Study and diagnosis of sterility

Sterility can be defined as the difficulty a couple has to achieve pregnancy naturally after a period of regular sexual relations without the use of contraceptives.

When should a couple begin a sterility study?

In general it is accepted that a couple who have been having sexual relations with contraceptive measures for at least one year without having become pregnant should consult the gynecologist to attempt to determine the possible causes for this difficulty.  

One very important factor to take into account is the age of the woman since it is known that after the age of 35 years there is a reduction in the reproductive capacity of women which lowers even more, after the age of 40.

What type of tests are performed?

Although sterility studies have been simplified over the years there are a minimum number of tests which are considered essential to determining causes of both male and female sterility. These tests provide clear pathological results from which, specialists are able to determine the most exact and effective treatment for each case. These tests include:  
 
1.Seminogram:  An essential part of the sterility study is the study of semen and its characteristics.  A seminogram involves analysing a semen sample to determine the concentration of sperm, its size, shape and movement.

2.Blood hormone determinations:  On the third day of a women’s cycle, her ovarian reserve is studied along with the present levels of follicle-stimulating hormones (FSH) luteinising hormones (LH) and estradiol hormones. The analysis of ovarian reserves and hormones allows specialists to evaluate a woman’s capacity to respond effectively to ovarian stimulation, with a view of possible assisted fertilisation. The determination of progesterone in the second phase of the cycle establishes whether the cycles are ovulatory or not. In the case of suspicion of ovaulatory dysfunction, in women with very long cycles or the absence of menstruation, the hormone studies are more complete and also include determinations of androgens, prolactin, thyroid hormones, etc.
 
3.Hysterosalpingography: This is a radiologic study which visualises the uterine cavity and the permeability of the fallopian tubes. An iodine contrast is injected through the cervix and goes into the uterine cavity and the fallopian tubes and finally leaves at the end of the tube to the abdominal cavity if there are not obstructions.

4.Transvaginal echography: This is performed in the context of a gynecological revision which enables specialists to detect disease in the uterus and/or  ovaries.  This test does not provide direct information as to the reproductive capacity of the female however.