What tests should I take when planning a pregnancy? Checklist for those who responsibly plan children

Blood test for sex hormones (female only)

This analysis is required if a woman has problems conceiving (assessing the quality of ovulation), there was an early termination of pregnancy, or an irregular menstrual cycle. The analysis is taken strictly on certain days of the menstrual cycle: on days 2-3 of the cycle

follicle-stimulating hormone (FSH);
luteinizing hormone (LH) (the peak of the hormone in the middle of the cycle indicates the onset of ovulation);
estradiol;
prolactin (increased hormone causes ovulation disorders);
testosterone (increased hormone causes anovulatory cycles);
DHEA.

On days 20-22 of the cycle :
progesterone (a decrease in the hormone warns of the threat of miscarriage or a change in the condition of the placenta)

If necessary:

cortisol and thyroid hormones (deficiency leads to anovulation and early miscarriage. Excess leads to developmental abnormalities and premature birth).

How to prepare for research?

No special preparation is required for the test for human chorionic gonadotropin. General recommendations:

Eating stops 10 hours before taking biomaterial . Most often, venous blood is donated in the morning on an empty stomach;
12 hours before the test, any physical and emotional stress is excluded;

Fluid intake is limited 3-4 hours before blood sampling;
If possible, you should temporarily stop taking any medications , especially hormonal drugs (48 hours before the test). If this is impossible, you should definitely report the problem to the gynecologist who referred the woman for analysis.

As part of the hCG test procedure, a specialized specialist may prescribe a series of studies in which biological material is collected 3 times within 48 hours. This procedure allows you to track changes in hormone concentration over time. Accordingly, the above recommendations should be followed taking into account the indicated time interval.

Ultrasound monitoring (folliculometry)

This study makes it possible to determine how the dominant follicle develops, how tall the endometrium is, and to determine at what time ovulation occurs. For ovulation to occur, the dominant follicle must reach 20 - 22 mm, and the thickness of the endometrium must be 10 - 12 mm. Ultrasound monitoring is carried out several times per cycle, the timing depends on the duration of the menstrual cycle. If a woman’s cycle lasts 28 days, then the first study should be carried out on days 6–8 of the cycle.

After a positive hCG became negative: reasons, what to do

Changes in the level of hCG in the blood have a clearly visible trend - a dynamic sharp increase in concentration up to the 11th week of pregnancy, followed by a slow decrease until childbirth. A significant discrepancy with such a scheme may be caused by the following reasons:

False positive result of the first test;
Fetal growth retardation;
Ectopic or frozen pregnancy;
Threat of miscarriage, death of embryo.

If a woman has previously been diagnosed and confirmed pregnant, she should immediately contact a gynecologist - most likely, urgent hospitalization will be necessary.

In the same case, when the test was taken for the first time, but pregnancy was not confirmed, it is worth undergoing a comprehensive examination to make sure there are no tumors or to identify a potential hormonal imbalance.

Spermogram

Statistics show that 50% of cases of infertility are caused by male problems.
When planning parenthood, you should definitely visit an andrologist or urologist. Determining the qualitative and quantitative characteristics of sperm helps to identify a problem that interferes with normal pregnancy planning. Normal spermogram indicators:

sperm concentration – the number of sperm in 1 ml should exceed 20 million;
sperm motility. Category A – sperm with fast motility and category B – sperm with slow motility – there should be at least 25% of each type. Normally, category A+B sperm make up more than 50% of the total. Category C – sperm with non-progressive movements – there is practically no motility. Category D – immotile sperm. The number of sperm of category C+D should not exceed 50%;
sperm morphology. Normally, more than 30% should have a normal structure;
the ejaculate volume must be 2 ml or more;
degree of sperm aggregation and aglutination. Sperm agglutination is the gluing of sperm together, which prevents their forward movement. It shouldn't be normal.
presence of leukocytes and erythrocytes. There are always 3 - 4 leukocytes in the field of view. There should be no red blood cells.

After testing, one of the following diagnoses is possible:

normozoospermia – parameters within normal limits;
oligozoospermia – decreased sperm count;
asthenozoospermia – decreased sperm motility;
teratozoospermia – an increase in altered sperm;
azospermia – absence of sperm in the ejaculate;
aspermia – absence of ejaculate;
necrozoospermia – the presence of dead sperm.

Causes of low hormone levels

A decrease in the level of human chorionic gonadotropin as part of the natural process of bearing a baby can be caused by the following reasons:

Initially incorrect determination of the timing of the actual pregnancy;
Retarded embryonic development;
Complex placental insufficiency;
Ectopic pregnancy;
Risk of miscarriage;
Fetal death.

If there is a significant decrease in the concentration of hCG, it is necessary to urgently contact a gynecologist, who will prescribe an unscheduled ultrasound, conduct a direct examination and other measures, if necessary, in order to accurately identify the type of pathology and develop an individual plan for further actions.

Immune compatibility test

Immune conflict is detected at the level of the cervix. The mucus that is in the cervical canal can delay the progress of sperm and pregnancy may not occur. Normally, this is due to changes in the characteristics of mucus at different periods of the menstrual cycle, and in pathology – with the production of antisperm antibodies (antibodies against sperm that reduce their motility). In order to identify an immunological conflict, the following list of tests is carried out.

Postcoital test

– determination of the number and mobility of sperm in the mucus some time after sexual intercourse. In case of a negative result, it is recommended to repeat the analysis in the next cycle, as well as perform the Kurzrock-Miller test.

Kurzrock-Miller test

– determination of the reaction of the husband’s and donor’s sperm in mucus.

Determination of antisperm antibodies in cervical mucus.

