Examination

Medical history

The first step before setting up any treatment program is taking a detailed medical history. This involves gathering as much information as possible about patients’ health and any medical conditions. We also need to know what examinations the couple has already undergone as well as any illnesses, abnormalities or operations they may have had in the past.

Gynecological examination

Before starting treatment and during the course of treatments, the doctor will need to do a standard pelvic exam and abdominal and transvaginal ultrasounds as necessary.

Hormone profile

AMH

Anti-Müllerian hormone (AMH) is one of the biomarkers for the “ovarian reserve”. We can determine AMH levels in a woman’s blood to estimate how many oocytes (eggs) still remain in her ovaries.

Androgens

The most important androgens are testosterone and DHEA. Elevated androgen levels can negatively affect oocyte maturation and overall fertility.

LH/FSH + LH:FSH ratio

LH and FSH are regulated in the pituitary gland and assisted by the hypothalamus. Both these hormones are responsible for producing sex hormones and gonad function in men. In women, they are responsible for estrogen and progesterone production.

We see a high ratio between LH and FSH in PCOS (polycystic ovary syndrome), for instance.

Thyroid hormones

Serology

Genetics

Genetic testing means we can examine embryos before transferring them to the uterus. This lets us identify any hereditary diseases and lower the risk of miscarriage from genetic causes.

HSG

Hysterosalpingography (HSG) is a method of examining the uterine cavity and fallopian tubes using a radio-opaque material. This allows us to determine fluid distribution in the abdominal cavity and assess any blockage in the fallopian tubes.

Seminogram (semen analysis)

A seminogram is a test to analyze a man’s semen and sperm quality. We determine the sperm parameters and assess them using WHO (World Health Organization) criteria: motility, concentration, morphology, color, etc.

Reference values based on WHO standards

  • Color: grey, opalescent
  • Volume: > 1.5 ml
  • Agglutination: 0 – 1 degree
  • Concentration: ≥ 15 million / ml
  • Motility: ≥ 40%
  • Progressive motility: ≥ 32%

Source: World Health Organization reference values for human semen characteristics, Human Reproduction Update, Vol. 00, No. 0, p. 1-15, 2009.

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