n Vitro” Clinic is a leader in the field of artificial fertilization and reproductive health not only in Georgia, but in post-soviet countries. In vitro fertilization was founded 20 years ago by the team of Mr. Gia Tsagareishvili and Ms. Natalia Khonelidze and so far it became a token of brining happiness for thousands of hopeless couples. Many years’ experience, the most sophisticated technologies, high professionalism, loyal dependence to patients and close contact with foreign colleagues is a guarantee of success of “In Vitro” Clinic.
Infertility is a syndrome when during 12 and more months against unsafe, regular sexual life the pregnancy does not approach.
In the world, 1 out of 6 couples of childbearing age has infertility:
✔ In 20-35 % infertility is caused by female factor;
✔ 20-30 % – by male factor;
✔ In 25-40 % – together by factor of both;
✔ 10-20 % – it is impossible to establish infertility reason
Accordingly in case of existence of infertility problem it is necessary to jointly examine as a woman, so a man, for this all conditions are created at our Clinic.
Generally, from infertility standpoint we begin examination of a couple if during 1 year against the background of unsafe, regular sexual life the pregnancy has not approached and if a woman’s age is above 35 – it is reasonable to ascertain the infertility reason already after 6 months after beginning of unsafe, regular sexual life.
Woman’s age is the first and the main index enabling us to prognose pregnancy chance as in natural, so in in vitro cycle.
During a woman’ examination is studied the state of ovaries, uterus, fallopian tubes.
Great importance has a detailed collection of anamnesis – attention is paid to menstrual cycle regularity, menstruation nature, body mass index, type of adipose tissue distribution on the body, assessment of hyperandrogenism external evidences (excessive pilosis, acne), surgical intervention in small pelvic organs, frequency of sexual life, etc.
At the first stage of examination is assessed ovarian reserve, for this is made blood hormone test – AMH, FSH, E2 and ultrasonographic investigation for purpose of establishment of quantity of follicles in ovaries, then we assess whether ovulation (maturation and release of follicle) takes place timely or not.
For assessment of uterus state are conducted 2D and 3D ultrasonographic investigations, in case of suspicion on uterine cavity pathology is recommended conduction of diagnostic hysteroscopy.
As functioning of ovaries and uterus is in direct relation with hormonal status, is conducted blood hormonal test. Besides ovarian hormones, is assessed functioning of hypophysis, thyroid, adrenal glands and pancreas.
For assessment of fallopian tubes is conducted hysterosalpingography, hysterosalpingo-contrast-ultrasonography.
Diagnostic laparoscopy is one of the most important method of infertility research, especially in patients who have in anamnesis small pelvic inflammation diseases, surgical intervention in small pelvic organs, endometriosis, or in patients whose infertility reasons, by means of the above mentioned examinations, was impossible.
Before planning pregnancy are investigated TORCH and intracellular infections. Also is conducted screening of a couple for the purpose of revelation of HIV-infection, hepatitis.
If necessary is conducted genetic analysis, as of a woman, so of a man.
During man’s examination, at the first stage we assess spermogram data that shall be assessed by the newest criteria provided the World Health Organization, according to which sperm is considered to be normal if:
✔ Concentration of spermatozoa in 1 millilitre of ejaculate exceeds 15 million and in entire ejaculate – 39 million;
✔ Percentage of motile spermatozoa exceeds 40 % and progressively motile – 32 %;
✔ Concentration of spermatozoa with normal morphology is more than 4 %.
If spermogram indices do not conform to the norm, for the purpose of diagnosis specification is recommended it repetition. If necessary is conducted hormonal examination in men.
In case of non-existence of spermatozoa in ejaculate (azoospermia) is conducted biopsy of seminal
glands for the purpose of detection of spermatozoa.
As concerns determination of antisperm antibodies in blood or sperm, also conduction of cervical
mucous membrane postcoital test is not recommended due to their low information value.
Ketevan Kakashvili: reproductologyst, obstetrician-gynecologist