Skrevet af:
Anna Grynnerup
04. oktober - 2022
The examination consultation is "the key" to fertility treatment in the private and public sectors. In this article, Doctor Anna Grynnerup explains what you can expect if you are a woman.
Whether you and your partner have been trying to conceive for a year, know you will need a sperm donor, or decide to go solo, it requires an examination consultation.
The examination is simply the "key" to fertility treatment in the public - and, for that matter, in the private - sector too. Because the examination and diagnosis give doctors a clue as to what the challenge might be (as a solo monomaniac, it might be uncovering PCOS or other possible obstacles to becoming a parent).
What is the first step in the examination?
The first step is to phone your doctor and ask for a chat about wanting children and an examination consultation. That consultation will then lead to an examination to find an explanation for why you are not getting pregnant. If you are a heterosexual couple, you should see your doctor after you have been trying at home for a year.
Homosexual couples will also need to approach their doctor and express their wish to start a family to be examined. If you want to be a solo parent, you should also contact your doctor, who will initiate a consultation examination.
Did you know?
In about 10-15% of cases,
the doctor will not have found
a reason for the lack of pregnancy
despite an investigating examination.
First step: Blood tests
The first and easiest step is blood tests. You need to go and have several blood tests taken. What do they look for? A bioanalyst takes the blood sample and analyses the blood on the machine, and a doctor looks at, among other things, hormone balance. More specifically, they measure LH and FSH hormones, which can tell us if there are disturbances in the menstrual cycle. These hormones must be measured within the first three days of your menstrual cycle. Another hormone called AMH is also measured. It can tell us about egg reserve - how many eggs are left in the ovaries. However, this is a test you have to be very careful about interpreting yourself. Fertility doctors can use the test to determine the specific hormone dose you need if you need to start treatment. Metabolic hormones and vitamin D are also measured, as these can also affect fertility. Standard tests for HIV and hepatitis must always be done before you can be referred for fertility treatment, including the male partner.
In addition to the standard tests, your doctor may also consider that more tests are needed - for example, if you have a family history of diabetes, a blood glucose test may be appropriate, or if you have symptoms of PCOS, your doctor will do more hormone tests. The blood tests will typically be done at your doctor's office, or you will be sent to a blood testing clinic.
Next: Gynaecological examination
After the blood tests, there is also a gynaecological examination. You will have a chlamydia test as standard and possibly a cervical cell test if you have not had this done as part of the screening programme.
Your uterus and ovaries will then be scanned to check, for example, whether the uterus is heart-shaped, whether the fallopian tubes are filled with fluid or similar. For example, there may be "mechanical" reasons why you are not getting pregnant. You will also have what is called a passage test. Here, as the name suggests, we look to see if there is a passage in your fallopian tubes.
If there is no passage, the egg cannot be fertilised - the sperm simply cannot get to the egg, and fertilisation takes place in the fallopian tube.
They may have "collapsed" due to STDs or just by accident. If there is no passage in any of your fallopian tubes, we recommend IVF/ICSI at this stage, as you will need to remove eggs from the ovaries to fertilise them.
A gynaecologist performs more advanced tests, such as scanning and testing.
After the investigation examination, what is next?
The answers to both the male and female tests will give your doctor a picture of your overall fertility - or infertility. Whatever the results, a strategy will be laid out for a possible course of treatment; IUI, IVF or ICSI.
Knowing the cause of infertility will also enable fertility doctors to talk to you more realistically about the chances of successful treatment and what you can expect from the process.
It may also reveal other conditions that need to be treated before you are referred for fertility treatment, such as metabolic disorders or diabetes.