Currently, we recommend consulting with a specialist after spending a year of unprotected sex and not getting pregnant. On the other hand, there are several associated factors that would advise starting the fertility study at 6 months (woman’s age, menstrual anomalies, history of pelvic pathology, testicular or surgeries).
In the first visit, we elaborate a complete clinical history of the patient and perform a gynecological examination and a vaginal ultrasound test that allows us to decide which complementary examinations are the most appropriate for each couple.
From the data collected in the clinical history of each patient, we decide which are the most appropriate analysis determinations to diagnose each case in particular.
These analysis may range from basal hormone determinations between the second and fourth day of the cycle (such as FSH, LH and estradiol) to chromosomal studies such as the karyotype. In Spain, the Assisted Reproduction law states that any couple starting a treatment should have a serological study of HIV, hepatitis B, hepatitis C and syphilis.
Gynecological ultrasound is a technique that allows us to study the internal genitals, evaluating the uterus, the tubes and the ovaries, as well as working on endiometriosis diagnosis. In assisted reproduction, it contributes to the evaluation of ovarian reserve and follicular growth monitoring.
In ivf cycles, it allows ultrasonography, follicular puncture and embryo transfer.
Hysterosalpingosonography is a radiological study (test image). Involves the injection of a radiopaque contrast through the cervix, the uterine cavity filling and tubes. Thus, we can indirectly study the anatomy of the inside of these organs.
This study allows us to diagnose, for example uterine pathologies (malformations, synechiae or adhesions, tumors), tubal pathologies (blockages, stenosis, polyps, hydrosalpinx) and peritoneal adhesions.
Hysteroscopy is a technique that allows us to visualize the inside of the uterus (uterine cavity and cervical canal). It is performed whenever there is any indication of uterine pathology (polyps, myomas). It is also part of the study of infertility (repeat miscarriages).
It is a procedure that allows us to visualize the inside of the abdominal cavity, including internal genitals. It is always performed under general anesthesia and requires a hospital stay of 12-24 hours.