The basic diagnosis we perform in those who begin trying for pregnancy is hormone diagnosis. Furthermore, we order semen analysis as the basic diagnosis in male infertility. During subsequent visits, we assess the cycle in women and we examine the patency of fallopian tubes. The additional element we would like to check in such couples is post-coital test (PCT). Based on this comprehensive diagnosis, we decide whether the couple can continue trying for pregnancy with natural methods or we find the factors we are able to correct, thus beginning the extended diagnosis or treatment of these patients. In the course of hormone diagnosis, we first check the ovarian reserve with the AMH hormone. Then we order the Inhibin test which informs us about the quality of egg cells. As regards other hormones, we also check FSH, LH and estradiol – with this, we are able to assess the pituitary and ovarian function. Male hormones, like testosterone or DHEA – the so-called youth hormone – inform us, in the first place, partially about the quality of egg cells and, in the second place, about any anomalies which could affect the number of egg cells the woman possesses. Moreover, we try to exclude thyroid-related disorders; the most common disorder in young women is the Hashimoto’s disease, i.e. a lymphocytic thyroiditis, which can be detected by testing for anti-thyroid autoantibodies, anti-TPOs. In order to diagnose hypothyroidism or its absence, we examine the TSH level.
The basic examinations carried out in those who only begin trying for pregnancy include also the cycle assessment. We check whether the follicular growth and ovulation occurs. If it is possible, we also try to assess when the ovulation will occur in relation to the “LH surge”, i.e. the time when the body decides to start ovulation; this time point is also of significant importance.
Fallopian tube patency assessment
Typically, we assess tubal patency with an ultrasound device. This examination is easier to carry out than X-ray imaging, provided that it is carried out by an experienced person. Moreover, it does not expose ovaries to X-radiation, which is important when taking into account the fact that we will need the ovaries to produce the possibly healthiest egg cells. The X-ray controlled HSG examination is carried out only in case we have doubts concerning the result of the ultrasound examination and the patency of fallopian tubes.