Diagnosis of female infertility
A diagnosis of infertility is not just a list of studies. It requires: professionalism and attention to detail; personal approach according to age, history and goals.
Diagnosis of female infertility
Infertilità femminile è l'impossibile accedere al gravimento dopo 12 mesi di vita sesso unprotetto (o dopo 6 mesi in donne più di 35 anni). It can be due to various factors, such as hormonal disorders, anatomical changes, inflammatory processes, genetic abnormalities, or a combination of several causes.
In our clinic, we approach each woman with individual care and systematic, multi-stage diagnostics in order to find out the exact cause and draw up the most effective therapeutic plan.
First stage: Anamnesis and clinical examination
L'intervista dettagliata è un punto chiave che ti fornisce guidare le causi potenziali:
- Duration of attempts to get pregnant;
- Regularity, length and nature of the menstrual cycle;
- Signs of ovulation (pain, changes in cervical mucus, temperature);
- Painful menstruation or intercourse (dyspareunia);
- History of sexually transmitted infections, operations or abortions;
- Diseases of the thyroid gland, diabetes, autoimmune diseases;
- Family history of early menopause or genetic diseases.
A physical examination includes an assessment of:
- Body mass index (BMI);
- Secondary sexual characteristics (hair growth, breasts, acne);
- Primary gynecological status.
Second stage: Hormonal and laboratory profile
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Stage Three: Ultrasound Assessment
Transvaginal ultrasound is a key diagnostic tool:
- Evaluation of ovarian reserve by the number of antral follicles (AFC);
- Existence of endometrial polyps, fibroids, cysts, thickened or atrophic mucosa;
- Suspicion of endometriosisdiseases (endometriomas, pain zones);
- Measurement of endometrial thicknessin the luteal phase;
- Follicular growth and dominant follicle monitoring.
Stage Four: Evaluation of Ovulation
- Serial ultrasound examinations to track follicular growth;
- Examination of LH surge by urine tests;
- Progesterone in the middle of the luteal phase (>10 ng/mL confirms ovulation);
- Basal temperature and cervical mucus (additional means).
Fifth stage: patency of the fallopian tubes
The most commonly used methods:
- HSG (hysterosalpingography)— X-ray examination with contrast, which visualizes the uterus and tubes;
- Sono-HSG (sonographic hysterosalpingo-sonography)— with saline under ultrasound control;
- Laparoscopy with chromoperforation— gold standard for suspected adhesions, endometriosis or tubal damage.
Sixth stage: Immunological, thrombophilic and genetic tests
Az an miscarriages,:
- Karyotypingof both partners;
- Thrombophilic mutations(Factor V Leiden, MTHFR, PAI-1, etc.) ;
- Antiphospholipid syndromeanticoagulants (ACL, β2-GP1, lupus anticoagulant);
- NK cells and cytokines— immunological environment in the endometrium;
- HLA compatibiliteit(in rare cases).
Seventh stage: Hysteroscopy
A diagnostic or operative procedure performed with a minicamera:
- Examination of the uterine cavity and endometrium
- Removal of polyps, septums, adhesions, submucous fibroids
- Improving conditions for implantation
Individual approach and team care
A diagnosis of infertility is not just a list of studies. It requires:
- Professionalism and attention to detail;
- Personal approach according to age, history and goals;
- Synchronized work between gynecologist, embryologist, endocrinologist and, if necessary, geneticist.
Every woman deserves clarity, certainty and a plan. We will help you find them — step by step, with care and professionalism.