Step by Step – The first steps to pregnancy

The first step is an extensive discussion. Many questions will be asked initially like: How long have you wanted to conceive a child? Do you both want to conceive? Which medicines do you take on a regular basis? From the woman we need to know how long and consistent her cycle is and whether her period is accompanied with intense pain. Were there previous pregnancies and how did they go? These are some of the questions that can lead us in the right direction. An ultrasound examination serves to exclude the possibility of disrupted egg cell maturation.

A number of hormones levels will be measured. Running blood tests at the beginning of the menstrual cycle could be necessary to establish the levels of estrogen, LH, FSH, testosterone, prolactine and the thyroid hormone TSH and, maybe in the second half of the cycle, for progesterone. Sometimes it's helpful to record a basal body temperature curve to gain more information about the progression of the cycle. The level of certainty that ovulation actually occurs before the temperature increase of about 0.5 degrees, is only about 70 %. That's why an ultrasound is also performed between the 10th and 12th day of the menstrual cycle. The man's conception capability can be determined by a microscopic evaluation of the sperm (Spermiogram). The partner is requested to provide a sperm sample to the laboratory, attained through masturbation. There it will be examined under a microscope to see whether enough sperm with a healthy form and good mobility are present in the ejaculation. Since the quality of sperm can vary greatly, a second examination should be carried out within 3 months at the latest.
The next step determines whether the fallopian tubes are open. Usually an ultra sound or x-ray using a contrast substance are sufficient for initial indications. For an exact diagnosis an abdominoscopy will be necessary (Laparoscopy). Sometimes it's simple: intercourse was too infrequent or at the wrong time. But if an egg cell maturation problem is identified, usually taking specific hormonal medicines is necessary.