Primary diagnosis of infertility: examination for infertility in women, men and what tests need to be taken. Infertility Infertility pregnancy diagnosis

Infertility in women can be determined using an integrated approach. Doctors say that childlessness is a situation when a couple is unable to conceive a child while having regular unprotected sex for a period of more than 12 months. Pathology is classified into absolute and relative. The second option is treatable.

Diagnosing infertility in women is important stage to combat the problem. The very first clinical blood tests are prescribed to determine inflammatory diseases of internal organs and pathologies of the blood system.

It is necessary to undergo examination hormonal levels, which can influence conception. Its change is closely related to pathologies:

• gonads;
• thyroid;
• pituitary gland, hypothalamus;
• adrenal glands

An important test is the infectious TORCH panel, as well as an instrumental examination of the patient - ultrasound of the uterus and its appendages, MRI, etc. An ovulation test is performed to determine best dates for conception or identification of an anovulatory cycle.

Taking anamnesis for female infertility

This method makes it possible to understand some of the causes of childlessness, as well as to identify conditions such as menstruation disorders and other diseases of internal organs. The gynecologist finds out the complaints, the course of the patient’s life, the presence of previous pregnancies, infectious processes, evaluates sex life and woman's activity.

Physical examination

This diagnostic method includes a general examination to identify some pathologies of the genital organs. The main assessment criteria during a physical examination of a girl are:

• measuring temperature, pulse, pressure;
• physique, body weight;
• bimanual manual examination;
• gynecological examination of the genital organs;
• hair growth;
• development of secondary sexual characteristics;
• palpation of the mammary glands, whether there is discharge from the nipples;
• study of regional lymph nodes.

Laboratory diagnostic methods

The main purpose of laboratory tests is to determine hormonal levels. The main indicators are:

• luteinizing and follicle-stimulating hormones LH and FSH;
• free and bound testosterone;
• cortisol;
• prolactin;
• anti-Mullerian hormone;
• estradiol;
• progesterone.

Table 1. Normal sex hormones in a woman.

Hormonal imbalance plays a big role in infertility. Doctors recommend that all women be checked periodically. Childlessness in this condition can be cured by prescribing adequate therapy.

The level of hormones in the blood is determined by collecting biological material from a vein, after which it is delivered to the laboratory, where it is assessed using special equipment.

Tests are performed on days 5-7 and 21-23 of the cycle. Functionality needs to be assessed thyroid gland.

Infectious screening for infertility in women

For determining female infertility survey includes search infectious diseases. This procedure includes:

• regular bacterioscopy of a vaginal smear, indicating the presence of pathogenic microflora;
• scrapings from the cervix are subjected to PCR tests, which can detect herpes, cytomegalovirus, ureaplasma, papillomavirus and other pathologies that lead to infertility;
• ELISA, where the test material is venous blood.

TORCH-complex

This complex is mandatory when planning pregnancy. All diseases that are included in it provoke intrauterine infection and pathologies of fetal development or spontaneous miscarriage. This includes toxoplasmosis, rubella, cytomegalovirus and herpes and others. The abbreviation is based on the Latin names of all diseases.

It is important to understand that examination for TORCH infection does not answer the question of how to test for infertility in a woman, but it will help plan the birth healthy child. The test is recommended to be performed several months before pregnancy is expected.

Instrumental methods for diagnosing infertility in women

Instrumental diagnostics include ultrasound, CT, MRI, radiography, colposcopy, hysteroscopy and endoscopy. These methods are prescribed to identify organic problems. Sometimes they need to be used after curettage of the uterine cavity to determine the condition of the endometrium.

Uterine infertility is diagnosed through an endoscopic examination of its cavity, when a special device is inserted inside. It allows the doctor to evaluate appearance endometrium, the presence of nodes, bleeding and other problems.

Endoscopic diagnostics

Endoscopic methods involve diagnostic laparoscopy, when an endoscope is inserted into the abdominal cavity. This technique allows you to reduce the period of examination of girls with infertility. Its advantages include:

• determining the cause in a short time;
• identification of comorbid pathology, including endometriosis;
• the possibility of simultaneous treatment of the condition;
• reduced trauma to internal organs, fallopian tube, uterus;
• reduction of surgical intervention time;
• short recovery and rehabilitation period;
• barely noticeable cosmetic defects of the skin.

