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Initial Consultation




For the initial consultation it’s desirable to visit gynecologist-reproductologist specialized in infertility treatment.


After you have selected your doctor you’ll have to pass a series of examinations requiring considerable physical and emotional efforts, as well as time and money.


Before assigning any examination, your doctor will ask you some questions and will look into previous examinations of yours or your spouse. Try to provide your doctor with maximally possible detailed information on the previous treatment, as this will essentially save your time and money for conducting repeated diagnostics and treatment procedures. You should try to attend your initial reception together, as the infertility is a problem for both of you. During that visit you’ll start understanding what kind of insistence and mutual assistance you and your spouse will need during the whole process of diagnostics and treatment.


The reason for the infertility can be both man and woman. Usually during the initial reception the doctor will ask the woman whether her menstrual cycles are regular, whether menstruations are painful, whether she has any painful feelings in or around pelvis minor, whether discharges from the vagina are too abundant or suspicious, whether she had strange bloody discharge, whether she had urogenital diseases, as well as diseases of other organs. Besides that, be ready for questions on your previous marriages, miscarriages, surgical operations and methods of contraception. The man will questioned on previous traumas of sexual organs, how long they are trying to get pregnant, how frequent they have sexual intercourses, whether they use any lubricants during the sexual act and whether someone from their family has had inborn disease. As many of infertile married couples have more than one reason for infertility, it’s very important to learn all possible male and female factors.


The entire sexual and reproductive history of each of partners, including previous marriages, is also an object for study.


During that visit you can tell the doctor about your psychological problems connected to the infertility which you can’t share with your friends and relatives. Tell the doctor everything you are concerned or worried about. Doctors-reproductologists have considerable experience in communicating to infertile couples and can give you the right advice and provide necessary psychological assistance.


After the conversation you’ll be assigned medical check-up, and first of all, examination of the reproductive system. The doctor will pay special attention to the signs of hormonal imbalance, and depending on the situation, will fix a schedule of analyses of hormones in the blood.


Many doctors start examination during the initial consultation based on the history of previous examinations, results of gynecological and ultrasound examination. Ultrasound machine is a necessary instrument of the qualified reproductologist and as a rule the initial reception also includes compulsory ultrasound examination. If there are signs of infection or inflammation, the doctor may take a swab of yours or your spouse. Other tests should be assigned on the specific dates of the menstrual cycle of the woman.


To understand the goal of examinations it’s important to have an idea how the natural conception proceeds.


Natural Conception


In order to achieve natural conception man should have a sperm ejaculation (liquid containing spermatozoa) into the woman’s vagina during the period of her ovulation, when  an oocyte is released by her ovary. Ovulation is a complicated process controlled by hypophysis – an endocrine gland, located in the basis of the encephalon. Hypophysis produces follicle-stimulating hormones (FSH) which affects the maturing of follicle. The follicle contains a maturing oocyte and produces oestrogen hormones. When the oocyte gets ripped, the hypophysis produced luteinizing hormones (LH) and under their influence the follicle breaks and releases the oocyte (ovulates).


After the ovulation the oocyte appeara in the Fallopian tubes. As usually the fertilization process takes place within the Fallopian tube, the spermatozoa should pass through the vagina and cervical mucus to the cervix, then – to the uterus through cervical channel and finally appear in the Fallopian tube and inpour into the oocyte in order to fertilize it. After the fertilization the oocyte goes to the uterus and gets implanted into the endometrium. If everything is okay, a baby will be born in about 9 months.


Examination Schedule


In order to understand the reasons of lack of pregnancy, four critical objects responsible for the conception will be studied – ovaries, sperm, fallopian tubes and uterus. All examinations that seem endless fall in one of these sections. 40% of cases are conditioned with male problem, 40% - with women, and in 10% of cases both spouses have problems. In about 10% of cases even after the dull and comprehensive examination the reason of infertility remains unknown (so called infertility of unknown genesis).


After a detailed conversation during the initial consultation the doctor starts the patient's examination. This examination can provide doctor with important information and he/she firstly pays attention to such signs as high pilosis, excessively oily skin and availability of discharges from mammary glands.


Of course, the examination is not enough for the exact definition of the diagnosis. There is a defined standard for the examination of the infertile couple which require about one-two months. It’s very important to fix exact dates of the examination in accordance with the dates of the menstrual cycle.



Applying such sequence spouses will not lose time and can be sure that the probable reason for the infertility will be detected within 1-2 months.


The assigned examinations shouldn’t be stopped, even if the reason for the infertility has been detected at the intermediate phase, as frequently infertile couples can have several problems. Many diseases such as inflammatory diseases of organs of the pelvis minor frequently bring to the obstruction of uterine tubes.


Aberrations detected during tests don’t necessarily indicate the availability of any pathology, and they may require recheck to confirm its availability.


Unfortunately sometimes examinations are not fully conducted and sometimes are not conducted at all. Frequently the treatment is assigned before the final diagnosis. Or doctors may protract the examination so that patients simply break down. Frequently gynecologists of the general practice just take swabs for flora and check the availability of sexually transmitted infectious diseases. When detecting presence of microorganisms they prescribe anti-inflammatory treatment with high quantity of medicine for several months. Such treatment has no relations to the infertility treatment.


Only after the accomplishment of necessary examinations the treatment schedule can be fixed and the decision on the selection of the treatment method can be made.


The most important factors of infertility overcoming


  1. The age of the patient. This is the most important factor influencing on the efficiency of the treatment. The quality of female oocytes sharply impairs as she gets older independent of their general health conditions. Therefore, if the patient is over 35 we avoid low-effective and long-term treatment methods, as well as those requiring long-term rehabilitation.
  2. Life style. Such factors as smoking, overuse of alcohol and caffeine, overweight and chronic stress have a negative impact on the female reproductive function. In this regard, all patients passing examinations are recommended to have healthy life-style and try to minimize the factors that can negatively affect the efficiency of the treatment
  3. Exact diagnostics. Maximally effective treatment can be assigned only in case of exact definition of the infertility reason.
  4. Quality of treatment. When selecting the most effective method of treatment all possible methods which the contemporary medicine should be taken into account.
  5. Duration of treatment, general principles of treatment. You should avoid multiple repetition of procedures, which didn’t have the desirable effect and should pass to alternative methods of treatment in time. 

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