Infertility Diagnostics in Wroclaw, Poland – Nowa Estetyka Medical Center

Effective infertility treatment requires an accurate diagnosis. At the Nowa Estetyka Medical Center, infertility diagnostics for women is based on tests prescribed after a thorough medical interview. Our goal is to quickly identify problems that hinder conception and implement an effective method for treating infertility.

Causes of Infertility in Women

The inability to conceive is defined as infertility if regular attempts, without the use of contraception, do not lead to pregnancy after 12 months. Early diagnostics for infertility is recommended:

for patients over the age of 35
in cases of irregular menstrual cycles, such as every 2-3 months, which may indicate delayed or absent ovulation
when painful periods occur – these may be associated with endometriosis, one of the more common causes of infertility in women
after an ectopic pregnancy or previous miscarriages.

When it comes to female infertility, we distinguish between primary infertility (difficulty conceiving the first child) and secondary infertility (difficulty conceiving subsequent pregnancies). The most commonly diagnosed issues are hormonal imbalances, such as thyroid dysfunction and hypothalamic-pituitary axis disorders. Abnormal levels of sex hormones or elevated levels of male hormones can lead to problems such as:

irregular menstrual cycles, delayed or absent ovulation,
premature menopause and cessation of menstruation,
growth of empty Graafian follicles,
non-rupturing Graafian follicles (ovulation does not occur, making pregnancy impossible).

Common anatomical issues that impede the fertilization of an egg include:

blocked fallopian tubes
uterine anomalies
uterine fibroids
polycystic ovaries
endometriosis
cysts.

During the tests, infections and inflammations of the fallopian tubes and ovaries (adnexitis) should also be ruled out. During the initial consultation for infertility diagnosis, inform the doctor of any previous gynecological procedures, as these can also impact the ability to conceive. In some cases, despite comprehensive testing, the doctor may not be able to make a definitive diagnosis – this is referred to as idiopathic infertility, meaning the cause is unknown. Even when both partners’ test results are normal, conception may still not occur. In such cases, the treatment method is in vitro fertilization (IVF).

Female Infertility Diagnostics – Tests

After the initial infertility consultation, the doctor usually orders a set of laboratory tests:

Cytological test
Measurement of Anti-Müllerian Hormone (AMH) from venous blood to assess the number of ovarian follicles containing eggs. During the reproductive period, AMH regulates egg maturation and ovulation. Low AMH levels indicate the possibility of premature ovarian insufficiency, thyroid overactivity, or underactivity. This test can be performed on any day of the cycle.
FSH (Follicle Stimulating Hormone) test from a blood sample – along with the AMH test, this is one of the essential laboratory tests. FSH, produced by the pituitary gland, regulates the menstrual cycle and ovulation. The FSH test helps assess ovarian reserve. The doctor may order the test on a specific day of the cycle. Some medications can affect the results, so inform the specialist about all medications you’re taking during the first consultation.
Thyroid profile
Tests for infectious diseases and viruses (e.g., chlamydia, syphilis, rubella).

In addition to standard ultrasound (USG) tests, the Nowa Estetyka clinic also offers additional physical/endoscopic examinations for infertility diagnostics:

Sono-HSG, a test for checking fallopian tube patency. It helps detect potential changes in the reproductive system (polyps, tumors, endometriosis, fibroids, and more). The Sono-HSG procedure is preceded by a standard ultrasound to detect significant uterine anomalies or undiagnosed pregnancies. Using a catheter, a special solution is introduced into the uterine cavity, and its flow through the fallopian tubes is monitored via ultrasound. The Sono-HSG test is painless and typically does not require anesthesia. It can only be performed during the first half of the cycle, after the bleeding has completely stopped.
Hysteroscopy – this test evaluates the anatomy of the uterine cavity and fallopian tube openings, allowing the detection of pathologies not visible in basic ultrasound (adhesions, submucosal fibroids, polyps, and more). During the examination, a sample from the endometrial lining can be taken, and small changes (endometrial polyps) can be removed. In the gynecological position, an endoscopic device equipped with a camera is introduced into the uterus. Hysteroscopy is performed during the first phase of the cycle. Indications include suspected uterine anatomical abnormalities visible during ultrasound. Endoscopic examination is also recommended for women who have experienced multiple miscarriages.
Gynecological laparoscopy – a minimally invasive examination of the reproductive organs, requiring a small incision of 0.5-1 cm to insert a trocar equipped with a digital camera and microsurgical instruments. The specialist evaluates the condition of the uterus and fallopian tube openings on a screen. Like hysteroscopy, laparoscopy enables the removal of previously detected changes such as cysts, adhesions, and polyps. After the procedure, sutures are applied to the incision.