Therapeutic and diagnostic endoscopic laparoscopic surgery is rightfully considered one of effective methods infertility treatment. Already at the stage of laparoscopy, it is possible to determine the cause of a woman’s infertility, eliminate it, or decide on further treatment without the use of methods such as IVF or artificial insemination.

Hysteroscopy

Hysteroscopy is used to evaluate the internal cavity of a woman’s main reproductive organ – the uterus. The cervical canal is examined, the place where the fallopian tubes meet the uterus (ostium).

This method of minimally invasive examination of the uterine cavity allows you to identify polyps, adhesions, endometritis and other pathologies that contribute to childlessness in women. The procedure can be done like independent method examinations for infertility, or together with laporoscopy, which gives the doctor full information about the condition of the female reproductive system.

Diagnosis of sexual partner

It happens that when examining a girl in an infertile couple, doctors make a conclusion that she does not have any pathological processes that negatively affect reproductive function. Then male infertility occurs. At the same time, most representatives of the stronger sex are confident that if they have normal erection and ejaculation, then they have no health problems.

Diagnostic measures for men begin with carrying out. The ejaculate is taken for the test. There may be no sperm in it, which indicates a violation of spermatogenesis. A situation is possible when they are produced normally, but for some reason do not enter the lumen of the vas deferens. Then a diagnosis of obstructive infertility is made. Doctors check the patency of the ducts using genitography.

A spermogram can also show increased sperm aggregation due to the antibody. Then it is necessary to look for and treat autoimmune processes. In this case, male reproductive cells have reduced mobility, which prevents normal fertilization of eggs.

Examination of a man in an infertile couple has great value for the treatment of childlessness, since a fairly large proportion of such couples suffer from health problems among the stronger sex.

When taking a spermogram test, men are advised to adhere to the following rules.

1. Sexual abstinence for at least three days before the test.
2. Smoking and alcohol are prohibited during this period.
3. You should not use different medicines, unless they are prescribed for health reasons (insulin, inhalers for bronchial asthma).

Ovulation test

A test for infertility in women includes a so-called ovulation test. The advantage of the technique is that it can be carried out at home. It also allows you to identify problems with ovulation, determine best time to conceive a baby.

The bottom line is that the egg is released from the ovary approximately on the 10th day after the start of the cycle. This period is characterized by an increase in the concentration of luteinizing hormone in the blood. The definition of ovulation is based precisely on this moment.

After the egg is released from the ovary, the corpus luteum is formed, which produces progesterone. Doctors call it the pregnancy hormone. As it increases, the concentration of luteinizing hormone begins to decrease.

The ovulation test consists of strips and a urine jar. The technique is the same as for regular test for pregnancy. When two stripes appear, ovulation is expected in the next three days. It is important to pay attention to the brightness of these stripes; they should be approximately the same. If the color changes, the test is considered invalid.

According to modern disappointing world statistics, approximately 5% of families cannot have children at all. These numbers represent infertility in humans, which, unfortunately, is more difficult to correct. Diagnosis of infertility has become the most popular service.

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Sees doctors a large number of couples who, after examination, turned out to be absolutely healthy, but the long-awaited pregnancy still did not occur naturally. Such cases occur in about 15% of married couples in any country.

What is infertility?

We can talk about infertility when a couple cannot conceive a child for more than a year if they do not use various contraception. Unfortunately, quite a lot of married couples are now facing this problem in our country! Modern medicine has already been able to achieve the most high precision in diagnosing various functional abnormalities that result in such a health condition. However, doctors often, after examination, cannot find the problem and patients desperately grasp at any, even unimaginable, methods of treatment, in some cases surgical intervention occurs.

Causes of infertility in women and men

The most common factors in the development of the disease are various anatomical disorders, namely anomalies in the structure of the organs of the reproductive system itself. To identify them, it is necessary to conduct an examination of the body. Diagnosis of infertility in women is carried out to identify possible diseases and appointments effective treatment. More often main reason are different gynecological diseases, also endocrine and infectious. Infertility in male patients can be acquired or genetic, in some cases it can occur as a result of injury, under the influence of unfavorable factors (consumption of alcohol, psychostimulants, constant smoking, stress). In addition, immunological and endocrine forms of the disease can occur in men, so it is necessary to conduct an examination here. The development of the disease in many cases can be caused by the simplest problems, so if a couple cannot conceive a child naturally, then first an examination and diagnosis of infertility in men should be carried out. In some cases, pregnancy may not occur due to genetic incompatibility of partners or the appearance of hormonal problems.

