The diagnosis of female infertility begins with a thorough medical interview with the patient. The doctor will ask you about your medical history, current and previous medications, any diagnosed congenital abnormalities, menstrual cycle regularity, and any genetic diseases diagnosed in the patient or her family members. Details about any previous miscarriages are also essential.

Subsequently, the doctor must delve deeper into the woman’s menstrual cycle. Typically, a transvaginal ultrasound and hormone level tests are prescribed. Decisions about further diagnostic tests are taken later, after examining the results of initial tests.

What are the most common causes of infertility in women?

Infertility in women can be associated with various health issues, but not only. The most common reasons for conception difficulties include menstrual disorders, endometriosis, fibroids, infections, inflammation of the appendages, cysts, hormonal disorders, and past surgeries. However, these are not the only causes of infertility. Women often have difficulty getting pregnant also because they are under a lot of stress or have an improper diet. Structural abnormalities in the reproductive system shall also be taken into account.

What types of infertility in women can be distinguished?

There are two types of infertility in the case of women: primary infertility and secondary infertility. Primary infertility refers to the inability to conceive, whereas secondary infertility refers to difficulty getting pregnant again after having one or more children.

Female infertility diagnosis – tests

In order to precisely determine the cause of infertility and then plan an appropriate, effective treatment, it is necessary to first perform relevant tests.

AMH Test

Female infertility diagnosis is based on hormonal tests. These tests mainly aim to determine ovarian reserve. Among other tests, the AMH test (Anti-Müllerian Hormone test), is especially crucial. The AMH’s role in the body is to control the proper growth of ovarian follicles at the early stages. The AMH test result allows for an assessment of the so-called ovarian reserve, which depends on the number of small follicles in the ovary. AMH values dictate the dosage of medications used in infertility treatment.

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Gynaecological ultrasound scan / 3D ultrasound

Gynaecological ultrasound scan is typically performed using a transvaginal probe ensuring the best image quality. A standard examination performed in all clinics is the 2D ultrasound scan to evaluate the uterus, ovaries, and other female pelvic organs. A newer technique providing more details about a reproductive organ is the 3D (three-dimensional) ultrasound scan performed with the use of next-generation equipment and specialized probes. This technique allows for a detailed assessment of the uterine cavity, comparable in quality to hysteroscopy. Additionally, this scan provides an accurate count of small follicles in the ovaries. A written 3D ultrasound scan report includes information beyond the standard scope provided in “regular” ultrasound scan reports. It is also accompanied by a series of images (5-10).

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Sono-HSG Test

The Sono-HSG test, also referred to as HyCoSy (Hysterosalpingo-Contrast Sonography) involves introducing a special solution containing micro air bubbles, called an echo-enhancing agent, into the uterus and simultaneously visualizing its flow through the uterus and fallopian tubes. Sono-HSG is painless, no anaesthesia required, and can be performed in the gynaecological clinic by the physician. After inserting a speculum into the vagina, the doctor ensures no current infection symptoms are present. After cleaning the cervix with a gauze pad soaked in disinfectant solution, a special catheter is introduced, through which the contrast agent is be administered. Under transvaginal ultrasound guidance, about 3 ml of contrast agent is injected into the uterus. Patients may feel a slight pressure in the lower abdomen, similar to menstrual discomfort. Visualizing the fallopian tubes during the ultrasound scan lasts about 5 minutes. When it is over, the catheter is removed. A written report is handed over to the patient immediately following the test.

Hysteroscopy

This procedure involves using a specific instrument, a hysteroscope, which is a special camera that allows for a detailed assessment of the uterine lining, known as the endometrium. During the test, the presence of abnormalities such as polyps or adhesions can be easily confirmed. Our equipment also allows for precise “repair” of these irregularities. Hysteroscopy at our center is usually performed under short-term intravenous anaesthesia for our patients’ comfort, under the supervision of an anaesthesiologist. The procedure lasts about 10 minutes. The total time spent at our clinic in connection with the test is around 2.5 hours.

Breast ultrasound scan

The breast ultrasound scan is crucial in diagnosing pathologies of the mammary glands and lymph nodes in the armpits in both women and men. The method is based on using ultrasound waves, therefore it is safe and can be repeated multiple times. No special preparation for the test is required and it is painless. It is best performed during the first phase of the menstrual cycle. The appointment lasts about 20 minutes, and the ultrasound scan is preceded by a thorough interview. The patient receives the results with recommendations immediately after the test.