Female infertility can have many causes.
Before starting treatment, it is imperative to identify the underlying factor that caused the fertility disorder.
To do this, you must undergo an examination.
Some tests for female infertility are basic and recommended for everyone, others are prescribed by reproductologists on an individual basis.
My name is Mrs. Maria Rudnik, I’m the CEO of the Mami.clinic, a fertility coach and I have been helping women get pregnant for many years. I constantly talk with women, immerse myself in their problems and know what is going on not only in their body, but also in their head.
Tests for hormones
To assess the reproductive function of the body, the gynecologist-reproductologist will need the results of your hormone tests.
The list of necessary studies is determined by the doctor individually for each patient. Sometimes in the blood it is required to determine not only the concentration of sex hormones, but also the hormones of the thyroid gland and the adrenal cortex. They also affect a woman’s fertility.
- Sex hormones
Follicle stimulating hormone (FSH). Produced by the pituitary gland. With its low content in the blood, ovarian function is inhibited. The result is a decrease in the secretion of progesterone and estrogen. With a low concentration of FSH in the blood, a violation of the menstrual cycle occurs.
luteinizing hormone (LH). Synthesized in the pituitary gland, affects the formation of progesterone in the ovaries. An elevated LH level in the blood is more likely to indicate polycystic ovary syndrome or endometriosis, and in older women it may indicate ovarian exhaustion.
Prolactin. Secreted in the pituitary gland. The main function is to control lactation (milk production after childbirth). When its level in the blood changes in non-pregnant women, ovulation is disturbed.
Testosterone. In women, it is produced in the ovaries. At elevated levels, it disrupts ovulation, reducing the chance of conceiving a child. If, despite the high concentration of testosterone in the blood, pregnancy still occurred, the woman’s risk of miscarriage is significantly increased.
Progesterone. Elevated levels of this hormone indicate ovarian pathology. With a decrease in its concentration in the blood, ovulation is impossible.
17-hydroxyprogesterone (17-OP). The hormone is produced in the ovaries and adrenal glands. An elevated concentration of 17-OP outside of pregnancy may indicate congenital adrenal hyperplasia.
Anti-Müllerian hormone (AMH). It is a reflection of the ovarian reserve of the ovaries. As the level of AMH decreases, the likelihood of pregnancy also decreases. A pronounced decrease in the level of anti-Müllerian hormone indicates ovarian exhaustion.
Estradiol. The maturation of eggs depends on this hormone. Both low and high levels of estradiol in the blood can lead to infertility. An increase in its secretion is more common, and this may indicate endometriosis, a tumor, or an ovarian cyst.
Donating blood for sex hormones, you must remember that you need to do this on an empty stomach, on a certain day of the menstrual cycle:
- prolactin, AMH, LH, FSH – for 2-3 days;
- 17-OP and testosterone – for 8-10 days;
- progesterone and estradiol – for 19-21 days.
- Thyroid hormones
Changes in the concentration of thyroid hormones in the blood can have a negative impact on the growth of follicles and ovulation. Hypothyroidism is one of the possible causes of infertility.
It is advisable to take a blood test for thyroid hormones on an empty stomach, in the morning. It is better to reschedule it to another day if the woman experienced severe stress on the eve of the study.
- Hormones of the adrenal cortex
The adrenal cortex produces glucocorticoids, as well as some sex hormones. A change in their concentration in the blood can have a negative impact on ovulation, the production of cervical mucus, and the development of follicles. On the eve of the test, you should stop smoking, alcohol, and fatty foods.
Tests for infections
Infection is a common cause of infertility. Inflammatory processes that develop in the genital organs often proceed in a subclinical form.
As a result, the woman is unaware of the pathological process, there are no symptoms, and the infection can only be determined with the help of targeted diagnostics.
Usually, the inflammatory process causes obstruction of the fallopian tubes, as a result of which the sperm cannot penetrate the egg.
Tests for infections involve the delivery of a smear from the genital tract, as well as venous blood. A woman should take the same tests not only because of infertility, but also before a planned pregnancy.
Some microorganisms significantly increase the likelihood of miscarriage, others can lead to malformations of the baby.
Blood chemistry
The cause of infertility in a woman is not always the pathology of the organs of the reproductive system.
The inability to conceive a child may be due to a disease of other organs and systems, so the patient is often recommended to do a biochemical blood test.
In serum, the level of cholesterol, glucose, urea, creatinine, bilirubin, hepatic transaminases, albumin, potassium, and sodium is determined.
Clinical blood test
In any medical institution, regardless of the reason that prompted you to seek medical help, you will be asked to take a clinical blood test.
It involves determining the concentration of blood cells, hemoglobin, and erythrocyte sedimentation rate in the blood.
With the help of a clinical blood test, an inflammatory process in the body can be detected. In addition, during a clinical analysis, doctors determine the presence of anemia in a woman, which is a contraindication for many medical manipulations and surgical interventions.
Coagulogram
A blood coagulation test is another test that is prescribed for women with infertility. Laboratory doctors determine prothrombin and thrombin time, prothrombin index, antithrombin III, plasminogen, fibrinogen.
Karyotype analysis
A karyotype is a human chromosome set. This genetic study is recommended for all patients with infertility: both men and women.
It allows you to identify numerical and structural changes in chromosomes that lead to delayed sexual development, amenorrhea (absence of menstruation), miscarriage, missed pregnancies, severe abnormalities in the spermogram in men.
Histological examination of the endometrium
For many patients, during the examination, the reproductologist can prescribe a diagnostic procedure – an endometrial biopsy. It is needed to evaluate the lining of the uterus.
A small piece of mucous membrane (endometrium) is taken and sent to the laboratory for histology (study of tissue).
Using this method, you can determine the presence of inflammation in the uterus, hyperplastic processes, tumors. This study is very important and determines the further treatment tactics of the doctor.
