STUDY OF THE
WHAT IS THE STUDY OF FEMALE FERTILITY?
The study of female fertility aims to obtain a clear diagnosis of the causes of infertility, as well as to know the biological age and to corroborate the proper functioning of the entire female reproductive system, in order to choose the best treatment towards pregnancy.
To know the biological age of the ovaries it is necessary to understand the concept of ovarian reserve, that is, the availability of good quality eggs that a woman has at this particular reproductive moment.
The first phase hormone determinations (FSH, LH, Oestradiol and Prolactin) performed between the third and fifth day of the cycle, and/or the determination of the specific antimullerian hormone (AMH) as well as the antral follicle count by means of a vaginal ultrasound within the first 7 days after the period; will help us to know this ovarian reserve and thus determine one of the factors that best indicates the prognosis of the treatment to be performed.
The objective of the integral study of fertility
is to get a clear diagnosis of a fertility problem.
WHEN IS A FEMALE FERTILITY STUDY PERFORMED?
- In couples under 35 if they have been seeking pregnancy for more than a year or six months in couples over 35.
- If either partner has a medical history of infertility
- If either partner has a hereditary disease.
- If the couple has had previous abortions.
- In couples who have performed previous cycles of assisted reproduction without success.
TESTS THAT CAN BE PERFORMED
AS REQUIRED IN EACH CASE
ENDOMETRIAL RECEPTIVITY ARRAY TEST (ERA)
The endometrium is the tissue that lines the inside of the uterus and the one that will host the embryo for implantation. It is prepared every month to receive the embryo, but if implantation does not take place, this tissue is shed, giving rise to menstruation.
For implantation to be successful, it is important that the embryo finds a receptive endometrium. The implantation window is that period in which the endometrium is receptive to embryo implantation.
The Endometrial Receptivity Array Test (ERA) allows us to detect the implantation window and customize the embryo transfer at the most appropriate time for each patient.
To carry out the study, only a sample of endometrial tissue that can be easily obtained from the gynaecological practice is needed and the gene expression of the genes will be analysed.
If the result is receptive, it means that the implantation window is located in the period in which the endometrial biopsy was performed, being ideal the embryo transfer in this period. If it is not, the implantation window will be displaced, forward or backward, and the most appropriate period of implantation to make the transfer will be estimated.
There are also two other variants of the ERA study that look at endometrial quality:
- EMMA: It studies the microbacterial composition of the endometrium indicating if there is an ideal flora in this organ or on the contrary it is necessary to administer probiotics to repopulate the “good” bacteria that allow a correct implantation.
- ALICE: Detects if there are pathogenic bacteria that cause endometritis (inflammation of the endometrium) and recommends the most appropriate treatment to palliate this solution and allow the endometrium to disinflame so that it can cause non-implantation or even miscarriage.
STUDY OF FOLLICLE STIMULATING HORMONE (FSH) RECEPTOR
The study of follicle stimulating hormone (FSH) receptor, which with a simple saliva sample allows us to know which receptors of the FSH hormone each patient has, and thus determine what type of hormone treatment we can administer to obtain a better response, thus making the fertility treatment more efficient.
This study analyses the genetic variants involved in the ovarian response. Specifically, it analyses the variant located in the gene of the FSH receptor, the androgen receptor and the ESR1 (SNP and STRs) and AMHR2 genes. The information obtained from this study makes it possible to specify how a patient will respond to a treatment, facilitating the design of the medication schedule and thus optimizing the dose and type of drug to be used.
Thrombophilia is the predisposition to develop blood clots. Women with thrombophilia can create placental microcoagulae during pregnancy by decreasing the blood supply to the fetus and causing a miscarriage.
In addition, thrombophilia also increases the risk of thrombosis (formation of clots in the veins) during pregnancy, leading to various complications in the woman’s health.
The Thrombo inCode Reproductive Health test is a genetic test that analyses 12 genetic variants related to repeat abortions and thrombosis in pregnancy.
With a simple saliva or blood sample, we can obtain more complete information about the thrombophilia to guide your treatment and reduce the risk of suffering a new abortion.
The study of the uterine cavity in 3D during the second phase of the cycle allows a better assessment of its morphology compared to conventional 2D ultrasound scans.
The development of 3D ultrasound allows transvaginal ultrasound to identify different uterine malformations (bicornate uterus, septa, T-uterus), which often cannot be detected in a conventional ultrasound and explain implantation failures or even previous abortions.
The fact of carrying out an exhaustive study of the uterine cavity in 3D by our specialist gynaecologists, allows a correct diagnosis and an improvement in its reproductive prognosis since the uterine cavity has the morphology that it should have is also a key factor for a full-term pregnancy to occur.
At Embriogyn we perform a 3D ultrasound study of the uterine cavity on all fertility patients, to address from the beginning the possible effects that can be detected as part of the basic fertility study of the patients.
It allows to know the internal contour of the uterus and the permeability of the fallopian tubes.
It consists of the introduction, through the cervix, of a contrast liquid that will initially fill the uterine cavity and subsequently the fallopian tubes, while serial x-rays are taken to assess the passage of this contrast through the entire system.
It is important to emphasize that this is a dynamic test, where the radiologist’s assessments of the ease of passage must be taken into account.
Histrosalpingography is one of the tests that must be performed in order to perform an artificial insemination.
It allows direct visualization, through a lens of a very small camera, of the interior of the uterine cavity.
It is especially indicated in cases of infertility (repeated miscarriages) or in cases where ultrasound or clinical suspicion of some intracavitary pathology (polyps, fibroids …)
There is a diagnostic and a surgical modality to perform small interventions, such as the removal of a polyp or the resectoscopy of a vaginal wall, etc. In its diagnostic modality, it does not require anesthesia and is performed on an outpatient basis.
Embriogyn has a specialized Hysteroscopy Unit with all the necessary equipment to perform any of these interventions.
Es la técnica quirúrgica que permite la visualización directa de la superficie de los órganos (útero, ovarios, trompas de Falopio y cavidad pélvica).
Esta visualización se consigue distendiendo el abdomen con la introducción de un gas (CO2) y creando un espacio de exploración óptimo.
Se requiere anestesia general que acompaña de un ingreso hospitalario de corta estancia.
MAKE AN APPOINTMENT
It’s quite simple. All you have to do is contact Embriogyn and make an appointment with our specialists at the time that suits you best. In case you can’t come in person to the clinic, visits can also be arranged via Skype.