Infertility (Subfertility) Tests

Infertility Treatment Is Individualized.

Many couples are eager to start treatment when they apply to our clinic for treatment. Impatience over the long-awaited baby not arriving and pressure from the surroundings play an important role in this. Rather than starting treatment immediately, it is best to begin after all factors that may adversely affect the process have been evaluated and the necessary tests have been completed. Saying “let’s do these tests too” in the middle of treatment or after an unsuccessful result is the greatest injustice done to the couple. Listening to the couple, who often arrive under great stress, understanding them, knowing the processes they have gone through, and evaluating the tests performed is the right starting point. Infertility treatment is a personalized treatment. The same treatment cannot be given to everyone. If there have been unsuccessful attempts before, lessons must be learned from them. The investigation should begin with the simplest tests that cause the least harm to the couple and are least burdensome. The first and most important stage of the investigation is to meet with the couple together, allow sufficient time, and obtain information about what has been done up to that point. The couple’s previous health problems, illnesses, health problems in the family, whether a pregnancy has occurred before, treatments received, and menstrual irregularities are very important for diagnosis. In light of this information, the woman undergoes a gynecological examination and is evaluated by ultrasonography. While the vagina, cervix, uterus, and ovaries are being evaluated, the tubes (canals) cannot be evaluated. Since having a baby is a matter that concerns both man and woman, a semen analysis should be performed to investigate whether there is a problem on the male side. The sperm sample is examined by an embryologist. For hormonal evaluation, a blood sample is taken from the woman in the morning on an empty stomach at the beginning of the menstrual period. Close to the end of the period, an HSG (tubal/uterine film) is taken to evaluate the canals. This film provides information about the internal structure of the uterus and the canals. The procedure is somewhat painful; patients compare it to a severe menstrual cramp. We recommend that patients with a low pain threshold have this film taken under anesthesia. Patients who wish to have the film taken under anesthesia should not eat or drink anything, including water, for 6 hours beforehand. These tests are the basic tests in infertility. Advanced tests may be required in patients with recurrent pregnancy losses or diminished ovarian reserve. These tests are, in turn:

• Genetic screening tests for the prospective mother and father
• Blood coagulation tests
• Immune system tests
• Investigation of systemic diseases in the mother
• If necessary, examination of the organs via a camera-guided route called laparoscopy/hysteroscopy

A treatment decision should be made according to the cause identified as a result of all these tests. It should not be forgotten that IVF treatment is not the only solution for every couple seeking a baby. Once the problem is identified, it may resolve on its own without the need for IVF. Results can also be achieved with methods such as insemination and ovulation monitoring. Infertility treatment is individualized. Evaluating the patient well, understanding them, and taking a personalized approach are essential for a positive outcome.