Estudio de esterilidad femeninaEstudio de esterilidad femenina

Female infertility study

Fertility analysis through hormonal and immunological testing and a gynaecological ultrasound scan.

Commencement of the process

For women, the infertility study begins with:

  • Hormonal and immunological analysis
    It should be performed between the 2nd and 4th day of menstruation. There is no need to fast or skip meals.
    • est-femeninoest-femeninoHormonal: Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin (PRL), and 17β-oestradiol, often alongside Anti-Müllerian Hormone (AMH).
    • Immunological: HBsAg / HC Ac / RPR / Ac.VIH
  • Gynaecological ultrasound
    The best time to perform an ultrasound scan is during the first few days of the cycle after menstruation. At this point, the follicular reserve of the ovaries can be assessed, anatomical abnormalities of the uterus (intrauterine deformities or septa) can be ruled out, endometrial alterations that hinder embryo implantation, such as the presence of endometrial polyps, can be identified, and ovarian cysts or tumours that may be causing infertility can be ruled out.

Based on these basic tests, the specialist will recommend additional diagnostic tests, either to identify other less likely causes of infertility or to investigate further any problems that may have been revealed in this basic study.

Additional tests for women

Hysterosalpingography (HSG)

Hysterosalpingography is performed when initial examinations are normal or when there is suspicion of possible tubal abnormalities, due to a history of endometriosis, previous surgery in women such as appendectomy or a history of peritonitis, etc. It also shows the correct morphology of the uterine cavity and its possible malformations: double, septal, arcuate uterus, etc. It is very useful for diagnosing dilations of the fallopian tubes such as hydrosalpinx, some of which can have negative effects on embryo implantation.

It is a simple technique that is performed at a radiology centre. Although it can sometimes be a little uncomfortable, it does not require anaesthesia. Performed under antibiotic prophylaxis, this technique has a very low complication rate (1%). It consists of introducing a radiopaque contrast fluid into the uterus through the vagina, which fills the uterine cavity and spreads through the fallopian tubes, outlining them and showing their permeability as it exits into the peritoneal cavity.

Hysteroscopy

Hysteroscopy involves inserting a thin camera into the uterus to view the inside of the uterine cavity. It allows for the assessment of internal alterations of the uterus, the presence of polyps and their removal, the presence of submucosal fibroids, etc.

It is a simple examination technique that does not always require anaesthesia.

Laparoscopy

Laparoscopy is a surgical examination technique performed in the operating room under general anaesthesia that allows access to the abdominal cavity to examine the correct morphology of the female reproductive system and correct any abnormalities. Sometimes the permeability of the fallopian tubes is also assessed, and pelvic adhesions that could alter the mobility of the tubes or trap the ovaries, making them difficult to access, are ruled out. It is a complementary invasive test and only performed if required by other infertility tests.

Karyotype

cromosomas-femcromosomas-femKaryotyping involves taking a blood sample to determine each individual's chromosome pattern. Karyotype abnormalities may be linked to infertility problems or recurrent miscarriages. This entails an examination of 22 pairs of chromosomes and the 2 sex chromosomes: X and Y. Requested in cases of recurrent miscarriage, unexplained infertility, and sometimes before commencing an IVF-ICSI [In-Vitro Fertilization (IVF) - Intracytoplasmic Sperm Injection (ICSI)] cycle.

Infertility analysis (in cases of recurrent miscarriages)

To perform this analysis, a blood sample is taken and coagulation and immunological factors that may explain infertility are determined.