> Sterilità female: diagnosis

L’anamnesi 

the first step is always the medical history and gynecological examination after: the entire medical history will haveà be told by the patient with particular precision on the aspects related to the menstrual cycle.

 basal body temperature

this measure the body temperature every day (at awakening), by inserting the thermometer in one of the cavità natural (vagina, rectum, or mouth) and holding it for about 5 minutes.

If, within 14 days before menstruation it is higher for 3 or more tenths of a degree compared to the average temperature of the previous days, we talk about the temperature biphasic, which expresses a proper functioning of the ovary.

Così as if the temperature remains più high during the period of 14 days is reasonable to think that the luteal function is normal.

it Is important that the basal temperature is measured for several cycles. Può happen, in fact, that even a woman with no problems to the ovaries may have, every now and then, a cycle anovulare, that is; without the liberation of the ovum, or vice versa.

If associated with the search of the peak of the luteinizing hormone in urine, basal body temperature allows you to identify the best time for sexual intercourse is well-aimed at the reproduction.

L’ecografìa pelvica

the information provided by The ultrasound examinations are of undoubted usefulness;. The pelvic echography allows us to highlight problems in the ovaries, the uterus, the presence of polyps, myomas, etc., Of lesser effectiveness, however, is sonographic assessment daily the purpose of establishing the phases of ovulation, and, in particular, the moment of the “breaking” of the follicle.

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è rare, in fact, with the ultrasound you judge anovulari (and not fruitful) cycles that, on the contrary, lead to the conception.

And dosaggi ormonali

If a woman has normal menstruation you run a dosage of hormones ipofìsari and ovarian blood in the first few days of the cycle, of around 4°-5° day. If a woman suffers from oligoipomenorrea (i.e.; has cycles of long duration or reduced menstrual flow) può be useful to induce menstruation with the use of drugs (progesterone) before performing the assay of the above hormones in più stages of the cycle.

however, If a woman is in amenorrhea (that is; if he has not the menstrual cycle by più than three months) it is necessary to detect the basal body temperature for a few days so be sure that the ovaries have not resumed work before the blood withdrawal.

hysterosalpingography

Is a radiological exam that allows you to assess any malformations or lesions that can be the basis of the sterilità mechanical. Consists in injecting into the uterus and the fallopian tubes with a contrast medium and performing a series of x-rays to study the path.

Today is considered by many to be a exam passed (but it remains one of the più in use) for several reasons: it is sometimes painful if done without anesthesia, it is free of complications and not è always reliable from the diagnostic point of view. The error percentages are quite high, especially if the interpretation is not è entrusted to competent staff.

La laparoscopia

Definitely più reliable hysterosalpingography, is used to assess the presence of endometriosis, adhesions or other conditions that cause sterilità, mechanical or non-mechanical. Is performed under general anesthesia through a small incision in the navel, inserting an optical probe that allows you to observe all of the pelvic organs.

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laparoscopy involves, albeit rarely, to a series of complications such as injury of a large vessel, arterial, small intestinal lesions, abdominal pain. In all three cases it is the complications of fast and easy resolution that does not leave the unpleasant consequences. Laparoscopy requires a short hospitalization, which canò vary from a few hours to two days, depending on the structure where it is performed.

La falloppioscopia

There are different modesà study of the structure of the tubes: they can be incannulate during laparoscopy; può injecting a liquid medicated or air, so as to assess the pervietà and muscle tone; or it is possible to falloppioscopia, technique of great usefulness; but, not yet così widespread, which consists in introducing into the tube through the uterus with a thin catheter with a fibre-optic, so you can take a close look at the state of health of the internal wall of the tube, along the route, which will haveà accomplish the ovum.

Thanks to the falloppioscopia is possible to note any damage to the mucosa of the tubes which, otherwise, would not be seen with laparoscopy. the

Ettore Cittadidini, Carlo Flamigni, A Child, wanting to be able to have – And. The New Italy Scientific

page updated on 2 September 2007