Evaluation of Women
The evaluation of women in couples applying for infertility problems is a complex situation that includes general examination, examination of reproductive organs, various laboratory tests and diagnostic endoscopic applications. For this reason, it is a sensitive process that must be carried out by a specialist physician.
Evaluation of Women at Liv Hospital
Liv Hospital offers a comprehensive women's health assessment service led by gynecologists and reproductive health specialists. Intrauterine examination, hormonal tests, ultrasonography and other advanced tests enable detailed examination of the reproductive health and gynecological conditions of patients. Liv Hospital's expert team combines modern technology and a multidisciplinary approach to develop personalized treatment plans tailored to each patient's specific situation.
Detailed Inspections and Examinations
In order to avoid unnecessary physical, psychological and financial burden in this process, which is especially difficult for women, the first examination should be carried out carefully and only the tests/examinations appropriate to the patient's condition should be planned; Therefore, it is extremely important for the patient to choose a physician and center that he can trust. During the initial examination, the following parameters will be questioned and you will be asked to provide clear, honest and accurate information so that the treatment can be planned properly.
- Infertility period (period in which pregnancy cannot be achieved despite unprotected sexual intercourse)
- Information about menstrual cycle
- Previous illnesses that may affect reproductive health (infections, viral diseases),
- Systemic diseases (liver, kidney diseases, diabetes, thyroid disorders) and medications used
- Information about previous diagnostic or operative procedures, if any (Hysteroscopy, laporoscopy, tubal ligation)
- Family history of infertility, hereditary genetic disease
- Previous pregnancy and/or miscarriage history, if any
- Information about previous trials, if any (treatments applied, fertilization rate if KOH was applied, embryo development and quality)
- Life style (smoking and alcohol use, eating patterns, working conditions)
Tests Are Important
After this verbal evaluation process, a swab sample (pap smear) is taken to detect a possible cervical infection. During the subsequent ultrasound evaluation, a rehearsal of passage with the catheter is made to detect any possible problems in passage through the cervix canal. This rehearsal is informative before insemination or embryo transfer procedures using a catheter.
During ultrasound evaluation, the condition of the uterus and ovaries and the reserve in the ovaries are examined (antral follicle count). It is necessary to evaluate this examination together with the blood test (AMH-antimüllerian hormone) to be applied in order to evaluate the response of the ovaries to the planned treatment.
After the mentioned routine evaluation, you will be asked for some standard blood tests. These tests provide guidance in planning the treatment approach to be applied specifically for the patient.
FSH (Follicle Stimulating Hormone)
It is used to evaluate pituitary gland functions. It is important for the diagnosis of problems such as primary/secondary ovarian failure, gonadal insufficiency (hypogonadotropic hypogonadism), polycystic ovary syndrome (PCOS). Normal values are at the following levels:
- 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 to evaluate hypothalamus and pituitary gland functions. Its diagnostic value is similar to FSH. Normal values are at the following levels:
- 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 reproductive functions is used for the preliminary diagnosis of menstrual irregularity. Normal values are at the following levels:
- Pregnancy 10-35 pg/ml
- Follicular phase 30-119 pg/ml
- Peak 149-350 pg/ml
- Luteal phase 97-216 pg/ml
- Ovulation tracking 29-97 pg/ml
- prolactin
The regular function of ovulation functions is used for the preliminary diagnosis of menstrual irregularity. It is important for the diagnosis of hyperprolactinemia. Normal values are at the following levels:
- 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) and free T3/T4
- It is used to evaluate thyroid gland 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 preliminary diagnosis of viral infections that will negatively affect pregnancy success and may be transmitted to the baby during pregnancy.
Blood Group and Complete Blood Count
Blood type is necessary for the risk of blood incompatibility, and complete blood count is necessary for the preliminary diagnosis of possible anemia and platelet level problems. In addition to these routine tests, it is also important to perform the following examinations in cases of repeated unsuccessful in vitro fertilization attempts and recurrent miscarriages:
Peripheral Karyotype Analysis
In the analysis made from the blood sample, the presence of structural chromosome disorders such as translocation, inversion and deletion is examined.
Thrombophilia Tests
It is applied to examine possible mutations in the main gene regions (MTHFR A1298C, MTHFR C677T, Factor V, Factor II) that manage the blood clotting mechanism in women. All of these regions can be examined as a collective panel or individually. In addition to the laboratory tests mentioned above, the following diagnostic endoscopic applications may also be required if deemed necessary:
Hysteroscopy (H/S)
By passing through the cervix and entering the uterus with a camera with a fiberoptic light source, it is possible to detect myomas, polyps, etc. that may be present in the uterus. It is the examination of structural disorders.
Laparoscopy (L/S)
It is the examination of the structure of the uterus, ovaries and tubes, the patency of the tubes, and the presence of any possible adhesion in the organs by entering the abdominal cavity through a small hole opened in the abdomen with a camera with a fiberoptic light source.
Hysterosalpingography (HSG)
Also known as the womb movie. It is to check the structure of the uterus and the patency of the tubes with an x-ray film taken by injecting a contrast fluid that can be visualized on ultrasound into the uterus.