Most of infertility cases both in men and women can be diagnosed with infertility basic analysis A correct diagnosis can be obtained in more than 90% of infertility cases thanks to the infertility basic analysis. For this purpose, both members of the couple should be studied, getting their clinical history, having a complete physical assesment and performing the indicated infertility tests. As some of these studies should be done in specific days of the womans cycle, it is very important to have a proper coordination in order to perform all necessary analysis and tests in less than two months, avoiding any loss of precious time. Each couple and each infertility case is different, that is why the tests should be individualized. Some tests or analysis will be necessary for some people and wont be necessary for other. Basic studies for the couple: Ovaries and ovulation studies: hormonal test and pelvic ultrasound Fallopian tubes study: hysterosalpingography, laparoscopy Male study: spermiogram Study of the uterus: transvaginal ultrasound, hyterosalpingography, hysteroscopy, laparoscopy Ovaries and ovulation studies The purpose of the infertility studies in women is to investigate how the ovaries are performing, to know their eggs reserve and to know if the ovulation is happening correctly. The study of the ovaric function is done as follows: Menstrual cycle evaluation: to know if the cycle is regular (each month) or not. Ovaries evaluation with transvaginal ultrasound: the folicules in the ovaries are counted (dark images that appear inside the ovaries where we find the eggs) Hormonal studies in blood: female hormone profile, anti mullerian hormone. According to the regularity of the menstrual cycles and the ultrasound valoration, it will be decided if it is necessary to have a hormonal study or, given the case, the determination of the anti mullerian hormone. In most of the cases, only a hormone profile will be necessary and it should be done in the second to the fourth day of the menstrual cycle. Show more The ultrasound study is very important, it should be transvaginal and it should be performed by an expert. By counting the follicles in each ovary, the egg reserve can be counted, as there is supposed to be one egg in each follicle. It is supposed as some folicules must be empty of eggs. A number of less than 6 folilcles in the first days of the cycle in both ovaries can be considered as a low ovaric reserve. Age should also be considered, as 6 follicles is not the same at 41 than at 34. Besides the follicles number, the ultrasound also searches for any abnormality or cysts in the ovaries. Fallopian tubes study It is necessary to confirm that the Fallopian tubes are permeable (unblocked). This confirmation is done through an hysterosalpingography, which consists in the introduction of a contrast media through the cervix, previous to a pelvic radiography to assest how the uterus cavity is filled and how is the road through the tubes and to the exterior. As this study can be painfull, some indications must be considered. An hysterosalpingography is not always necessary, it will depend on the results of the semen study and the number of sperm. Male study To study the male, a spermiogram is performed. This study should be done in a special assisted reproduction center that has all the tecnology and experience necessary for it. The WHO parameters should be used in terms of motility, quantity and normal shape, besides, some other data as the presence of cells showing infection will be also considered. Show more It is important to point out that the production of sperm is done in 3 months renewing constantly during mens life. This is why the quantity and motility of sperm can vary from one moment to the other, being in some occassions necessary to repeat the semen study. The most common case is when there are no sperm present in a study, this study should be repeated in 2 weeks or even until 3 months, so we can confirm there is no sperm present. For the cases where a severe alteration of sperm appears, is recommended to request for karyotype studies of the male, as well as sperm fragmentation study in some cases. When no sperm is present in the semen (azoospermia), other studies will be necessary such as hormonal determinations to discard any infection and to consider if a testicle biopsy is needed. Show more The testicle biopsy is the confirmation of sperm in a sample of testicular tissue. For the cases of obstructive azoospermia, no sperm appear in the semen but they appear in the testicle, making possible to perform an in vitro fertilization with intracytoplasmatic sperm injection (ICSI). Study of the uterus This study is done through a transvaginal ultrasound where we can detect data suggesting any abnormality. When there is any suspicion of abnormality, the following studies can be requested: Hysterosonography: introduction of a saline solution inside the uterus that will give abnormal images by ultrasound. This procedure can be done at the doctors office. Hysterosalpingography: cointroduction of a contrast media in the uterus doing then a radiography that will show the complete uterus and help detect any abnormal image. This procedure is done in specialized radiology centers. Hysteroscopy: introduction of a small camera inside the uterus to see the uterine cavity directly and detect any abnormality. Laparoscopy: introduction of a camera in the abdomen to confirm any uterine abnormality suspected in the previous tests. This procedure is performed in an operating room. It would be the last study to request as it an invasive test compared to the other tests than can be done without anesthesia.