Study of a woman with infertility
requires a lot of attention;It should not focus only on the genitals, but cover all organs and systems.
Anamnesis should be detailed. All complaints should be considered, not only those relating to the genitals, for example: pain in the pit of stomach, spastic constipation, renal colic, etc. Since diseases of all organs are related to the function of the genitals, IL Braude advises when collecting an anamnesis in a barren woman to find outas well as issues such as fertility of family members, endocrine diseases they have - diabetes, myxedema, Graves disease, etc.
Anamnesis about sexual function should be more detailed.
After collecting anamnesis and general examination, a gynecological examination is performed, which must be performed with exhaustive completeness. As stated above, the doctor must have preliminary information about the health of the patient's husband. However, even if there is evidence of a possible infertility of the husband, a woman's
study is still necessary, for a sterile marriage is often the result of defects in the genital area and in the husband and wife.
Bimanual examination should be very thorough. If necessary( obesity, excessive painful reaction of the patient) produce a rectal examination. Research with mirrors is mandatory;special attention should be paid to changes in the cervix, the condition of the arches and vagina. Sometimes additional methods of research are required-sounding, diagnostic curettage of the uterine mucosa, etc.
Finally, some types of functional research are used to determine the condition of the pelvic floor and abdominal press, the patency of the tubes( pertubation, metrosalpingography), to diagnose the functional state of the endometrium( anovulatorycycle) and ovaries( reactions to estrogens, pregnanediol, gonadotropins).
3. D. Savelyeva and VG Orlova, studying the exchange of ovarian hormones in infertility, found that the infertility in the women they examined is a violation of the exchange of ovarian hormones, a single-phase menstrual cycle, and in some cases - deep violations of the hormones metabolism of the adrenal cortex.
In addition to routine laboratory tests( blood, urine, gonorrhea swabs, Wasserman reaction), it is necessary to investigate the secretory function, the vagina and the uterus: acidity, pH, purity, determine the cytology of the vaginal contents, etc. The study of a male
is usually performed by a urologist, The gynecologist should be aware of its results. About potentia generancli husband can be judged on the basis of semen research. A severe sperm defect is the complete absence of spermatozoa - azospermia, when conception is impossible. A small amount of spermatozoa, oligospermia, isolated from the ejaculate can lead to conception in single cases, but in the vast majority of cases leads to infertility in men, as well as necrospermia( immobility of spermatozoa).It is necessary to pay attention to the change in the shape of spermatozoa;defects in their normal structure make conception impossible.