Diagnosis & Treatment of IVF Explained in Detail

Diagnosis of Infertility

As in any medical evaluation, the diagnosis of the infertile couple begins with a clinical history and physical examination of the woman and the man. Both the woman and the man must understand that infertility can be a problem that can be caused by one of them or both at the same time. The clinical history of women is aimed at identifying pathologies such as polycystic ovary syndrome, hyperandrogenism of other causes, hypothalamic amenorrhea mainly caused by stress, abnormal bleeding, and its corresponding differential diagnosis, endometriosis, pelvic infections, polyps, myxomatosis, hyperprolactinemia, hyper or hypothyroidism, recurrent losses, etc. The simplified protocols that we use in the Assisted Reproduction Center are designed to identify a series of pathologies through diagnostic procedures and laboratory tests in a staggered manner, taking into account both the male and female factors of infertility. With these protocols, we try to discover the problem quickly and give specific treatment to solve the problem.

The woman’s evaluation begins with some easy questions found in Let us explain your problem.

We perform the following studies on women:

1- Sonohysterography with saline solution, which is a conventional ultrasound in which we help by infusing saline solution to improve the visualization of the endometrium and its cavity.

2- Hysterosalpingography: it is an x-ray study that allows us to see the liquid’s tubal permeability and helps us evaluate other pathologies, especially of the body of the uterus and the endometrium.

3- Progesterone on day 21 to evaluate: ovulation and insufficiency of the corpus luteum.

4- If there are abnormalities in menstruation, we carry out a battery of simple and inexpensive tests that allow us to evaluate:

 * Problems with prolactin

 * Problems with the thyroid

 * Polycystic ovaries

 * Hyperandrogenism of any cause or even reduced ovarian function before symptoms manifest.

The evaluation of the man begins with some easy questions that can be found in tell us about your problem.

Contrary to women, the studies carried out on men are much less, and on many occasions, it is only reduced to obtaining a basic spermogram or semen study. The important thing about the spermogram is that it will tell us if the man is responsible for the couple’s infertility program and immediately qualifies the man as mild, moderate, or severe in terms of his degree of infertility.

Female factor infertility:

Female factor infertility is corrected with several strategies: one of them is the stimulation of ovulation with drugs, another way to correct infertility is with surgery, especially laparoscopic surgery. If we find that the woman has blocked tubes and they cannot be corrected by surgery, then we resort to the test tube baby or in vitro fertilization.

Male factor infertility:

It is initially evaluated with the basic spermogram.

The most common strategy to solve the male infertility problem is to concentrate the sperm and separate the best ones with a density gradient centrifugation method. These concentrated sperm are then introduced into the woman’s uterus with a catheter. This procedure is called artificial insemination. Most of the time, we can solve THE CAUSE OF INFERTILITY with insemination, but on some occasions, the sperm count problem does not give us enough to do the insemination. We also resort to the test tube baby or in vitro fertilization in these cases.

 

Treatment:  

Treatment of male factor infertility.
Mild and moderate male factor  
Step 1 3 – 4 cycles of inseminations stimulated with clomiphene plus gonadotropins.
Step 2 In vitro fertilization
severe male factor  
Step 1 In vitro fertilization plus injection of the sperm into the egg.
Azoospermia (total absence of sperm in the ejaculate)  
Step 1 Extraction of the epididymis or testicular extraction.
Step 2 If fertilization does not occur despite performing ICSI or spermatozoa are not recovered after processing the sample, donor sperm is used.

 

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