Before starting the infertility treatment process, a couple is examined by fertility specialists with the aim of determining the causes of infertility and determining treatment procedures. 

The first consultation can be carried out separately or simultaneously for both partners. Before that, we strongly propose to perform VIRTUAL CONSULTATION (link) in order to prepare accordingly for the first visit. 

We support simultaneous consultation. It includes a complete anamnesis of both partners, with special emphasis on fertility factors or the assessment of fertility potential. It is important that before the first consultation or examination, couple assures all the results of past investigations and interventions. They can be uploaded to PATIENT PORTAL after signing informational consent (link). Prescreening can be done at home by filling in FERTILITY ASSESMENT FORM (link) and uploaded to Patient Portal. It will be assesed by fertility specialist during the consultation.

FEMALE PARTNER

The specialist gynecologist will ask the woman about her menstrual cycle – at what age did she first have her period, were the cycles regular in the past, have they been regular in recent years (or when she and her partner were trying to conceive) and whether there were any major problems (like heavy bleeding, very painful periods, recurrent inflammation, etc.). 

Next questions are about possible past pregnancies and/or pregnancy losses, complications during pregnancy, complications during childbirth. 

Important information is the presence or absence of ovulation (to the extent that the woman monitored or determined it), frequency of sexual intercourse, potential sexual problems (presence of pain during sexual intercourse, vaginismus, etc.) and information about infertility treatment in the past – e.g. use of drugs to stimulate the ovaries, use of drugs to regulate the menstrual cycle, etc.  

After the initial consultation, an ultrasound examination of the reproductive organs will be performed. In some cases, the woman will be referred for other, additional gynecological examinations and/or procedures (eg. HSC, LPSC, HSG, HSSG or HyCoSy). This usually applies to women with medical conditions such as PCOS and endometriosis or older women. 

Before entering the MAR procedure, the female partner should perform the following tests :

• PAP smear (less than 3 years old)
• the level of reproductive hormones (mainly TSH, FSH, LH, prolactin, if necessary also others) 
• if necessary, complete blood count or hemogram
• tests on sexually transmitted diseases (syphilis, HIV, hepatitis B and C)
• the presence of antibodies to chicken pox (varicella-zoster virus) 
• the presence of rubella virus antibodies

MALE PARTNER

The andrologist will talk to the man about the frequency of sexual relations and about potential problems with sexuality (e.g. erectile dysfunction, retrograde ejaculation, called “dry orgasm”, etc.). 

An important information is, whether the man already has children or not (with his current partner or with his past partners). Important informations are also possible inflammations, sexually transmitted diseases, congenital problems (e.g. undescended testicles, birth with an inguinal hernia), damage to the testicles in childhood or adulthood, surgical interventions in the pelvis or on the reproductive organs, etc.. Lifestyle factors will be discussed (e.g. predominantly sedentary work) and possible addictions – smoking, drug use, alcohol and others.

The most important examination for a man is a spermiogram or the analysis of the semen sample.

If necessary, additional diagnostic can be done: 

• biochemical examinations of semen;
• sperm functional tests (like DNA fragmentation test)
• hormonal tests (FSH, testosterone, PRL)
• urological examination
• ultrasound examination (testicles; prostate, ductus, vesicles; kidneys)
• testicular biopsy (indirect diagnosis of obstruction)
• genetic tests
• other tests (diabetes, cystic fibrosis)