Initial examination
In Gyncare Center for Assisted Reproduction, we work closely with your gynecologist to diagnose infertility. The results of the tests and assessments you have already gone through are important. We want to pay attention to and monitor your overall health condition. Therefore, in addition to examining your hormonal profile or ovarian patency of the fallopian tubes, we are also want to know if you are experiencing excessive stress and learn more details about your lifestyle.
Assessment of hormonal profile
Evaluation of your hormonal profile takes place simultaneously with the ultrasound assessment (folliculometry). It represents a complete mapping of a single menstrual cycle, in which we perform three tests of hormones from a blood sample and an ultrasound assessment of the small pelvis.
- Test of ovarian reserve – using the concentration of gonadotropic hormones, we identify what is the supply of eggs in your ovaries. The assessment is performed on the second or third day of your menstruation cycle. An even more accurate indicator of your ovarian reserve (supply of eggs) is the level of AMH (anti-Mullerian hormone). It can be detected on any day during the menstrual cycle.
- Ultrasound assessment (Folliculometry) using ultrasound to detect the presence of a maturing follicle (in which there should be an egg capable of maturing and being released from the ovary) on the ovary and the thickness of the mucosa – the epithelial lining of the uterus, which should be about 8 mm at that time. The assessment is performed approximately on the day 12 to 13 from the beginning of your menstruation cycle. Using ultrasound in the later period of the cycle (day 21 from the beginning of your menstruation cycle), we will perform one more assessment again. The so-called yellow body (corpus luteum) is present on the ovary. It is formed by the transformation of the follicle from which an egg was released at the time of ovulation. The epithelial lining of the uterus is also altered, as it is already affected by the corpus luteum hormone – progesterone. In addition to the ultrasound assessment, we will also take a sample of your blood to check your progesterone and prolactin levels.
- Further testing – at any time during the menstrual cycle, we take samples to determine TSH (thyroid function), insulin in patients with polycystic ovary syndrome (to rule out non-reactivity to insulin, which leads to ovulation disorders), vitamin D, male hormones – androgens, and possibly other tests as indicated by the physician.
Assessment of the fallopian tube patency
Ultrasound assessment of the fallopian tubes (HyCoSy) is performed on an outpatient basis without anesthesia. A thin catheter is inserted into the cervix, through which a contrast agent is applied visible on the ultrasound imaging device. During the assessment, the doctor can see whether the contrast agent passes through the fallopian tubes and enters the ovarian area. This assessment is not optimal for every single patient, for example, it cannot rule out or confirm endometriosis (this can only be confirmed by a laparoscopic examination).
