The woman’s infertility assessment is prescribed during the first female infertility consultation and contains various tests to assess the woman’s fertility. This 4-stage fertility assessment involves examining the fallopian tubes, ovaries and mucus.
From the examination of the fallopian tubes to the ovary test: the assessment of female infertility in 4 steps
- The assessment or fertility test of the woman is at 3 levels and therefore concerns 3 examinations: the fallopian tubes, the ovary and the mucus.
- The ovarian assessment or test
- The temperature curve
- A flat curve indicates the absence of ovulation.
- A biphasic curve shows ovulation with a thermal plateau of approximately 13-14 days just after ovulation.
- Ovulation is the lowest point just before the temperature increases by 0.3 degrees.
- The temperature curve gives a simple but approximate analysis of the cycle.
- It can be experienced as stressful.
- The hormonal balance practiced on the 3rd day of the cycle
- FSH, LH, Prolactin, TSH, estradiol, AMH and depending on the context testosterone, DHAS and ∆4 androstendione.
Within the framework of a female infertility examination, the hormonal assessment makes it possible to identify:
- a hormonal abnormality responsible for ovulation disorder such as elevated prolactin
- an inversion of the FSH / LH ratio (polycystic ovaries OMPK),
- an increase in FSH or a decrease in AMH in ovarian failure
Serological tests make it possible to look for an infection (Chlamydia) and are compulsory 3 months before an MPA then every year: syphillis, HIV, hepatitis B and C. You can click here and have the best choices.
As part of the fertility examinations of women, this assessment is optional but recommended in the event of miscarriages or unexplained failure of treatments: the immunological causes which can alter the different stages of female fertility, and in particular implantation.
- Hysterosalpingography (HSG) or examination of the fallopian tubes and uterus
- Also called hysterosalpingography or examination of the fallopian tubes and uterus,
- HSG can detect abnormalities in the uterine cavity (polyps, fibroids, synechia, septum, malformation).
- Examination of the fallopian tubes also allows for a test on their permeability (see section 2.4.3).
- The post coital test
- The post coital test (PCT) assesses the mucus-sperm interaction.
- This female infertility test is performed in the ovulatory period 8 to 12 hours after intercourse.
- The CPR is good if> 5 mobile sperm are seen.
- A bad test (<5 mobile sperm) will lead to insemination management if there is enough sperm.
Endovaginal ultrasound performed at the start of the cycle makes it possible to examine a woman’s fertility on several levels.
At the level of the ovary
To measure the ovary, the ovarian reserve by the count of antral follicles (CFA), to identify polycystic ovaries (OMPK) and to detect ovarian cysts (endometriomas, functional cysts).
At the level of the uterus
- To identify the position (anteverted or retroverted), the presence of fibroma, polyp, the appearance of the endometrium.
- In the event of an anomaly, a contrast ultrasound or hysteroscopy can complete the assessment of female infertility.
- A doppler of the uterine arteries can also supplement the ultrasound to measure the uterine vascularization (important for implantation).