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Examinations with the woman
To establish the reasons for the fertility disturbances with the woman, one makes use of very various, partial effortful and also painful examination methods. Of course everyone isn't carried out but the possible causes are found out.
Physical and gynecological examination
At the beginning a physical and gynecological examination of the woman stands. Alone by feeling the reproductive organs changes or inflammations can be stated. In every case an examination is carried out also with the ultrasonic apparatus. This examination method is painless and harmless. With it on-due dates of the internal organs can be recognized. Lets the egg vesicle in the ovaries watch itself the changes in the womb mucosa and the development.
Hormone state
The concentrations of the hormones important to the cycle event and the fertilization are determined by blood tests. These hormone value examinations are carried out on particular days of the monthly cycle. By the questions in the first conversation the attending doctor gets indications, perhaps which hormone values couldn't be correct.
For the construction of a complete hormone state at least three blood withdrawals per cycle are necessary.
The base hormone state should happen in the morning of the third cycle day. It contains the hormones prolactin, LH, FSH, estradiol, progesterone, the androgens (testosterone and DHEA s), the thyroid hormones (FT3, FT4 and TSH).
At the time of the ovulation estradiol, LH and progesterone are determined. A third progesterone control is carried out by the 21 day after the menstruation beginning. She gives information about it whether an ovulation has taken place or not.
Prolactin causes actually the milk production in the female mamma and the non-appearance of the menses after the birth and silent time. It is formed in the pituitary gland. With some women too much is formed by this hormone which among other things can lead itself to the disturbance of the ovum maturation.
The the values show the forthcoming ovulation to luteinizing hormone (LH.)
The values of the follicle stimulating hormone (FSH) give information about the growth of the follicles. Places of origin and exact mode of action of the two last mentioned messenger substances are discussed in the cycle event.
The estradiol values indicate whether the maturation of the ovums goes without complications. Estradiol is the most important estrogen. Information about the undisturbed expiry gives the second cycle phase the progesterone concentration primarily. This hormone is important to fixing the ovum into the uterus.
The maturation of the ovum suffers at a too high value of the androgens (collective name for male hormones). The most important androgen is the testosterone. It is formed with the woman in the ovaries and in the adrenal gland. A positive effect is the libido increase with the woman, to the virilizations (beard, deep voice, amplified muscle construction) it comes at too high testosterone values. DHEA S it gets educated also in the adrenal gland that dehydroepiandrosterone is determined in the hormone state and a predecessor hormone (prohormone) of the estrogens is with the woman sufat the second androgen ( - ).
The thyroid hormones (FH3, FH4 and TSH) also can influence the reproduction. Both become produces FH3 (free triiodothyronine) and FH4 (free Tyroxin) in the thyroid. Both hormones activating the energy expenditure of the human body and impeding the distribution the TSH (Tyreotropin stimulation hormone)a hormone of the hypophysis is TSH and the thyroid stimulates. -> the formation of FH3 and FH4. One calls this reciprocal impeding and activation process negative feedback. However, TSH is also responsible for the iodine installation, hormone secretion and the follicle growth. Is one too highly talks to the thyroid gland values of a thyroid hyperfunction (hyperthyrosis), they are too low of a thyroid hypofunction (hypothyroidism). A thyroid hypofunction can be to blame for the non-appearance of a pregnancy. The conception doesn't so often disturb a hyperactivity, it, however, leads untreatedly to early and miscarriages. However, often suspect nothing for many women of their thyroid gland disturbance. If the thyroid hormones are adjusted optimally with medicines, the female hormones regulate themselves again, too. A pregnancy can adapt quite normally at another physical health.
Oviduct examination
The ultrasound carried out at the physical and gynecological examination can give a reference to damages or changes at the oviducts.
A permeable testing comes the following methods for use as an examination method to it:
- Hysterosalpingography (hysterosalpingography)
- Hysterosalpingokontrastsonography (HSKS)
- Laparoscopy
An x-ray of the internal reproductive organs is made at the hysterosalpingography with the help of a contrast medium. Open it is recognizable for the x-ray image, how do the womb and the oviduct fill with contrast medium. So changes can be stated at the womb or at the passing of the oviducts into the uterus. The permeable one is but also the oviduct visibly.
The permeable of the oviducts is checked at the HSKS with a contrast medium and ultrasound. The treating physician introduces a thin catheter to the womb at this diagnostic procedure by the sheath. The contrast medium tiles by the catheter into the womb and the oviducts. How in the ultrasonogram can be turned off, and whether the contrast giving fluid flows through the oviducts. This examination can ambulatorily and without general anesthesia be carried out. Pains as in the case of the menstruation are possible.
The laparoscopy is used to the more exact diagnosis position at oviduct closure. Cysts, adhesions and endometriosis herd also can be recognized at once and removed operatively. Being introduced by a small cut at the navel and on the edge of the pudendum hairiness operation instruments into the abdominal cavity under general anesthesia. Before the introduction of the so-called laparoscope the abdominal cavity gets filled the gas carbon dioxide. The instrument is attached to a monitor. So the abdominal cavity can be looked.
Womb endoscopy (hysteroscopy)
This investigation method is chosen to state adhesions, myomas (benign swellings of the womb wall), malformations and mucosa changes of the womb. A thin probe (optical apparatus) is introduced to the womb over the cervix. The womb is developed with the help of carbon dioxide gas or a fluid. The uterine cavity and the passings of the oviducts can be looked at so. The operation can be carried out ambulatorily.
These informations may be considered a substitute for a piece of medical advice in no case. The content of health-illness.com doesn't can and may be put into any case to make diagnoses or carry out self medical treatment independently.
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