In cases where desired pregnancy is not achieved, as well as in cases of miscarriages, laboratory testing is necessary. The following should first be ruled out:
If no issues arise from these tests, then the following are recommended:
Karyotype analysis in both women and men. This examination checks the number and quality of chromosomes. Genetic abnormalities in chromosomes can make natural pregnancy difficult and pose serious health risks for the child.
Testing for thrombophilia: Mutations in specific genes involved in blood clotting regulation may increase the likelihood of blood clots in the uterine vessels at the implantation site. This can make blood flow difficult or interrupted in the uterus vessels, leading to problematic embryonic development and eventual miscarriage.
A complete thrombophilia check is recommended, which includes:
Testing for endometriosis: Endometriosis, where endometrial tissue develops outside the uterus, is one of the significant causes of infertility. This condition is diagnosed through laparoscopy, which is invasive. Laboratory testing can indicate the need for laparoscopic examination by detecting inflammation markers of the ovaries CA- 125 and the general inflammatory marker IL-6.
DNA testing for bacterial infections: Classical cultures recommended in fertility testing often yield falsely negative results, reaching up to 60% in some cases. However, in cases of infertility, confirmatory detection in urine for ureaplasma, mycoplasma, and chlamydia, using the sensitive DNA detection method PCR, is recommended after negative culture results.
These tests are recommended to be done gradually (to reduce costs) and under the guidance and monitoring of the responsible gynaecologist or geneticist.