Evaluation of Women
The evaluation of women in couples presenting with infertility problem is a complex condition including general examination, examination for reproductive organs and various laboratory tests and diagnostic endoscopic applications. Therefore, it is a sensitive process that should be carried out by a specialist.
In order to prevent unnecessary physical, psychological and material burden in this process, which is particularly difficult for women, the first examination should be done gracefully and only the tests / investigations appropriate to the patient's condition are planned; therefore, it is extremely important for the patient to choose a physician and a center that he / she can trust.
During the initial inspection process, the following parameters will be questioned and you will be asked to provide clear, honest and accurate information about the proper planning of the treatment.
Duration of infertility (Unprepared duration of pregnancy despite unprotected sexual intercourse)
Information about order
Transmitted disorders that may affect reproductive health (Infections, viral diseases),Systemic diseases (liver, kidney disorders, diabetes, thyroid disorders) and drugs used
Information on any diagnostic or operative procedures (hysteroscopy, laparoscopy, tubal ligation)
Family infertility, hereditary genetic disease history
Previous pregnancy and / or low history
Information about previous trials (Applied treatments, fertilization rate, embryo development and quality if KOH is applied)
Lifestyle (smoking and alcohol use, eating order, working conditions)
After this verbal evaluation process, a swab specimen (pap smear) is taken to determine a possible cervical infection. In the subsequent ultrasound evaluation, a passage through the cervical canal is performed with a catheter to determine a possible problem. This proof is informative prior to the inoculation or embryo transfer procedures used in the catheter. In the ultrasound evaluation, the status of the uterus and ovaries and the examination of the reserve in the ovaries (antral follicle count) are performed. The evaluation of this examination together with the blood test (AMH-antimullary hormone) to be applied is necessary to evaluate the response of the ovaries to the planned treatment.
After this routine evaluation, you will be asked for some standard blood tests. These tests will guide the treatment of the patient-specific treatment approach.
FSH (Follicle Stimulating Hormone)
It is used in the evaluation of pituitary gland functions. Primary / secondary ovarian failure, gonadal insufficiency (hypogonadotropic hypogonadism), polycystic ovary syndrome (PCOS) is important for the diagnosis of problems such as. Normal values are as follows:
Follicular phase 2,00-10,00 mIU / ml
Peak 8,50-30,00 mIU / ml
Luteal phase 2,00-10,00 mIU / ml
Pregnant 2,00-10,00 mIU / ml
Menopause 20,00-140,00 mIU / ml
LH (Luteinizing Hormone)
It is used in evaluation of hypothalamus and pituitary gland functions. The diagnostic value is similar to FSH. Normal values are as follows:
Pregnant 2,00-15,00 mIU / ml
Menopause 10,00-90,00 mIU / ml
Follicular phase 2,00-15,00 mIU / ml
Peak 12.00-80.00 mIU / ml
Luteal phase 5,00-20,00 mIU / ml
Ovulation tracking 2,00-15,00 mIU / ml
E2 (Estradiol)
The regular function of the reproductive function is used for the diagnosis of menstrual irregularity. Normal values are as follows:
Pregnancy 10-35 pg / ml
Follicular phase 30-119 pg / ml
Peak 149-350 pg / ml
Luteal phase 97-216 pg / ml
Ovulation monitoring 29-97 pg / ml
Prolaktin
The regular function of ovulation functions is used to diagnose menstrual irregularities. It is important for the diagnosis of hyperprolactinemia. Normal values are as follows:
Pregnancy6,50-180,00 ng / ml
Follicular phase 6,50-30,00 ng / ml
Peak 6,50-30,00 ng / ml
Luteal phase 6,50-33,00 ng / ml
TSH(Thyroid Stimulating Hormone) ve free T3/T4
Used to evaluate thyroid function.
Serological Tests(HbsAg, Anti-HBs, Anti-HCV, Anti-HIV I+II, Rubella IgG, Rubella IgM, Toxo IgG, Toxo IgM)
It is necessary for the prediagnosis of viral infections that may adversely affect pregnancy success.
Blood Group and Whole Blood Count
The blood group is required for the risk of blood incompatibility, the complete blood count is a possible anemia and a prediagnosis of the platelet level. In addition to these routine tests, it is important to carry out the following examinations in cases with recurrent failed in vitro infant trials and recurrent abortions:
Peripheral Karyotype Analysis
Analysis of the blood sample reveals the presence of structural chromosomal disorders such as translocation, inversion, and deletion.
Thrombophilia Tests
It is applied for the investigation of possible mutations in the major gene regions (MTHFR A1298C, MTHFR C677T, Factor V, Factor II) that direct the blood coagulation mechanism in women. All of these regions can be viewed as a collective panel or separately. In addition to the above-mentioned laboratory tests, the following diagnostic endoscopic applications may be required:
Hysteroscopy (H/S)
A camera with a fiber optic light source can be found in the uterus through the cervix and into the uterus. structural disorders.
Laparoscopy (L/S)
A small hole in the abdomen, with a camera on the fiberoptic light source to enter the abdominal cavity, uterus, ovaries and the structure of the tube, the opening of the tube, the presence of a possible adhesion in the organs is to examine.
Hysterosalpingography (HSG)
Also known as uterus film. It is the control of the uterine structure and the opening of the tubes with the X-ray film taken by giving a contrast fluid to the uterus.