Conclusion
Additional examination allows to identify the cause of infertility in 73% of cases. Thanks to accurate diagnosis, doctors can prescribe the most appropriate therapy regimen for the patient. Its passage has a beneficial effect on the functioning of the reproductive system, which increases the likelihood of a successful outcome of the IVF procedure.