Diagnosis of infertility at the Neo Vita clinic

The basis of treatment is an individual approach, as well as a search for the main cause. After the examination, a group of specialists carefully works with each patient of our clinic. This group includes a gynecologist, endocrinologist, urologist, osteopath, family psychologist, reflexologist, nutritionist, and psychotherapist. We have at our disposal the most effective ways treatment. Each of them serves to achieve one goal - to harmonize the processes in the body of a woman and a man so that conception can occur naturally.

To reveal real reasons diseases, doctors use the most effective, harmonious and comprehensive techniques:

• Spermography. This is the main method for judging a man’s reproductive ability. Physical and Chemical properties sperm, the number of live sperm and their motility. Based on this study, a conclusion is made about the man’s fertility and the factor of male infertility in the couple is excluded or confirmed. The results of a spermogram may indicate certain diseases of the male reproductive system, which are often the cause of infertility.
• Analysis of hormonal levels. Hormones regulate all processes occurring in the body and reproductive function is no exception. Failures in the functioning of the endocrine system often cause infertility in both women and men. When diagnosing the causes of infertility, it is important to find out the hormonal status of both partners.
• Comprehensive 4D diagnostics. This hardware study provides a comprehensive picture of the state of the body and its functions, based on an analysis of the vegetative activity nervous system. 4D diagnostics allows you to identify hidden diseases and disorders even at the earliest stages of their development. The method is very informative and is successfully used in the diagnosis of infertility along with traditional types of research.
• Carrying out psycho diagnostics emotional state. In some cases, psychological infertility is not an ephemeral concept, but an objective reality. Unconscious fears and internal conflicts can have a very tangible impact on the reproductive system. This is possible because the function of the genital organs is regulated in a neurohumoral way and depends on the activity of the hypothalamic-pituitary system, which sensitively responds to the slightest changes in a person’s emotional state. Our feelings and emotions can be the cause of psychosomatic disorders that inhibit reproductive function. In such a situation, in order to treat infertility, it is necessary to combine the efforts of doctors with the work of a qualified and experienced psychotherapist.
• Carrying out diagnostics by an osteopath. This specialist can identify circulatory disorders, spasms, excessive muscle tension that limits the natural mobility of the pelvic organs and other pathologies that prevent successful conception. By providing a special manual effect, the osteopath activates the process of restoration of the reproductive system.
• Testing for possible sexually transmitted infections. Sexually transmitted infections are the main cause of inflammatory diseases of the reproductive organs. Long-term inflammation leads to adhesions and tubal obstruction in women. In men, some infections can reduce sperm motility and cause obstructive infertility if the epididymis is affected.
• Hysterosalpingography. Highly informative patency study fallopian tubes and uterus. During the study, adhesions, endometrial polyps, uterine malformations and other pathologies can also be detected.

Diagnosis of infertility in Moscow is carried out quickly and efficiently, since the clinic employs experienced specialists.

Infertility treatment at the Neo Vita clinic

Unfortunately, doctors often offer a solution to the problem of infertility using IVF and patients agree to this unsafe procedure, without realizing the consequences of such an unsafe method of achieving results. Our specialists always proceed from the fact that infertility treatment consists primarily of eliminating all causes that prevent the natural occurrence of pregnancy, even if this is required long time, because in most cases, you can help solve the problem using gentle methods that do not harm the health of the woman and the fetus. The Neo Vita clinic has developed a number of unique techniques with which our doctors have been helping women for many years to get rid of such common causes of infertility as cervical canal stenosis, endometriosis, uterine fibroids, incompatibility of vaginal mucus with partner’s sperm, and psychological infertility. The experience of our specialists shows that there are very few cases where IVF is the only way out in the treatment of infertility, mainly complete obstruction or absence of the fallopian tubes, which is quite rare. At the Neo Vita clinic, a gynecologist-endocrinologist, the creator of unique proprietary methods for treating infertility, as well as uterine fibroids and endometriosis without surgery, provides free consultations on these problems. As a result comprehensive examination Individual treatment is developed that combines effects on each identified factor. The purpose of our consultations is to help as much as possible more women to identify the disease in time and receive maximum information on the most correct, harmonious treatment.

