Male Infertility Diagnosis

1. Semen Analysis
This is the first test regarding infertility. Because many factors such as smoking, alcohol use, heat, medication and infections affect sperm production, analysis of abnormal samples should be repeated at least twice leaving about a month's time in between. If the analysis reveals an infertility issue, the next step to take is physical and hormonal examination of the male patient.
The male reproductive cycle (sperm production) is renewed/repeated every 2-3 months. A newly produced sperm will be released into the semen after 2-3 months' time. Thus, possible harmful agents and interaction (inflammatory disease, stress, fatigue, environmental factors) or useful medication for the treatment can affect the features of the sperm to be produced 3 months later. While evaluating semen analysis results, this period should be in mind. If no medication has been used or no inflammatory disease has been experienced, then, at least two sperm samples should be evaluated with 3-4 weeks between them, and decision should be made according to the average outcome of the results.
It is recommended that the samples be collected at the IVF centre.

When to do the semen analysis?
This test should be done after a period of 3-5 days of no intercourse. If it is done in less than two days, the sperm concentration will be low; samples after 7 days without intercourse are not advised due to low sperm motility. Semen to be analyzed should not be kept in temperatures below 20°C and above 40°C. Cold and hot shock causes dramatic changes in sperm motility.

How semen is collected?
Sample is collected by masturbation; condoms, soap and cream (lubricants) should not be used and sterilized collectors/cups should be preferred. Since the first ejaculated semen contains more sperm cells, in case the first amount cannot be put in the cup or pours out, the laboratory assistants should be informed about it.

Infertility Diagnosis in Women

Hormone Tests/Assays
On the 2nd (or the 3rd if the 2nd is a Sunday) day of the menstrual cycle, FSH, LH, E2, PRL, TSH, FTY tests are required. If necessary, in order to decide on the ovary reserve, further tests such as inhibin-A and AMH might also be needed.

Ultrasoonography (USG)
To analyse ovary reserves, and to evaluate the uterus and uterus tubes (fallopian tubes) ultrasound scan is done on the 2nd or 3rd  day of the menstrual cycle.

Saline Infusion Sonohisterography (SIS)
A procedure to detect formations such as polyps, fibroids, uterus septums and other attached particles in the uterus. With the help of a catheter serum is pushed into the uterinecavity through the vagina and an ultrasound assessment is made.

HSG (Hysterosalpingography)/Uterus Scan
By the injection of radiographic contrast medium into the uterus, the uterine cavity and tubes are monitored and a series of x ray films are taken.  Cervical incompetence, uterine malformations, abnormal growth, fallopian tube blockage and cervical fluid/mucus build-up can be monitored in this method.

The uterine cavity is monitored through equipment with built-in light (i.e. endoscopy). This  allows to diagnose and possibly treat issues in the uterine cavity at the same time.

Under general anaesthesia, the organs in the abdominal area are monitored with equipment with built-in light (i.e. endoscopy), through a small incision in the abdomen. The method allows diagnosis and treatment in one go. It is used when other diagnostic methods fail to provide accurate information, and in diagnosing and treating abnormal abdominal attachments, endometriosis (where cells from the lining of the uterus, that should be inside the uterus, appear and flourish outside the uterine cavity), fallopian tube infections, cysts, ectopic pregnancies and unknown pain and infertility conditions. .

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Ivf For Who?
Infertility may be welded male or female. Sometimes a problem is detected in either one of the pair. Today, the most advanced infertility treatment methods applied in solving the problem tube baby.
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