There are a number of tests to evaluate the cause (s) of infertility. Each exam evaluates several factors, and different tests may be indicated for each specific case.
The basic study of women’s infertility
|Hormonal analyzes||The determination of certain hormones in the blood allows the evaluation of the functioning of the ovaries, as well as other glands that influence the functioning of the same.
The results of these tests are used as a diagnosis but also to guide the choice of the most suitable ovulation induction or stimulation treatment for each case.
|Gynecological ultrasound||Gynecological ultrasound allows the morphological and physiological evaluation of the uterus and ovaries.
Held in different stages of the cycle, it allows the evaluation of different functional aspects. It also allows the diagnosis of utero-annexial pathology (myomas, polyps, cysts, hydrosalpinxes, etc).
|Hysterosalpingography (HSG)||HSG is a radiological examination that, by introducing a contrast agent through the cervix, allows the evaluation of the characteristics of the uterine cavity and the permeability of the tubes.|
|Hysterosalossalpingography (HSSG)||It is an endovaginal ultrasound in which it is possible to introduce liquid into the uterine cavity allowing a more detailed evaluation of the same. It can be performed when intrauterine pathology is suspected, as an alternative to hysteroscopy. When used a with a specific hyperechogenic product also allows the evaluation of the permeability of the tubes.|
|Hysteroscopy (HSC)||It is a simple examination that consists of the introduction of an optic unit into the cervical canal, allowing the observation of the uterus.
During the examination, it is possible to perform some surgeries, such as endometrial biopsies, exertion of small polyps or the release of adhesions.
|Post-coital test (Hühner test)||The post-coital test allows evaluating the characteristics of the cervical mucus, as well as the quantity and mobility of spermatozoa in contact with it.
This test should be performed in the preovulatory phase (10-14th day of the cycle), because the mucus is more abundant at this stage and of better quality to transport the spermatozoa.
|Spermogram||The spermogram is the microscopic and biochemical analysis of the sperm, which allows the evaluation of the physical characteristics, concentration, mobility and morphology of spermatozoa.|
|Uterine catheterization||Uterine catheterization consists of introducing a catheter into the uterine cavity through the cervix.
With this procedure we intend to guarantee the possibility of embryo transfer in an IVF or ICSI cycle, with the minimum trauma.
|Diagnostic Laparoscopy||This laparoscopic intervention is performed in the operating room and under general anesthesia. It allows the direct visualization and characterization of the internal female genital organs, as well as the identification of pathologies that could hinder the normal fertilization process.
When performed in the context of the infertility study, it can be complemented with a tubal color 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: the release of pelvic adhesions, destruction of foci of endometriosis, excision of ovarian cysts or small fibroids.
|Genetic studies||Changes at the genetic level may be the cause of infertility or recurrent abortions and should be investigated when there are antecedents that support it.
Through a blood analysis, it is possible to perform the karyotype, which allows knowing the chromosomal constitution of an individual.
Genetic studies are currently under constant research.
Male Factor Study and Diagnosis
Sperm CropsThrough the microbiological analysis of the sperm a seminal infection can be diagnosed.
|Spermogram||To evaluate the Male factor is always included a sperm analysis in order to determine the number of spermatozoa (concentration), as well as the quality of their respective movement (mobility) and the shape (morphology). It is accepted as normal the presence of more than 15 million spermatozoa per milliliter of sperm, with a minimum of 32% of mobile and progressive forms, and at least 4% of the normal forms.
An abnormal result may show several changes:
When the results of the spermogram show moderate to severe changes, it is essential that the couple’s male member is evaluated in an Andrology Consultation, in order to research and, whenever possible, treat the cause of these changes.
|Sperm Crops||Through the microbiological analysis of the sperm a seminal infection can be diagnosed.|
|The Migation Tests
||The migration test is an important complement to the simple spermogram allowing, through a discontinuous density gradient and the swim-up technique, to separate the mobile spermatozoa and with intact DNA, those motile and / or mobile with fragmented DNA or with aneuploidies.This test can help detect the causal infertility factor and guide the ART to be used.|
|Sperm DNA fragmentation test
||Approximately 15% of infertile men have normal seminal parameters according to the World Health Organization but there are other nuclear and sub cellular factors that contribute to male infertility and are not detected by conventional seminal analyzes. The nuclear content of the spermatozoon, especially the integrity of the sperm DNA, is fundamental for the processes of fertilization, implantation and normal embryonic development to occur. The sperm DNA fragmentation test evaluates the sperm count with DNA damage in a given sperm sample through a specific core-blending technique. It is indicated in cases of idiopathic infertility, recurrent miscarriages and implantation failures. The sperm sample is considered normal for this parameter when it presents less than 32% of spermatozoa with abnormal coloration.|
|Hormonal Analyzes||It consist in the determination of the hormones that control testicular functioning in the blood.|
|Testicular biopsy||It allows studying the process of sperm formation (spermatogenesis) and its possible changes, by extracting a small sample of tissue from the testicle. If spermatozoa are found in sufficient quantity and quality to be cryopreserved, they may be later used in the ICSI technique.
This procedure is performed on an ambulatory basis and under local anesthesia.
|Genetic Studie||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 chromosome studies on sperm or molecular genetic studies (such as Y chromosome microdeletions and cystic fibrosis gene mutations).
Genetic studies are currently under constant research.