Infertile – woman diagnostics

Fertility and a woman’s age

The most important factor influencing a woman’s fertility is her age. Over the years the changes occurring in a woman’s body reduce her changes for fertilisation. The number of follicles decreases gradually, those which remain are aging, the percentage of aneuploidies (abnormalities of chromosomes number) is growing resulting in lower chances of fertilisation and the risk of pregnancy loss.

OVARIAN RESERVE EVALUATION
– key element of the infertility diagnosis

A woman’s reproductive potential is determined on the basis of evaluating her ovarian reserve. Every woman has the definite number of primary follicles which are partially used in every cycle. The ovarian reserve depends on the number of primary follicles remaining in the ovary. Only these follicles can transform into a mature ovum.

Evaluation of ovarian reserve aims at:

  • detecting young patients with diminished ovarian reserve – accelerated treatment
  • detecting middle-aged patients who still have valuable ova – deciding on further clinical proceedings
  • eliminating patients who have no chances for pregnancy (costs of treatment, onerousness of treatment)

Important tests

AMH (Anti-Müllerian Hormone)

AMH (Anti-Müllerian Hormone) is a hormone produced both in women and men. In women AMH is produced in ovarian follicles by the cells surrounding the ova ready to grow. The AMH level does not depend on the female menstrual cycle so it can be tested on any day of the cycle. Its level decreases with increasing female age, therefore it is a very good marker of the decrease in fertility, including the premature ovarian failure. In patients PCOS (Polycystic Ovary Syndrome) the AMH level is significantly higher.

INHIBINA B

INHIBIN B serves the evaluation of ovarian reserve. Inhibin B is produced by granulosa cells in small antral follicles. The substance is secreted primarily in the follicular phase of the menstrual cycle. It level in the early follicular phase reflects the number and quality of ovarian follicles. There is a positive correlation between the Inhibin B levels and the number of antral follicles assessed in ultrasound examination performed in the first days of menstrual cycle.

AFC

Another important test is AFC (Antral Follicle Counts). In this case additional information relating to ovarian reserve is obtained in ultrasound examination which allows the assessment of endometrium and ovarian structure, number of antral follicles (follicles about 2-6 mm in diameter) and the follicle growth in patients with ovulation disorders or qualified to treatment using assisted reproduction techniques.

LABORATORY TESTS – FEMALE INFERTILITY DIAGNOSIS

Laboratory tests, when performed and interpreted properly, are the important diagnostic tool. The INVICTA Basic Diagnostic Panel for women consists of the set of 12 laboratory tests.

CHECK WHAT TESTS YOU SHOULD PERFORM BEFORE YOUR FIRST VISIT!

Basic Diagnostic Panel (woman)

AMH (Anti-Müllerian Hormone) – allows the evaluation of ovarian reserve, i.e. a woman’s reproductive potential, thus allowing the determination of the chances of pregnancy and estimation of the ovarian response to stimulation. The test provides important information about the ovarian function and allows predicting when the patient will enter the menopausal period.

INHIBIN B regulates the course of menstrual cycle. The Inhibin B level test allows to assess the number and quality of ova and predict the ovarian response to stimulation.

A protein binding sex hormones (testosterone, estradiol) and taking part in their transportation in blood. Its abnormal levels are present in hyperthyreosis or hypothyreosis, in the case of abnormally high levels of oestrogens or testosterone deficiency, suspected Polycystic Ovary Syndrome, hirsutism.

Estradiol is a natural oestrogen. This hormone is responsible, among others, for the development and functioning of female reproductive organs, influences the proper growth of uterine mucosa. Its normal level indicates proper ovulation.

FSH stimulates development of the Graafian follicle and oestrogen production. Its level is examined in order to eliminate premature gonadal failure.

LH plays important role in the ovulation process. It reaches its peak blood levels in the follicular phase of the cycle and causes the rupture of the Graafian follicle. On further stage this hormone is responsible for the proper course of the cycle, therefore also for ensuring the possibility of egg fertilisation.

This test allows to eliminate thyroid disease, including Hashimoto’s disease.

DHEA or dehydroepiandrosterone is a natural steroid hormone with slight androgenic action. The test of its blood level is helpful in assessing the function of adrenal cortex and pituitary gland as well as of the proper course of sexual maturation.

The DHEA test, together with the assessment of the blood levels of other hormones, is performed among others in the case of female infertility, primary and secondary absence of menstruation, suspected Polycystic Ovary Syndrome and on occurrence of premature sexual maturation.

MTCx2 is performed in order to diagnose potential ovulation abnormalities resulting from the increased levels of prolactin.

The TST test allows to eliminate, among others, the Polycystic Ovary Syndrome and other disorders associated with the excess of male hormones, affecting the menstrual cycle.

TSH or thyreotropic stimulating hormone is produced by the pituitary gland. This hormone stimulates the metabolism of almost every tissue in the body and regulates the secretory function of the thyroid gland. In blood tests, TSH is measured in order to assess the thyroid function and to eliminate its potential hyper- or hypoactivity. Sometimes physicians ask additionally for performing tests measuring the blood levels of other thyroid hormones, fT3 or/and fT4.

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It's worth knowing

Basic Diagnostic Panel (woman)

The Basic Diagnostic Panel consists of fasting tests. They are performed using a sample of the Patient’s blood collected in any of our facilities. All tests and filling in the documentation preparing for the first consultation appointment with a specialist will take approx. 2 hours.