About 15% of couples in Serbia is considered to be infertile.
In this sense, without the help of physicians and certain medical procedures pregnancy may be difficult to achieve.
- Spermogram (male fertility test-semen analysis)
- Microbiological and virological tests
- Examination of hormonal status
- Folliculometry – ultrasound monitoring of growth, maturation and rupture of the follicle (ovulation) and the characteristics of the womb lining (endometrial thickness and morphology)
- Endometrial biopsy with histopathological and microbiological examination
- Examination of tubal patency (HSG) – ultrasound tubal patency and morphology of the cervical canal and uterine cavity
- Hysteroscopy – an endoscopic method that allows direct visualization and testing of the cervical canal and uterine cavity
- Laparoscopy – an endoscopic method that allows visualization and direct inspection of the morphology of internal genitals and pelvic
- Besticular biopsy – if there is no sperm in the ejaculate it is possible to look for them and find a place of their origin. Epididymal aspiration biopsy and / or testis (TESA) or surgical biopsy of the testicles (TESA) with histopathological examination and freezing of obtained tissue.
ARTIFICIAL INSEMINATION - AIH - artificial insemination process involves entering seeds (washed and capacitated - activated spermatozoa) in the genital tract in women during spontaneous or induced ovulation, in:
- cervical canal - intracervical insemination ICI,
- cavity of the uterus - intrauterine insemination IUI
- fallopian tubes - intrautubal insemination ITI
It is suggested for couples in order to increase the chances to achieve conception:
- due to reduced mobility and / or the number of sperm
- sexual dysfunction
- low migration of sperm through the female genital tract (negative Postcoital test)
- accompanied by hormonal imbalance anovulatory cycles
- immunological problems (positive antisperm antibody)
- couples for which cause of infertility is just not detected (idiopathic infertility)
The procedure can be planned and carried out in a natural cycle in the expected time of ovulation, or the most stimulating ovulation, Clomiphene pills or gonadotropin injections during programmed ovulation (hCG injections that allows the timing of ovulation).
CONTROLLED OVARIAN STIMULATION
In any natural cycle about 30 follicles (eggs) starts to rise but at one point one of them set aside to continue to grow so usually ripe and usually release only one egg. During the procedure drugs that stimulate ovulation are given , the grow more follicles and thus gain more eggs. For this purpose, the clomiphene citrate tablets (clomiphene) and aromatase inhibitors (Femara) or injections of human menopausal gonadotropin (HMG) as Merional or MENOPUR or follicle-stimulating hormone (rFSH) as gonala-F or Puregon. The choice of therapy is individual and according to age, constitution, hormonal status, ultrasound images of ovaries and previous experience in treating infertility.
MONITORING THE DEVELOPMENT OF EGGS
The egg grows into a cavity filled with fluid called a follicle. During growth and maturation of the egg follicle produces and secretes into the blood hormone called estradiol. Ultrasound monitoring of follicles and estradiol levels in the blood is the optimal time for insemination or in vitro fertilization. Previously given beta HCG that allows final maturation of eggs. Pregnyl is usually given intramuscularly or subcutaneously Ovitrelle 24 to 36 hours before the planned intervention.
PREPARATION IVF - IN VITRO FERTILIZATION