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July 9

On July 7, in Novy Knizhny on Malaya Sukharevskaya Square, a seminar was held by the gynecologist-endocrinologist of the Neo Vita clinic, candidate of medical sciences Natalia Volkovinskaya

Diagnosis of infertility carried out in both men and women. There are several types of infertility diagnostics; for reliability, it is advisable to resort to several methods.

Infertility affects every fourth couple - its causes vary and are sometimes very difficult to determine. Experts say the most common in women are hormonal disorders, while for men it is often abnormal sperm parameters. Infertility occurs when a couple has been trying to get pregnant for a year. Then both partners are recommended to consult a specialist. The first step to solving a problem is to try to determine its cause - for this purpose, infertility diagnosis, which consists of a number of studies.

Diagnosis of female infertility

The doctor must specify: the date of the last menstrual cycle, regularity of the cycle, medical history, as well as hospital records (surgeries, treatment, births, abortions), ask about lifestyle (working hours, rest). Then carry out a gynecological examination (to assess the structure and condition of the genital organs, a bacteriological examination will be carried out to detect any abnormalities) and an ultrasound examination (thus, you can more clearly assess the condition of the reproductive organs, the shape and size of the uterus, the thickness of the endometrium, to detect anomalies). Only after this the doctor will refer you for appropriate examinations.

Types of diagnosis of female infertility

As a rule, the first will be a blood test (test of the thyroid gland). Then he moves on to more complex types diagnostics to determine the sequence and methods of optimal treatment. Your doctor may order tests such as:
Ovulation monitoring - This is a vaginal ultrasound examination, which is performed every 2-3 days, from the 10th day of the cycle. Thanks to it, it is possible to evaluate the growth of follicles, cracking and growth of the endometrium after stimulation of ovulation (medications to enlarge the bladder are taken before the test).
Ovulation stimulation . The purpose of this test is the growth and destruction of follicle vesicles in the ovaries. During the examination, the doctor can evaluate the growth and destruction of follicles in the ovaries (growth is caused pharmacologically - the patient takes drugs that stimulate ovulation before the study) and the endometrium in the uterine cavity.

Hysterosalpingography (HSG) , tubal patency testing is the process of placing a mark through the cervical canal into the uterus and fallopian tubes, after which x-rays. As a result, the doctor can determine the shape and size of the uterus, assess the patency of the fallopian tubes, and remove any irregularities. The test takes a few minutes and is safe.


Laparoscopy - performed under general anesthesia. Through a small incision in the abdominal wall, small surgical instruments are inserted into the abdominal cavity so that the doctor can better diagnose the permeability and mobility of the fallopian tubes, identify endometriosis and correct it if necessary.


Hysteroscopy - shooting using an endoscope (an optical eye - histeroskopu - is inserted through the vagina into the uterus). This allows the doctor to see and evaluate the endometrium, size of the uterus, fallopian tubes of the mouth, see damage, and then remove irregularities.


Hydro laparoscopy (hydro-laparoscopy) is an endoscopic examination that is performed through the vagina. With its help, the doctor can assess the size of the pelvis, fallopian tubes, patency of the fallopian tubes, the presence of adhesions and endometriosis in the abdominal cavity and uterine cavity.
Transvaginal endoscopy is a procedure that is performed under general anesthesia. It consists of inserting micro-instruments with a fiber-optic cable and camera into the pelvis (through the vagina). The marker fluid is then injected and the doctor observes whether it flows through the fallopian tubes, so he can assess the patency of the fallopian tubes, as well as the condition of the pelvic peritoneum and fallopian tubes.
Endometrial biopsy (uterine mucosa) - this is done under short-term local or general anesthesia. Using micro-instruments, a piece of the endometrium is taken and subjected to tests: histopathological, assessment of the endometrium and the regularity of the menstrual cycle.
Cervical mucus examination - consists of studying (under a microscope) the number and motility of sperm collected within 24 hours after sexual intercourse. As a result, the doctor can evaluate the so-called “cervical mucus hostility,” i.e., the extent to which sperm are able to pass through the mucus barrier.

Diagnosis of male infertility

. The man, through masturbation into a sterile container, receives the seed. Thanks to this study, it is possible to assess his fertility, as well as determine sperm parameters: volume, structure and motility of sperm. A study of bacteriological and enzyme immunoassay of sperm (antisperm antibodies and detection of bacteria) is also carried out.


