First steps

• A couple tries to conceive for more than a year, and a woman is younger than 35.
• A woman is older than 35 but has just started to try to conceive.
• A woman was diagnosed with endocrinological conditions or an inflammatory disease in the pelvis.
• A man has present or former urological conditions.
• A woman would like to preserve her fertility in case of chemotherapy or radiotherapy.
• A woman to bank her eggs to prolong fertility.

Getting pregnant is a multifactorial process. In other words, to conceive, a fertilized egg must implant correctly in the uterus. It requires many factors to be present and coordinated. That is why efforts to get pregnant may take a long time.

To understand medical tests and offered treatment, we need to recall the natural fertilization process. At first, the ovary releases the egg, which moves to the fallopian tube. Sperm moves through the vagina, cervix, and uterine cavity to the fallopian tube, where fertilization takes place. Embryo, developed from a fertilized egg cell, moves to the uterine cavity, where it implants within the endometrium. This is where the embryo develops.

Considering the complexity of the process, discovering the cause of fertility problems might be very complicated. At any stage of the fertilization process, many aspects can go wrong. Medical workup must always be performed on both partners and be individually adapted, depending on:

• woman’s age,
• her menstrual cycle,
• past surgical interventions in the pelvis,
• ovarian reserve,
• sperm quality,
• procreative plans.

In patients <35 with no known underlying conditions, fertility consultation is recommended after 12 months of regular unprotected intercourse. Patients older than 35 should consult a doctor after 6 months. Patients >40 should see a fertility specialist after 3-4 months of regular unprotected intercourse. Any abnormalities diagnosed in man or woman, no matter the age of patients, require early diagnosis and treatment.

Every couple willing to get pregnant consists of two extremely complex organisms, which need to be harmonized to succeed.  When specialist support is necessary, cooperation between patients and physicians is very important. Our team is fully aware that there is no universal method to help every couple. All treatments suggested by our specialists are tailored to individual needs. Some problems are easy to recognize and treat, especially for experts with great experience and knowledge. Those often require only a simple diagnosis and brief treatment without invasive methods.

The first visit to the fertility clinic always starts with a doctor’s appointment. During the visit, physician:

• analyses medical records of the couple (if there are any)
• discusses their fertility history
• performs basic laboratory and physical examinations
• addresses questions, doubts, and expectations

After gaining the knowledge, specialists can suggest further actions appropriate in the particular situation.

The cause of infertility may be difficult to diagnose and treat.

Often, despite the specialist diagnostic process, we are not able to find the cause. When the cause is intangible, we use the term “idiopathic infertility”. It may also happen that medical examinations show a few possible causes of infertility in both partners. Having all the diagnostic procedures done, the physician suggests a treatment plan.

In more complex cases, when basic treatment does not succeed, it is worth considering more advanced techniques, such as assisted reproductive technologies, including IUI (Intrauterine insemination) and IVF (in vitro insemination).