Dr. Draper, a specialist in Assisted Reproduction in Barcelona, has extensive professional experience, with specific training in reproduction and cell differentiation, physiological basis and medical application of Radioisotopes, organogenesis and clinical genetics.
When to see a specialist for the first time
Classically, in couples under 35 years of age, it is recommended to have unprotected sexual relations for one year before starting the sterility study. However, this criterion is not rigid and with the delay in childbearing we find patients who should not and cannot wait because they could compromise their fertility. The consultation with the specialist in Assisted Reproduction should really be done when the need arises, when the couple starts to worry and, especially, if the woman is over 35 years old, has irregular cycles, a history of pelvic surgery, hereditary diseases…
What questions does the specialist ask?
To begin with, a complete medical history should be taken in which the corresponding data of the family and of both partners are collected, as well as a review of the medical and surgical history.
Ask about the habits of both partners: tobacco, alcohol or toxic substances that may affect fertility, as well as environmental or professional factors.
Check that there is a sufficient sexual frequency to achieve pregnancy, assess previous contraceptive methods, possible previous pregnancies, together or with other partners.
What tests will be indicated?
First, a physical and gynecological examination to check the normality of the reproductive system.
First assisted reproduction tests in women:
- GYNAECOLOGICAL ECOGRAPHY: To verify that there are no uterine tumors, myomas, or intrauterine polyps, or malformations, such as double uterus or septum, that both ovaries look normal and do not present cysts or tumors of other nature that hinder their normal functioning. The ovarian reserve is also evaluated to determine the woman’s fertility expectancy. It is important to perform it in the first phase of the cycle, on the second or third day of menstruation.
- BLOOD ANALYTICS: To verify a correct balance in the sexual hormones, which orients us on a correct ovulation and gives us an idea about the expectation of fertility in women. Like the ultrasound, it should be carried out in the first days of the cycle. It is also interesting to carry out a study of sexually transmitted diseases that can sometimes affect the proper functioning of the tubes.
- HISTEROSALPINGOGRAPHY: It is done to check the normality of the tubes, this should always be done after the male study. It consists of the introduction of a contrast liquid into the uterus that will diffuse through the tubes and exit into the abdominal cavity, all this controlled by radiology will allow us to see the normality of the tubes. It should be performed in the first half of the cycle, after menstruation and before ovulation.
There are other tests that help us to make a precise diagnosis, but they are requested at a later time and if they are considered necessary: karyotype, laparoscopy…
First assisted reproduction tests in men:
- SEMINOGRAM: consists of delivering a semen sample to assess the quality: number of spermatozoa, motility and shape. To rule out infections and to evaluate some parameters of the sample. In case of alteration, the man should be referred to a visit with the Andrologist, who is the specialist in male reproduction.
How long does it take to get a diagnosis?
The basic study of sterility is performed in a woman’s cycle and the seminogram only takes a few days to be reported, depending on the results of this first phase, it is possible that a second month may be required to carry out other complementary tests.
We could say that between one and two months would be enough to reach a diagnosis.
We must not lose sight of the fact that in 10-15% of the cases it is not possible to make a diagnosis with certainty, due to the fact that sterility is also linked to the age factor, which gives us a low fertility rate without a specific pathology.