Sterility (infertility) is diagnosed with couples who do not have pregnancy even after a year of unprotected sexual intercourses. Frequency is about 8-15% of all the couples. Normal fertility is around 20% per cycle, but in normal population 60% of women conceive within the period of 6 months, 80% within 12 months and 90% within 18 months. When to start with a couple treatment depends on more factors, and the most frequently about the female patient’s age and anamnesis (surgical procedures in pelvis, PID – pelvic inflammatory disease, menstrual cycle disorder, endometriosis…) and anamnesis of a male partner- recovered diseases…
Following examinations are included in the treatment of sterility:
- Gynaecological examination, PAPA test and ultrasound result
- Semen analysis in the clinic (Petrova., Merkur, Vinogradska…- after 3 to 5 days of abstinence from sexual intercourse)
- Microbiological processing of the cervix- bacteriologically (aerobes, anaerobes) Chlamydia, Mycoplasma, Ureaplasma
- Urine culture
- Hormonal examinations- 2nd to 5th day of cycle FSH, LH, E2 (estradiol), A (androstenedione), DHEA-S, AMH, SHBG, PRL, f-T (free testosterone), TSH and P4 (progesterone) on the 21.day of the cycle.
- Ultrasound examination of fallopian tubes 3D SHSG (saline)
After the examination which excluded greater abnormalities in the results of the semen analysis or for example it excluded ultrasound findings which indicate ovarian obstruction, it is possible to plan ultrasound folliculometry (see under the title “Ultrasound”) in the natural cycle or the cycle stimulated with the clomiphene citrate tablets and in that way cure a great number of patients aho have sterility. Such milder disorders include anovulation- PCO syndrome, mild changes in semen analysis, poorly timed day of possible fertilization etc.
In case of need for assisted (artificial) fertilization methods ARM (assisted reproductive method) and before sending to other clinics, a female patient needs following examinations too- serological antibody tests anti-HIV 1 and 2, antigen HBs, anti HBc, anti HCV, syphilis) Kg, Rh and processing the partner serologically.