Antibodies inhibit the movement of sperm through the cervical canal, preventing them from attaching and penetrating the egg, so pregnancy does not occur.

HCG is elevated: reasons and what to do

In some cases, with a successfully diagnosed pregnancy, confirmed by an examination by a gynecologist and an ultrasound scan, the level of human chorionic gonadotropin is significantly higher than it should be when actually calculating the age of the fetus. Possible factors that can provoke abnormal results:

Toxicosis in the active phase;
Multiple pregnancy;

Background activation of diabetes mellitus in a expectant mother;
Regular use of synthetic gestagens;
Incorrect calculation of the timing of actual pregnancy;
Various pathologies of fetal development;
Formation of a hydatidiform mole, benign or malignant neoplasm.

Regardless of the circumstances, the gynecologist should be familiar with the test results. He will refer the patient for additional examination and, if necessary, prescribe corrective therapy.

Karyotyping (genetic analysis, according to indications)

Is the couple at risk for genetic diseases? The answer to this question is provided by karyotyping, a cytogenetic method for studying the blood of both parents. The analysis allows you to identify deviations in the structure and number of chromosomes and determine the degree of risk of unwanted pathology. A genetic risk of up to 5% is considered low. A risk from 6 to 20% is medium, more than 20% is high. If the genetic risk is high, this does not mean that the child will be born with a pathology. It’s just that in this case, prenatal diagnosis is required during pregnancy:

at a period of 8-11 weeks, a chorion biopsy is used - the cells of the future placenta. Using the analysis, the vast majority of disorders can be identified: Down syndrome, cystic fibrosis, phenylketonuria, hemophilia, etc.;
starting from the 16th week of pregnancy - amniocentesis (analysis of amniotic fluid);
after the 17th week, cordocentesis can be performed - fetal blood sampling from the umbilical cord vessels. This analysis allows you to diagnose hereditary immunodeficiency conditions, blood diseases, metabolic disorders, as well as intrauterine infection of the fetus.

Risk group:

mother's age is over 35 years, father's age is over 40 years;
consanguineous marriage;
one of the parents has a hereditary disease or developmental defect;
the presence of hereditary diseases in relatives of future parents;
spontaneous miscarriages in previous pregnancies, threatened miscarriage in the early stages, stillbirth;
exposure to adverse factors in early pregnancy.

You can find out which tests you need to take specifically from your doctor. Having information about what kind of analysis is needed, it is better not to delay diagnosis. Timely testing will allow you to identify an unwanted problem, competently approach pregnancy planning and successfully give birth to a healthy child.

False positive hCG result

False-positive laboratory test results for human chorionic gonadotropin occur in the vast majority of cases in various pathologies. The most typical cases:

Active processes of formation of malignant or benign tumors. We are talking about both women and men. In the absence of pregnancy and a high concentration of hCG in the blood, underlying problems are most often found in the testicles, uterus, lungs, and kidneys. In addition, such findings may indicate choriocarcinoma;
Recent miscarriage. If fertilization is successful, but the fetus subsequently dies, the hormone circulates in the blood for some time, identifying a false positive result;
Bubble drift. As part of the pathology, the product of conception does not develop, and the chorionic villi grow in the form of specific round formations filled with liquid;
Sharp fluctuations in hormonal levels. Occurs in all women of reproductive age and adolescence.

What is needed for planning

A visit to the gynecologist is where you need to start. After a gynecological examination and interview, the doctor will determine the scope of diagnostic measures for the couple.

When collecting anamnesis, the doctor will be interested in:

Genetic diseases that may have run in the family.
Has the woman had viral hepatitis?
Does the couple have sexually transmitted diseases, tuberculosis, or other dangerous infections?
Are there any people in your family with endocrine pathologies?
Duration of the menstrual cycle.
Has the woman given birth before, have there been miscarriages or abortions?
What diseases were suffered by future parents in childhood?
What chronic pathologies are there, do the expectant mother and/or father constantly take medications.

Detailed answers will help you get an idea of the pathologies that can interfere with conception and normal pregnancy. And also prescribe mandatory tests and additional studies.

HCG as part of pregnancy screening

The level of the hormone is determined in venous blood serum. No complex preparation is required for diagnosis. Biomaterial is collected in the morning.

General preparation rules:

diagnostics are carried out on an empty stomach;
the woman must inform the gynecologist about all medications used, because the drugs can affect the results of laboratory diagnostics;
on the eve of donating blood, it is necessary to limit physical activity and eliminate the effect of unfavorable factors;
other instrumental studies are carried out after diagnosis and determination of the level of pregnancy hormone in the blood.

After collection, the blood is placed in a centrifuge and then separated into fibrinogen and serum. Specialists then determine beta units using immunometric methods. The woman is informed of the result within 24 hours. The hCG level increases in proportion to the number of fetuses.

Other ways to determine pregnancy

In addition to the hCG blood test, there are other methods for detecting pregnancy. The most effective:

Express tests. They are sold everywhere through pharmacy chains and used at home. Identical to the basic blood test, the presence of human chorionic gonadotropin is also detected, only in the urine. Modern means have a factual reliability of 85-90 percent, but it should be borne in mind that the hormone appears in the designated biological fluid later than in the blood - on average 2-3 weeks after successful fertilization;
Physical examination by a gynecologist. A classic technique that allows you to detect pregnancy with a high degree of reliability if a specialized specialist has the appropriate level of qualifications. Allows you to diagnose the presence of a fetus 1.5 months after fertilization;
Ultrasound. The main instrumental way to confirm and track the current level of fetal development. The fertilized egg is detected 5 weeks after fertilization. The embryo itself is in 7 weeks.