Fertility assessment

Fertility assessment

Basic assessments:

A basic assessment  is done to a couple who after a thorough medical history presented no previous history that make us suspect a certain risk factor that may be causing infertility, in an apparently healthy couple.

In women the assessment includes an ultrasound scan at the beginning of her menstrual cycle to assess the number of follicles that are in both ovaries and the uterus morphology to rule out conditions such as fibroids or polyps.  In some cases ultrasound scan should be supplemented with a diagnostic hysteroscopy. This is a test that allows us to assess the internal cavity of the uterus (endometrium) and collect biological samples to rule out chronic infections that may impede the implementation of analytical embryos. We also request a basic blood sample to assess ovarian function.

In the male partner the assessment includes a semen analysis to assess mobility, morphology and sperm count. This test requires  between three and five days of sexual abstinence, and that the sample is collected by masturbation in sterile conditions that will be indicated.

Fertility studies


Gynaecological Assessment+

Ovarian reserve assessment

The term “ovarian reserve” describes the functional potential of the ovary, i.e. the ability of the ovary to produce eggs with sufficient quality to achieve a normal pregnancy.

Among the tests that a patient must undergo before commencing an assisted reproduction treatment, assessment of ovarian reserve (OR) is undoubtedly one of the most effective.

It is important to know that the evaluation of the OR is not a test to see if the patient does or does not ovulate, it will give us very reliable data on the “quality” of eggs produced, and this we will help us to guide the patient on what treatment is the most appropriate to achieve a successful pregnancy.

One of the most important parameters in assessing the OR is age, as there is an inversely proportional relationship between the patients’ age and the number and quality of her eggs. For this reason, most assisted reproduction specialists consider essential to routinely perform this test to infertile patients over 35.

There are several parameters to assess the OR; clinical, ultrasound and analytical

Andrological assessment+

The male factor

Having a standard semen analysis, in terms of quantity, morphology and mobility does not guarantee that semen is fertile.

There are cases where the “genetic load” (DNA) of sperm is alterated, resulting in fertilization failure or non-viable embryos. This is what is known as sperm DNA fragmentation and depending on the percentage of sperm fragmentation could result in a poorer prognosis of male fertility.

The assessment of DNA fragmentation takes place in the andrology laboratory on a sperm sample by applying a specific technique known as the TUNEL Assay.

The cases where a disorder is diagnosed can be treated with antioxidant drugs. In patients who do not experience an improvement with this treatment, the recommendation for IVF would be to directly obtain sperm from the testicle by PESA/MESA, as a high percentage of fragmentation occurs during ejaculation.

The sperm, like the egg, contributes half of the 46 chromosomes of the embryo that contain all the genetic makeup of an individual.

The cellular process in determining the genetic load in the sperm is called meiosis. It is believed that alterations in meiosis are present already at birth so there is no treatment to correct them.

The diagnosis of abnormalities in meiosis is through a low testicular biopsy, usually performed on an outpatient basis under local anesthetic.

Psychological Assessment+

Psychological Assessment

Anxious, frustrated or especially expectant, may reflect how most couples feel when attending a fertility clinic. The difficulty of conceiving a child is an unexpected situation that may involve a multitude of reactions, each of which involve different needs.

That is why, from the outset, a psychological evaluation is essential to enable us to be aware of the initial emotional situation, the implications that may involved to assimilate the problem, the treatment itself, or even the results.

Through various assessment techniques, we can get a clear view of both the initial emotional state and the personal and social resources of both partners that will be key aspects in the planning of the intervention and/or psychological support appropriate to each case.

Likewise, it is a first contact which creates an environment of acceptance, security and trust, as a cardinal point of treatment is to have a space to express emotions, concerns, develop coping strategies and solve all kinds of doubts. Meaning you have constant support and guidance  throughout the process.

 

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