The patient who attends the gynaecological consultation to try to elucidate their fertility problem must be subject to a series of tests such as:
1. Clinical history
Consisting of a full clinical questionnaire, including both the personal and family history of the patient. The doctor will ask questions about age, profession, emotional state, illnesses suffered since and during childhood, if you suffer from any allergies, if you smoke, if you are taking or have taken drugs, your daily intake of alcohol, frequency of complete sexual relations, etc.
2. Pelvic examination of the reproductive organs
This is completed to rule out other types of problems. It is composed of three parts:
- examination of the outside of the genitals or vulva
- an internal examination to analyze the vagina and cervix. This is done using a Speculum, which is a device that helps open the walls of the vagina to correctly view the cervix
- A manual exploration to explore the morphology of internal organs.
Cytology is a test designed to detect abnormal (pre-cancerous) cells in the cervix (or lower part of the womb or uterus), and also to detect other infections. The test is undertaken using a small brush or stick to obtain cells, which are sent to the lab for further analysis.
4. Breast examination
A breast examination is a routine part of a complete gynaecological check. It is important that your Gynaecologist locates any abnormal lumps associated with benign conditions such as fibroadenomas or fibrocystic mastopathy.
5. Pelvic ultrasound
The size of ovaries will be assessed by ultrasoundecography. The number of follicles in each ovary and the size of each of them. The size of the uterus, shape and position and the measurement of the endometrium.
It will be also valuable to determine if there are fibroids or cysts and the possibility of treatment if they prevent the development of a pregnancy.
6. Hormone testing
To know the functionality and quality of the ovaries, it is necessary to perform an analysis of the following hormones in blood:
FSH, LH, Estradiol, Prolactin, TSH, Progesterone and AMH, etc. These analyses will provide us with information about the ovarian functionality and strategy about the medication and treatment to be followed.
THE SPERM SAMPLE COLLECTION CONDITIONS
It is important to get a good sample, so as the results are as reliable as possible, therefore the collection of the semen must be done according to the following guidelines:
- Sexual abstinence for a period of 3 days, but in some cases the doctor will recommend a different period according to the frequency of sex of the patient.
- Sample collection should be taken in the clinic, but if it is not possible due to individuals’ circumstances, the maximum period between collection and delivery of the sample must be a maximum of one hour. In addition the sample must be transported at body temperature.
- The ideal specimen collection technique is masturbation, collecting all of the semen expelled in a sterile jar.
- It is not recommended to apply ointments, 8 hours prior to collection of the semen.
It is important that the laboratory is aware about any incidence in the collection procedure, so that it can be included in the analysis (loss of any sample, difficulty in collecting, etc.). It is also important to know if there has been any significant clinical change in the patient (fever, drugs, etc) in the days or weeks prior the sample collection.
Following the completion of the sample collection, there is no need for special care, or further instructions.