Depending on the cause and treatment of your infertility, there are several tests that we can offer. It is important to remember that the exams and treatment that we decide will be personalized, so the exams below are only a guide and it does not mean you need to do them.

Hormonal tests are blood tests that help us determine the ovarian reserve and at what level of intensity the woman’s body is working to send signals to the ovaries to produce oocytes.

Hormonal tests are blood tests that help us determine the ovarian reserve and at what level of intensity the woman’s body is working to send signals to the ovaries to produce oocytes.

Hormonal tests include the evaluation of blood levels of different hormones such as:

  • Follicle Stimulating Hormone (FSH) – It is produced by the pituitary gland in the brain, stimulates the ovaries for the production of oocytes. It is necessary to measure this hormone on the second or third day of the menstrual period. FSH is important because it helps us understand how much work the pituitary gland needs to do to stimulate the ovaries. Elevated levels of FSH indicate that the ovaries are not responding adequately to stimulation which is associated with aging of the ovaries and low ovarian reserve.
  • Estradiol- It is the most common type of estrogen and it is measured to know how the ovaries are responding to the medication. Estradiol acts in various parts of the body and helps, along with progesterone, to prepare the endometrium for the implantation of the embryo.
  • Luteinizing Hormone (LH) – Stimulates ovulation, which is the process by which the ovules are released from the follicle.
  • Progesterone- The hormone that prepares the uterus and the endometrium to receive pregnancy.
  • Androgens – Typically they are thought to be male hormones, but in reality they are also extremely necessary in women since they are precursors of estrogen. However, in certain situations, androgen levels may be above the normal level as in the case of Polycystic Ovarian Syndrome. When this occurs, androgens have a deleterious effect on the ovulation process.
  • Thyroid Stimulating Hormone (TSH) – By measuring the levels of this hormone the degree of functioning of the thyroid gland is being analyzed. When this gland does not work well, some processes such as ovulation can be affected, and the risk of pregnancy loss increases.
  • Prolactin- Usually this hormone is associated with the production of breast milk, however when the levels of it are high it can interfere with ovulation.
  • Anti-Mullerian Hormone (AMH) – Anti-Mullerian Hormone levels are determined by a blood test that can be performed at any stage of the menstrual cycle. This hormone is produced by the cells that surround the follicles and their levels have a direct correlation with the quantity and quality of available oocytes (ovarian reserve). AMH levels allow to determine the ovarian reserve as well as the dose of drugs to be administered during ovarian stimulation.

The measurement of the levels of the different hormones is indicated according to the individual needs of each patient.

The antral follicle count is an ultrasound measurement of the number of follicles in each ovary with the potential to grow during that specific cycle. The ultrasound lasts approximately 5 minutes.

Each antral follicle contains an immature oocyte. By counting them, one can estimate the number of oocytes that will be obtained during ovarian stimulation, this being a very good indicator of ovarian reserve.

It is a radiological examination which involves the placement of contrast within the uterus and the fallopian tubes to determine if they work properly or not, thus determining if there is obstruction.

This procedure takes a few minutes during which a series of X-rays are taken to visualize how the contrast progresses through the different structures. It must be performed between the 5th and 12th day of the menstrual cycle.

The HSG determines if the fallopian tubes are functional or not. In case of being clogged there are different treatment options being the most common of these In Vitro Fertilization. If they are functional, the patient may be a candidate for low complexity treatments such as artificial coitus or artificial insemination.

What is a Spermiogram and how does it help me achieve my pregnancy?
It is a vaginal ultrasound, which helps visualize the different pelvic structures: cervix, uterus, ovaries and sometimes the fallopian tubes. Ultrasound will help us determine the count of antral follicles, whether or not there are structural abnormalities such as endometrial polyps or ovarian cysts.
It is a pelvic ultrasound in which saline is inserted into the uterine cavity before performing the study in order to better visualize the endometrium. By inserting saline solution and performing 3D ultrasound it is possible to determine with greater certainty if there are structural problems in the uterine cavity such as polyps or fibroids.
Endometrial biopsy is a procedure where a small catheter is inserted into the uterine cavity that allows a small sample of endometrial tissue (biopsy) to be removed and evaluated by a specialized tissue doctor under a microscope. By examining the biopsy, you can determine if there are factors such as chronic inflammation that are interfering with the ability to achieve pregnancy. Molecular exams can also be done and thus be able to define if the endometrial conditions are optimal for embryo transfer.

Genetic tests

To optimize the chances of achieving a healthy pregnancy, many patients choose to have genetic tests. In this sense there are several types of genetic tests that can be performed in Panama Fertility.

It is a blood test performed on all patients with or without infertility problems before attempting pregnancy to determine if it is a carrier of certain genetic mutations given that although the patient does not suffer from any medical condition is still possible to be carrier of different mutations. This type of genetic examination is recommended by different societies such as the American Congress of Obstetrics and Gynecology and the American College of Medical Genetics.

If both partners are carriers of genetic mutations, the baby will have a 25% chance of suffering a genetic disease.

These diseases can be from the most common as sickle cell anemia to others that can be lethal. If this is the case, Preimplantation Genetic Diagnosis can be performed to determine if the embryo is at risk of suffering from the disease.

It is a test performed directly on the embryo to determine if it contains the number of chromosomes needed to achieve a healthy pregnancy. In some cases, this test can also determine if the baby may suffer from a disease such as cystic fibrosis, sickle cell anemia, and others, and in this way advise the parents and decide if this embryo is used, before the patient becomes pregnant. It also helps reduce pregnancy losses and rates of genetic alterations that can result in serious illness in the newborn or even early death.