Due to delayed childbearing and the increasing amount of environmental factors harming our health nowadays, more and more people have to confront the problem of trying to become pregnant in vain. The scientific term for this condition is infertility, describing the situation when a couple does not manage to become pregnant even though they have regular sexual intercourse for more than one year. If you are older than 35 or have a relevant medical history (endometriosis, pelvic inflammatory disease), it is advised to consult a specialist and start treatment if necessary already after half a year of trying. The origins and causes of unsuccessfully attempts can usually be equally attributed to the female or the male side, and in 10% of the cases it is not possible to establish the reason of infertility.APPOINTMENT
During the examination, we look at the detailed medical history (previous diseases, surgeries, family history, etc.) followed by a gynaecological examination, comprising a bimanual examination and uterus ultrasound, checking of the uterus, mucous membranes and ovaries. If necessary, we also do a cervical screening and if indicated, an STD testing (testing chlamydia and other pathogens with PCR testing). This is followed by laboratory tests for any serious diseases of the organs (liver, kidneys, etc.) and providing a profound situational picture of the hormone system (functioning of the ovaries, hormone production of the pituitary gland, functioning of the thyroid gland).
The series of examinations ends with a fallopian tube test using the HyCoSy method. In case the medical history or the ultrasound examination point to the necessity of a hysteroscopy, this inspection of the uterine cavity by endoscopy can also be performed at our clinic. In order to examine the male partner, we advise to do a sperm test.
As far as the reasons for infertility are detected throughout these examinations, you can continue trying to conceive „spontaneously“ after solving the underlying problems, but of course there are also cases when getting pregnant is only likely with the help of medical treatment. In the latter cases, we perform ovarian stimulation. Naturally, if other treatments are not expected to lead to a pregnancy, we advise to do insemination or IVF (in vitro fertilization).
This ultrasound procedure assessing the patency of the fallopian tubes forms a particularly important part of examining infertility. Several diseases can cause blocking of the fallopian tubes. Such diseases attacking the fallopian tubes from the outside can be for example endometriosis, nowadays considered to be very widespread. It is a condition in which the layer of tissue that normally covers the inside of the uterus grows outside of it, shattering and blocking the fallopian tubes. Infectious diseases suffered in the past, for example chlamydia, can lead to the loss of fallopian tube functionality, in this case a jelly-like substance blocks the fallopian tubes.
HyCoSy (hysterosalpingo-contrast sonography) is a contrast-enhanced ultrasound examination. Due to the water-like consistency of the contrasting material, it is not such an uncomfortable examination and does not last very long (10-15 minutes). Unfortunately this examination is not supported by the OEP (national health insurance), hence it can only be performed at Villa Medicina, while the HSG test can be done at hospitals.
The inspection of the uterus by endoscopy is important both for examining the causes of infertility, as well as in the case of repeated miscarriages. The causes behind unsuccessful trials to become pregnant, as well as miscarriages after successfully becoming pregnant are related to anomalies affecting the uterus and its mucous membrane. Unfortunately the uterus ultrasound that is done during a routine gynaecological examination only shows bigger, more obvious anomalies.
The Office hysteroscopia examination uses a flexible, fibre optical, thin catheter, so that the examination does not cause any pain and it does not require a widened cervix. The advantage of this examination is that it is pain free and also very quick (5-10 minutes), there is no need to stay in the hospital. This examination allows us to promptly provide a 100% secure assessment of the uterus, just as in the case of a hysteroscopia.