An Andrologist is the Urologist physician who studies and treats male disorders that can affect fertility (seminal changes, sexual dysfunctions). The medical appointment has the purpose of searching for antecedents that may have affected the testicles or the seminal pathways and achieve a diagnosis. The treatment of male infertility can be medical, surgical or need to resort to ART techniques.

Conventional or Laparotomy Surgery

Surgery that uses the wide opening of the abdominal wall is reserved for more complex cases, where the laparoscopic route is not expected to resolve the situation.

Cryopreservation of Ovocytes

Women can preserve their fertility through a freezing technique that ensures good oocyte survival rates for future use – vitrification.
For this, they must undergo ovarian stimulation and follicular puncture.

This may be a fertility-preserving option in cancer patients undergoing chemotherapy treatments, which can deplete the follicular reserve.

Vitrification of oocytes may still be used in women who undergo IVF or ICSI treatments achieve a high number of good-quality oocytes but do not intend to cryopreserve embryos.

There are more and more women who want to postpone maternity for personal or professional reasons and who preserve their fertility by freezing their oocytes.

Ideally, this technique should be performed before the age of 35 years.

Cryopreservation of Sperm

Sperm may be frozen prior to the treatment cycle in cases where harvesting difficulties are anticipated on the day of follicular puncture or in some cases of oligoastenozoospermia.

Patients with oncological conditions who are to undergo pelvic chemotherapy or radiotherapy will be required to freeze sperm prior to preserving fertility, which may be affected by the treatments.

Defrosting can affect sperm quality. This change will be all the more pronounced and the worse its characteristics at the moment of freezing.

Cryopreservation of Testicular Tissue

In situations of azoospermia in which testicular biopsy was performed with collection of spermatozoa, these can be frozen for use in subsequent treatment.

Diagnostic Laparoscopy

This laparoscopic intervention is performed in the operatory block and under general anesthesia. It allows a direct visualization and characterization of the female genital organs, as well as identification of pathologies that could hinder the normal fertilization process.
When performed in the context of the study of infertility, it can be complemented by a tubal tube test in which a dye is introduced through the uterine cervix in order to confirm the permeability of the tubes through direct visualization.
Through laparoscopy, some therapeutic actions may also be performed: release of pelvic adhesions, destruction of foci of endometriosis, excision of ovarian cysts or small fibroids.

Early Ovarian Bankruptcy

Embryo cryopreservation

In the course of the IVF or ICSI cycle it may happen that a larger number of embryos are obtained than those required to transfer.
In these situations, surplus embryos are cryopreserved and, if possible, transferred later, without the need to resort to new ovarian stimulation.

In certain clinical situations it may be necessary to freeze all embryos and postpone transfer to a later, non-stimulated cycle.

According to the law in force, cryopreserved embryos must be used by the couple in a new transfer, within a maximum of three years. After this period, the embryos can be donated to another couple, used in scientific research or eliminated.

If it is the option of the couple, it is possible to cryopreserve fertilized oocytes before cell division occurs (pre-embryos).

Embryo Transfer

Embryo Transfer is, in most cases, a simple method, performed vaginally and without anesthesia.

The embryologist places the embryos in the transfer catheter, along with a small amount of culture medium. The gynecologist inserts the catheter through the cervix and deposits the embryos into the uterine cavity.

The number of embryos to be transferred may vary from case to case. Usually one or two embryos are transferred.

Endocrinology Medical Appointment

Endocrinology is the specialty that treats the hormonal and metabolic changes underlying infertility.

The excess weight or excessive thinness or even cases of uncontrolled diabetes mellitus are some examples of pathology that is treated in Endocrinology Medical appointment. Thyroid pathology should also be investigated not only by the high prevalence in the general population but also by the changes it causes infertility.

Genetic Studies

Changes at the genetic level may cause infertility or repeat abortions and should be investigated when there are antecedents that justify their achievement.
Through a blood analysis it is possible to perform the karyotype that allows analyzing the chromosomal constitution of an individual.

In some more complex cases of male factor, chromosomal studies in the blood (Karyotype) should be performed. In selected cases it may be necessary to perform the study of chromosomes in spermatozoa or molecular genetic studies (eg, Y chromosome microdeletions, cystic fibrosis gene mutations).

Genetic studies are an area currently under constant investigation.

Gynecological ultrasound

Gynecological ultrasound allows the morphological and physiological evaluation of the uterus and ovaries.
Held in different phases of the cycle, it allows us to evaluate different functional aspects. It allows the diagnosis of utero-annexiaL pathology (fibroids, polyps, cysts, hidrosalpinges, etc.).

Gynecology Medical Appointment

COIMBRA FERTILITY CENTER’s Gynaecology and Obstetrics Speciality focuses on female reproductive health, providing personalized medical care in each case, in the different stages of a woman’s life, ensuring the highest comfort for all patients.

With a vast and proven experience in the area, our team specializes in the prevention, diagnosis and treatment of diseases of the f the feminine genital tract (gynecology), as well as following up during Pregnancy, Child-birth and post child birth (Obstetrics)

Hormonal Analyzes

The determination of certain hormones in the blood allows to evaluate the functioning of the ovaries, as well as other glands that influence the functioning of the same.

The results of these tests are useful as a diagnosis, but also to guide the choice of the most suitable ovulation induction or stimulation treatment in each case.

In the case of man, it consists in the determination by blood way of the hormones that control the testicular functioning.

Hysterosalpingography (HSG)

HSG is a radiological examination that, through the introduction of a contrast agent through the cervix, allows the fundamental evaluation of the uterine cavity and the permeability of the tubes.

Hysteroscopic Surgery

The hysteroscope is an apparatus with a light system that is introduced into the uterus vaginally, allowing direct visualization of the uterine cavity. It is possible by this means to excision of myomas, polyps, septa or cure of synechiae. The patient may be discharged on the same day.

Hysteroscopy (HSC)

It is an endoscopic examination which consists of the introduction of an optic through the cervical canal allowing the observation of the inside uterus.

Hysterosonossalpingography (HSSG)

It is an endovaginal ultrasound in which fluid is introduced into the uterine cavity allowing a more detailed evaluation of the uterine cavity. It is used when intra-cavitary pathology is suspected but if a specific hyperechogenic product is used, it is also used to evaluate the permeability of the tubes.

Imagiology

The Surgical Center of Coimbra has an Imagiology Service that allows users to perform all the imaging tests for the study and diagnosis of infertility as well as some treatments that require interventional radiology.

In vitro fertilization

In Vitro Fertilization (IVF) is a PMA technique, which consists of the union of the female and male gametes in the laboratory. The ova are placed together with the spermatozoa in suitable culture media, and fertilization occurs spontaneously.

This technique was initially used in women with obstructed tubes (tubal factor) but is currently applied in many other cases (mild male factor, endometriosis, cervical factor and infertility without apparent cause).

Knowledge Center

Andrology Appointment