Andrological study - this is an examination of the organs of the reproductive system (through the anus and during ultrasound). As a result, the doctor can evaluate the structure of the testicles and penis, and detect pathologies (hernias, cryptorchidism, varicose veins, phimosis).
Hormonal tests - blood analysis. Most often these are: testosterone, prolactin, androstenedione, FSH, LH, estradiol.
Testicular biopsy - involves the collection, under general or local anesthesia, of a small piece of nuclear tissue. This allows you to obtain information about the presence or absence of germ cells and sperm in the testes.


Vasography - This is an x-ray examination of the vas deferens after intravenous administration of the marker. With its help, the doctor can assess the patency of the ducts, as well as detect obstacles in the wires that carry the seed. This study is rarely carried out, most often after preliminary constriction of the vas deferens.

The diagnosis of infertility is made after 12 months of unsuccessful attempts to become pregnant while maintaining an active sex life and lack of contraception. According to statistics, 20% of couples face this problem. But this diagnosis is not a death sentence. In most cases, the situation is fixable. It is necessary to identify the cause of infertility as soon as possible and prescribe treatment, which will result in a long-awaited pregnancy and the birth of a child.

Infertility (lat. sterilitas) is the inability of women and men to fertilize.

Infertility can be:

• absolute – the presence of a pathology that excludes the possibility of conception (in women – absence of the uterus, ovaries; in men – absence of sperm, testicles);
• relative - the presence of a cause that can be eliminated.

Also distinguished:

• primary infertility – failure to conceive in a sexually active couple;
• secondary infertility – failure to conceive after pregnancy.

The main causes of infertility include:

• hormonal imbalance;
• infectious diseases;
• abnormal structure of the genital organs;
• genital injuries;
• immunological problems;
• psychological problems.

Methods for diagnosing infertility

Infertility is most often blamed on the woman. But this is a deep misconception. According to studies, 40% of infertility cases are diagnosed in women, 40% in men. The remaining 20% ​​includes combined and unknown causes. Therefore, it is important to diagnose infertility in both women and men. Moreover, it is worth starting the examination with the man, because there are fewer factors influencing male infertility and this diagnosis is simpler.

Diagnosis of infertility in men

Examination of a man for infertility takes place in several stages. First, the main studies are ordered. If after them the doctor still has some questions, then additional ones are prescribed.

The main methods for diagnosing male infertility include the following steps.

1. Consultation with an andrologist or reproductive specialist.

Survey. Previous illnesses, pregnancies in other partners, characteristics of sexual life and the degree of influence are clarified negative factors(harmful industries, smoking, alcohol).

Inspection. The severity of secondary sexual characteristics is determined and the scrotum is palpated.

1. Laboratory diagnosis of infertility.

Spermogram is a study of ejaculate. Preparation for the analysis is very important and begins a week before the test. Following a diet, avoiding alcohol consumption, visiting the sauna and bathhouse, stress, and no sexual intercourse for two days. If a man has a cold, the test should be postponed until complete recovery. The research procedure takes place in three stages: masturbation (in a specially designated room in a medical institution or at home), sample collection, and analysis. The ejaculate must reach the laboratory within an hour and must be in the process of transportation during room temperature. Based on the results of the spermogram, the volume of ejaculate, the number of sperm, their motility, morphology and several other indicators are assessed. If deviations from the norm are detected, the analysis is repeated 2 more times to exclude errors or the influence of other factors.

Analysis of hormone levels. These are mainly follicle-stimulating hormone (FSH), testosterone, luteinizing hormone (LH) and prolactin. If these hormones are abnormal, we can talk about endocrine disorders.

1. Ultrasound examination (ultrasound).

Ultrasound and Dopplerometry of the scrotal organs. It is used to assess the structure and pathology of the testicles and their appendages.

TRUS (transrectal ultrasound) is performed to assess the condition of the prostate gland and seminal vesicles.

Additional diagnostics of infertility in men includes the following studies:

• genetic tests are prescribed for disorders of sperm maturation and production or their absence;
• analysis for sexually transmitted diseases (STDs) is carried out in case of inflammation combined with an abnormal spermogram;
• prostate secretion excludes or confirms inflammation of the prostate;
• determination of tumor markers is prescribed in case of suspected malignancy;
• an immunological study (MAR test) should reveal the presence or absence of antisperm antibodies;
• testicular biopsy is indicated in the absence of sperm or a serious decrease in their number;
• a study of post-orgasmic urine is carried out in the absence of ejaculation or its small volume to exclude or confirm the reflux of sperm into the bladder.

