At a fertility centre, reproductive health professionals look for answers to the question: `Why can’t I get pregnant?’
Initial consultation – start of treatment
It starts with an initial consultation at a fertility centre. During the initial meeting, the doctor’s sympathetic words are meant to instill trust. Yet, because the desire to have children is such a very sensitive matter, the meeting is fraught fear.
The doctor will talk to you about your medical history and previous visits with their doctors. Establishing the reason or reasons for infertility is essential.
The way forward
It is possible that certain past, as well as, current medical conditions are responsible to some degree for the infertility. It has been proven that the reasons for childlessness can be equally shared between men and women. The root of the problem can be the man, the woman or both.
During the first medical examination, blood tests are given to the man and the woman to determine their hormone levels. In addition, palpations of the external sexual organs and an ultrasound examination of INSRTmay also be performed. If hysteroscopy or laparoscopy is necessary, you will be given a separate appointment for this.
Finding the cause
The man provides a sperm sample that same day for a spermiogram.
Your doctor will review the tests to determine the following:
- What is the sperm count and motility?
- Are there any pathological changes in the uterus, such as fibroids, damage to the fallopian tubes or endometriosis, etc.?
- Is there a healthy hormone balance?
- Is the supply of egg cells (‘ovarian reserve’ ) sufficient for ovulation to occur?
A hormonal disorder may influence an excessive release and formation of two hormones, progesterone and estrogen, which result in
- Hyperandrogenemia (overproduction of male hormone – testosterone)
- Hyperprolactinaemia (overproduction of the female hormone – prolactin)
- Hyper- or hypothyroidism (over- or under-functioning of the thyroid gland)
Examination of the Woman
Women can undergo various types of examinations:
- Ultrasound examination
- Palpation
- Hormone level determinations in the blood
- Uterus endoscopy (hysterocopy)
Examination of the man
- Ultrasound examination
- Palpation
- Hormone level determinations in the blood
- Genetic tests may be required if family members are affected by a hereditary disease (e.g. haemophilia).
The Time Factor is critical
It takes time to evaluate test results.
Therefore, usually 2-4 visits to the IVF centre over an extended period of time may be necessary to before an exact diagnosis is made.
Cycle monitoring
Cycle Monitoring is conducted to determine the precise time of ovulation. Ultrasound examinations can be used to determine on which ovary a follicle is forming and how large it is. Urine and/or blood tests can also be conducted. The increase in the luteinising hormone LH is used to predict the exact time of ovulation to the nearest hour.
Once the diagnosis is established, the doctor will draw up an individual treatment plan for the couple. The GKV health insurance companies usually cover the costs of various preliminary examinations. However, special conditions apply to the actual IVF therapy, which is why contacting the health insurance company in the early stages is important.