To determine the precise date of ovulation and, therefore, the optimum time for conception, we start the fertility treatment with a detailed monitoring of all the parameters within a menstrual cycle which are important for conception:
The so-called post-coital test (also known as the Sims-Huhner test) establishes whether the sperm has the ability to climb out of the vagina through the cervix mucous. Hormone testing in the second half of the menstrual cycle clarifies whether there is a luteal insufficiency and whether, for this reason, hormonal stimulation should be carried out or the second phase or the menstrual cycle should be supported with progesterone. An examination of the functioning of the fallopian tubes by ultrasound and an ultrasound contrast agent fluid (HYCOSY) checks whether they are open for the passage of egg cells and sperm.
The precise procedure for monitoring the menstrual cycle:
One to two days before the suspected date of ovulation:
First ultrasound examination. (For 28-day cycles, ovulation takes place between the 13th and the 15th day of the cycle, for example). If there is a follicle of at least 16 mm, the daily tests for the ovulatory hormone in the urine, or alternatively in the blood, start. Urine tests can also be performed at home.
In the night of the predetermined ovulation:
sexual intercourse should take place now.
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The morning after:
some mucous is taken from the cervix with a soft catheter and examined for moving sperm under a microscope. If there aren’t any, the test must be repeated in the next menstrual cycle.
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On the third, sixth and ninth day after ovulation:
the progesterone is examined in a blood hormone test to find evidence of any luteal insufficiency.
The examination of the fallopian tubes by HYCOSY is optional and is generally performed one to two days before ovulation.