Each of the additional methods for diagnosing the causes of infertility has serious indications for research and should be carried out by experienced specialists.

Diagnosis of infertility in women

Female infertility requires more serious research than male infertility. After all female body must not only form a high-quality egg, but also create special conditions for fertilization, gestation and birth of a child.

As with the examination of male infertility, the diagnosis of female infertility is carried out in stages.

1. Consultation with a gynecologist or reproductive specialist.

Survey. The list of past diseases, operations (especially on the pelvic organs), genetic abnormalities in the family, the presence of pregnancies, characteristics of sexual life and the menstrual cycle, and the influence of harmful factors is specified.

Inspection. First, the ratio of height and weight and the development of secondary sexual characteristics are assessed. Then a gynecological examination of the vagina and cervix and a two-handed examination of the uterus and ovaries are performed.

1. Laboratory diagnostics.

Smear. Analysis of discharge from the cervical canal will indicate the presence of an inflammatory process or STD.

Blood test for hormones (FSH, LH, estrogens, progesterone and androgen), infections and increased clotting.

1. Ultrasound diagnosis of the condition of the uterus and ovaries. Ultrasound is the most informative and reliable way determination of ovulation. In addition, you can evaluate the condition of the uterus and ovaries, monitor the growth of the endometrium and determine the causes of menstrual irregularities.
2. Rectal temperature measurement. This additional research method is carried out over a period of 3 months and assesses the presence (37°C) or absence (<37°С) овуляции. Наблюдение и измерение женщина проводит самостоятельно.
3. Hysterosalpingography (HSG). This is an x-ray examination aimed at diagnosing tubal infertility and assessing the condition of the uterus. This research method is carried out on days 5-7 of the cycle by injecting a contrast agent into the uterus and assessing its movement through the fallopian tubes. This method is not always informative in assessing the patency of the fallopian tubes, because the patient experiences discomfort, which may affect the result. This method is more suitable for identifying uterine pathologies. And the most reliable way to assess the patency of the fallopian tubes is laparoscopy.
4. Laparoscopy. This type of examination is performed under general anesthesia using a special apparatus through small holes in the abdominal cavity. The undoubted advantage of this study is not only its high information content, but also the possibility of correcting identified disorders (restoration of fallopian tube function, removal of fibroids and ovarian formations).
5. Hysteroscopy. This method of endoscopic examination of the uterus not only evaluates its condition, but also allows for treatment of almost any uterine pathology.
6. Tomography of the skull and sella turcica is prescribed if endocrine infertility is suspected.
7. Spiral computed tomography of the pelvic organs is prescribed to clarify pathologies of the internal genital organs.

Diagnostics of partner compatibility

There are cases when conception does not occur due to incompatibility of partners. There are several methods for diagnosing such cases of infertility.

• Karyotyping is a study of the genetic compatibility of partners. The material for analysis is blood from a vein.
• HLA typing – assessment of immunological compatibility. The more antigens that react aggressively to foreign cells, the less chance of pregnancy.
• Kurzrock-Miller test. This diagnostic method examines the interaction of male and female germ cells. The specialist places cervical fluid and sperm into one tube and observes the behavior of the cells.
• Shuvarsky's test. This method is similar to the previous one, but the combination of cervical fluid and sperm occurs naturally. A woman takes this test no more than 6 hours after sexual intercourse.

There are many reasons why there are problems with conception. Conducting timely diagnosis and prescribing treatment for infertility in most cases can eliminate them. The main thing is to conduct a comprehensive study of both men and women. As a result, even already desperate couples have a high probability of becoming happy parents of a long-awaited child.

Diagnosis and treatment of female and male infertility is one of the main areas of the Center for Maternity and Reproductive Technologies of the Yauza Clinical Hospital.

