The process of diagnosing infertility begins by talking to a woman. Anamnesis of a woman (a case history established by interviewing a woman) with infertility problems, among others, includes the following:

• Time of first period (menarche), the length of the cycle, duration of menstrual flow, average blood loss, painfulness, irregular bleeding (intermenstrual, spotting, postcoital)
• Number and outcome of previous pregnancies in current or previous relationship(s). The outcome of a pregnancy can be a delivery, a spontaneous (miscarriage) or induced abortion, an ectopic pregnancy or a molar pregnancy
• Previous contraceptive methods. Birth control methods fall into natural methods, barrier methods, hormonal or postcoital contraception, intrauterine device (IUD), sterilization
• Previous testing and/or treatment(s) of infertility. Couple´s education – issues of fertility calculation, frequency of intercourse, frequency of intercourse during ovulating periods, amount of attempts. Dyspareunia (painful sexual intercourse)
• Conditions potentially impairing fertility: diabetes, thyroid disorders, tuberculosis, etc.
• Potential malignant diseases or diseases that required hospitalization or medical treatment
• Previous abdominal surgeries
• Inflammatory diseases, particularly of a pelvic region. STDs.
• Galactorrhea (discharge of milk-like substance from the breast not associated with pregnancy or breastfeeding)
• Exposure to toxins in working or living environment
• Alcohol or drug abuse

If infertility of a couple is suspected, the basic analysis will be performed:

• Gynecological exam
• Pap test
• Transvaginal ultrasound
• Cervical smears for aerobic and anaerobic cultures, Chlamydia, Mycoplasma, Ureaplasma
• Basic hormonal status – FSH (follicle-stimulating hormone), LH (luteinizing hormone), E2 (estradiol), PRL (prolactin), TSH (thyroid stimulating hormone) on day 2-5 of the cycle
• Semen analysis and microbiological examination of the ejaculate
• Testing of tubal patency
• Blood tests:
  •  Blood Type, Rh factor
  •  HBsAg (Hepatitis Bs Antigen), anti-HBs + Anti HBc total
  •  HCVAg (Hepatitis C), anti-HCV
  •  anti-treponemal screen
  •  HIV-1/-2 Antibody Evaluation

Using the above tests and detailed case studying some of the following diagnoses can be established:

• Infection
• Sexual dysfunction
• Hyperprolactinemia
• Hypothalamus and hypophysis (pituitary gland) disorders
• Irregular periods due to high levels of FSH – premature menopause
• Absence of ovulation
• Anomalies of female reproduction organs
• Fallopian tube blockage
• Adhesions in the pelvic region
• Endometriosis
• Other conditions – diabetes, thyroid disorders, hepatitis, AIDS
• Male factor