Many couples come to an assisted reproduction specialist because they are having problems in achieving pregnancy, usually after a year of trying. However, there are some cases in which it is recommended to see a specialist in a shorter period of time, either because of age, genetic disorders, medical or surgical history, among other situations.
First appointment in assisted reproduction
In the first visit, an initial study is carried out according to the following protocol:
- Complete interview: to assess family and personal history, consumption of drugs or other substances that may affect gestation.
- Physical examination: to evaluate the integrity of the reproductive system and secondary sexual characteristics.
- Transvaginal ultrasound: to study the morphology of the internal genital tract, including the endometrium and ovaries, and to rule out any malformations.
- Cervico-vaginal cytology: to rule out cervical cancer (if not performed within the appropriate time frame).
Fertility tests in assisted reproduction
After the first appointment, if no pathology requiring medical or surgical treatment has been found, a series of tests called basic sterility study is performed:
- Seminogram: assesses the quantity, mobility and morphology of the spermatozoa. If the result suggests that the patient has a pathology that is not very serious, the possibility of retesting in a few weeks should be considered due to the variability that may be present. If the result is doubtful, a motile sperm retrieval (REM) should be performed to study the option of resorting to artificial insemination or directly to in vitro fertilization.
- Determination of Follicle Stimulating Hormone (FSH) and estradiol: this is performed on the third day of the cycle to predict the ovarian response to treatment.
- Hysterosalpingography: this is a radiological technique that consists of introducing a contrast agent to analyze tubal patency. This test is not necessary if the result of the semen analysis is so abnormal that in vitro fertilization is used directly.
- Infectious diseases, including hepatitis and HIV serology, should be ruled out in the systematic analysis.
Depending on the evaluation of the couple and the results of the basic study, the most appropriate technique will be considered for each case, or the study will be expanded, orienting it towards the most indicated option.