• The CMRT complex includes a department of obstetrics and gynecology, a department of assisted reproductive technologies with a department of in vitro fertilization, laboratories of general and reproductive genetics, andrology and embryology, a cryobank, a department of radiation diagnostics (ultrasound, MRI, etc.), a hospital and an operating unit equipped with everything necessary for carrying out high-tech surgical interventions to restore reproductive function.
• The latest generation equipment, advanced technologies in radiation diagnostics, genetic studies and endoscopic surgery guarantee accuracy in making a diagnosis in the shortest possible time.
• The use of innovative solutions in the treatment of infertility, the highly qualified specialists of reproductologists at the Yauza Clinical Hospital allow us to solve the most complex problems of modern reproductology.

• Up to 15% of married couples, according to official data, are unable to give birth to a child and are forced to seek medical help due to reproductive disorders. The causes of infertility are equally distributed between men and women
• 100% accuracy in making a diagnosis using modern methods of radiation diagnostics, genetic studies, endoscopic assessment of the pathology of the uterine cavity and pelvis, objective computerized determination of spermatogenesis parameters - a guarantee of the effectiveness of the treatment
• More than 80% of couples suffering from infertility, thanks to the use of advanced assisted reproductive technologies at the Yauza Clinical Hospital, achieve the desired goal - the birth of a healthy child

Modern medicine, even in the most difficult cases, gives a woman the opportunity to have her own child.

The reason for the lack of pregnancy can equally likely be both female infertility and problems with reproductive function in men. Therefore, it is necessary for both spouses to come to an appointment with a reproductive specialist and undergo an examination to diagnose the causes of infertility.

Female infertility

Causes

The main causes of infertility in women are:

• disturbance of hormonal regulation with absence or irregular ovulation - polycystic ovary syndrome, diseases of the pituitary gland, adrenal glands and thyroid gland, metabolic disorders with overweight or underweight and stress conditions leading to disorders of central neuro-regulatory mechanisms;
• mechanical factors that prevent the onset or development of pregnancy - obstruction of the fallopian tubes, adhesions in the uterine cavity and pelvis caused by inflammatory conditions or endometriosis, damage to the cervix and uterine cavity during surgical procedures, pathological formations of the uterus and ovaries - tumors and congenital structural defects ;
• inflammatory diseases, which, on the one hand, lead to the formation of an adhesive process, and on the other hand, pathogenic microorganisms located in the woman’s reproductive tract prevent implantation and development of the embryo;
• reduced ovarian reserve - an insufficient supply of eggs in the ovary, caused primarily by genetic factors, as well as damage to the ovaries during surgery, chemotherapy and radiation in the treatment of various oncological diseases (see);
• genetic diseases in which the balance of genetic material in the germ cells is disturbed, and after fertilization the egg is not able to form a viable and full-fledged embryo;
• a disorder in the blood coagulation system with a predominance of thrombosis processes (thrombophilia), increased blood viscosity and deterioration of blood circulation in small vessels in the area of ​​embryo implantation and placenta formation;
• in some cases, it is not possible to identify a specific cause - infertility of unknown origin.

Diagnostics

To answer the question - what is the cause of infertility, reproductive specialists at the Yauza Clinical Hospital carry out a differential diagnosis of the etiology of infertility, which includes:

• collecting anamnesis and examining the woman by a fertility specialist;
• study of hormonal status (sex hormones, thyroid hormones, adrenal hormones and others);
• Ultrasound of the pelvic organs (allows you to determine the pathology of the uterus and/or appendages);
• hysterosalpingography (determining tubal patency and intrauterine pathology);
• hysteroscopy, laparoscopy (according to indications);
• study of the blood coagulation system;
• medical genetic counseling and examination.

Male infertility

Causes

The main factor in the development of infertility in men is a violation of spermatogenesis with an insufficient number of sperm, a violation of their function and structure. In a man, as well as in a woman, the causes of infertility can be: disorders of hormonal regulation, congenital defects of testicular structures responsible for the formation of germ cells - sperm, inflammatory diseases, circulatory disorders, abnormalities in the structure of the reproductive tract, neoplasms, genetic disorders and unfavorable external factors. factors, which also include bad habits - smoking and alcohol.

Diagnostics

In order to diagnose the causes of male infertility at the Clinical Hospital on Yauza, examinations are carried out by specialists - reproductive specialists together with urologists - andrologists. Taking into account the etiology of reproductive dysfunction in men, special attention is paid to a comprehensive study of sperm in a specialized andrological laboratory, CMRT (see).

The main list of diagnostic measures includes:

• expert spermogram according to WHO standards (assessment of the quantity and quality of sperm), carried out using a computerized automated system (SCA) MICROPTIC and giving objective results that allow further accurate assessment of the dynamics and effectiveness of treatment;
• microscopy of spermatozoa under high magnification;
• genetic examination, including assessment of genetic markers of spermatogenesis, FISH study - determination of the proportion of sperm with chromosomal abnormalities, study of sperm DNA fragmentation;
• studies to identify inflammatory diseases of the reproductive tract, including hidden infections;
• according to indications, an ultrasound examination with Dopplerography of the veins of the spermatic cord and ultrasound of the prostate gland are prescribed;
• hormonal profile study;
• diagnostic testicular biopsy;
• consultation of related specialists for concomitant diseases that affect reproductive function.

Treatment of infertility in women

After establishing the cause, conservative or surgical treatment is prescribed, the purpose of which is to restore the reproductive function (fertility) of the patient. In case of endocrine disorders, an individual selection of hormonal drugs is carried out to eliminate hormonal dysfunction and stimulate ovulation. When inflammatory diseases of the uterus and appendages are detected, antibacterial and anti-inflammatory therapy is prescribed. Women with an increased tendency to form blood clots (thrombophilia) are treated with anticoagulants. According to indications, surgical correction of the reasons preventing the onset and development of pregnancy is carried out. Surgical treatment of infertility (hysteroscopy, laparoscopy) is carried out by our specialists for the following indications:

• adhesive process of the uterine cavity and pelvis;
• endometriosis;
• ovarian cyst;
• uterine fibroids;
• polyps of the endometrium and cervical canal.
• disorders of the structure of the uterus (congenital septum)

Modern medical capabilities can help overcome infertility and give birth to a baby even in the most difficult cases with the help of modern assisted reproductive technologies, any of which are available in our clinic:

• intrauterine insemination with the sperm of a spouse or donor after ovarian stimulation;
• IVF with donor eggs;
• surrogacy.

Thanks to innovative solutions using highly effective assisted reproductive technologies at the CMRT of the Yauza Clinical Hospital, it is possible to achieve pregnancy in more than 80% of infertile couples.

Treatment of infertility in men

Treatment of infertility in men is primarily aimed at restoring effective spermatogenesis and normal sexual function. Conservative therapy - antibacterial and anti-inflammatory treatment is carried out in the presence of inflammatory processes, and hormonal correction is prescribed for endocrine dysfunction. Surgical intervention is required if:

• varicocele;
• obstructive azoospermia;
• violations of the structure of the penis;
• cryptorchidism;
• hypospadias.

It should be noted that improvement in spermatogenesis does not occur quickly. Spermatogenesis is a long process that lasts about 120 days and the results of the therapy can only be seen after several months. Therefore, in order not to waste time, it is recommended to combine treatment with artificial insemination.

Artificial insemination is the introduction of sperm into the uterus with a special catheter, which has been processed in the laboratory in order to remove substances from the semen fluid that are unacceptable for entering the uterine cavity, selecting the most active sperm and adding substances that improve the viability and activity of sperm.

Artificial insemination is an affordable and very effective method of assisted reproductive technology.

In case of severe disorders of spermatogenesis, IVF is performed using ICSI technologies (injection of sperm into the egg), IMSI (computerized selection of the morphologically best sperm) and PICSI (physiological selection of the most active sperm). According to indications, in case of obstruction of the vas deferens, IVF is performed with sperm obtained through testicular biopsy.

Advantages of our hospital

The international cooperation

A distinctive feature of our clinic is its wide international cooperation, in particular with the Preimplantation Genetic Diagnostics (PGD) Laboratory of the University of London. This made it possible to introduce innovative PGD techniques into the work of the hospital laboratory, which includes a full assessment of the embryo’s genome using modern methods of molecular genetics. Using such a technique, it is possible not only to determine the genetic pathology of the embryo, but also to significantly increase the effectiveness of IVF. Thanks to PGD and the use of embryos whose usefulness is genetically confirmed for transfer into the uterus, the effectiveness of IVF almost doubles, reaching 60–80%, depending on the cause of infertility.

Leading specialists

The doctors of the Clinical Hospital on Yauza are highly qualified reproductive specialists with extensive experience in Russia and abroad, authors of internationally recognized original diagnostic and treatment methods, candidates and doctors of medical sciences, who have thousands of successful pregnancies and grateful mothers to their credit.