Which tests are possible if pregnancy is not successful?

If you think that you are less fertile and go to the doctor for this, he first wants to talk to you and your partner. By asking questions he tries to find the causes of reduced fertility. Different organs and hormones play a role in fertility. By asking specifically, the doctor can sometimes already discover which organ (system) is not functioning. The GP also asks you questions about your sexual past. It may not always be nice for you to talk about such topics. But the GP has discussions with many people about sex and fertility. He therefore finds it very common to talk about this subject. If you find it difficult to talk about your sexual past in the presence of your partner, you can contact your doctor once again after the consultation. There are general practitioners who then refer you directly to a gynecologist. Other general practitioners first do additional research.

Physical examination

When physically examining, the doctor looks at your physique, length and pattern of care. This can give indications about the cause of the reduced fertility. The doctor looks at the sexual organs of you and your partner. In the case of the man, the doctor feels the size of the testicles, the vas deferens and he looks if there is bleeding from the penis. An internal examination takes place at the woman’s. She has to lie on her back with the feet in the supports. With a duckbill (speculum), the doctor keeps the vagina open and can watch the cervix. He takes a little slime for research. Then the doctor removes the speculum from the vagina and starts with an internal examination. With two fingers in the vagina and one hand on the abdomen, the GP feels the uterus size and the ovaries.

Basal temperature curve

The doctor can obtain a lot of information from a basal temperature curve. It is nice to have this for three months before you go to the doctor. This process of the study is then concluded and the doctor can immediately proceed with the treatment or other additional research. This also saves you time.

Seed research

For a seed test, the doctor’s husband gets a special game. This jar must be filled with seed from a fresh ejaculation and is then taken to the laboratory. The man has to induce ejaculation through self-satisfaction. Usually the lab asks for no sex or masturbation two days before this ejaculation, because that is good for the quality of the seed. The laboratory examines the quantity, shape and quality of the seed. When the examination is requested by the gynecologist, there is often the possibility to masturbate in a separate room in the hospital. In this room material for erotic excitement is present, such as videotapes and magazines. It is also possible that the partner will go along.

After the lovemaking test (post-coital test)

The post-coital test gives a lot of information about the different aspects of fertility. This test is often done by the GP, but can also take place in the hospital. You will be instructed to have unprotected sexual intercourse with your partner around ovulation day symptoms. The next day, the doctor does an internal examination with the woman and with a pipette she sucks some mucus from the cervix. The doctor assesses the quality of this mucus and looks under the microscope to see if sperm cells are present in the mucus. The test is good if there is at least one swimming sperm in the uterine glue.

Blood tests for chlamydia

Chlamydia is a venereal disease that occurs in both men and women. Women in particular may have undergone a chlamydial infection, without ever having suffered from it. Sometimes there are complaints of a burning sensation when urinating, dirty vaginal discharge and ovarian inflammation. If the infection remains untreated for a long time, it can lead to infertility. By means of blood tests the doctor can check whether you have ever experienced such an infection. Chlamydia is generally good to treat.

Ultrasound examination

If the doctor wants more information about the internal organs, he can do an ultrasound. An ultrasound of the female genital organs can be performed in two ways: internal and external. For an external ultrasound, the woman must have a full bladder. The internal organs can be assessed by shape and size by means of sound waves. Any cysts on the ovaries or uterine fibroids in the uterus can make the doctor visible in this way. For an internal ultrasound, the gynecologist inserts a rod-shaped echo gander into the vagina. This does not hurt, but does give you a weird feeling. With this ultrasound, the ovaries and uterus can be better displayed.

Viewing operation

If you have been referred to the gynecologist, he sometimes makes an appointment with you for a viewing operation (laparoscopy). You will then receive a general anesthetic. Then the doctor makes a small incision in the navel. This brings him a tube inside. Through this tube, the abdomen is inflated with a special gas, leaving space between the internal organs. After this, a viewer is inserted into the abdomen through the same or a second incision and the doctor can look into the abdomen. He can then judge the ovaries, the uterus and surrounding organs. He can also examine whether there is endometriosis of the uterine lining (endometriosis) and whether inflammation remains can be seen. If necessary, he removes small pieces of tissue (biopsy), which can be viewed under the microscope. When the doctor is ready, let him escape the gas again and the holes are attached; sometimes only a patch is sufficient. You wake up just after the operation and you can go home at the end of the day. What treatment options are available if pregnancy does not work? Depending on the cause of your fertility problems, there are different treatment options for this. If no cause is found, the doctor may advise you to continue trying to get pregnant. The treatment methods:

Hormone treatment

If there is something wrong with the hormone household, a hormone treatment can help. It consists of hormones (tablets and sometimes injections) that help awaken a normal cycle with ovulation.


If there is an occlusion in your fallopian tubes, an operation may be attempted to open the passage through the fallopian tubes. Such an operation is drastic and the results can often be disappointing.

Artificial insemination

There are different forms of artificial insemination (KI). Insemination literally means ‘sowing’ and means that seed is artificially introduced into the womb of the woman.

In vitro fertilization (IVF)

In vitro fertilization (IVF) is fertilization (fertilization) in glass (in vitro), also called a test tube fertilization. Usually, IVF is chosen, in case of abnormalities of the fallopian tubes and upturns of the uterine lining (endometriosis).

Intracytoplasmic sperm injection (ICSI)

If the sperm quality is poor, ICSI can be chosen. ICSI is an intracytoplasmic sperm injection. A single sperm is selected in the laboratory, which is injected (directly) into an egg cell using a very thin injection needle. Furthermore, there is no difference with the normal IVF procedure.

Egg donation

Egg donation can be a solution for couples who want their own child, but where the woman does not have her own eggs or has a hereditary condition. Another woman receives an IVF pre-treatment in which eggs are extracted. With the seed of the own partner, the donor egg is fertilized and then injected into the uterus of the woman who wants to become pregnant.

Children’s consultation hour

Even before you are pregnant, you can contact the midwife with questions about (healthy) pregnancy. She answers all your questions during the children’s consultation hour.

Healthy pregnancy

It is important to prepare well for a possible pregnancy. If you live healthy in the period before you want to become pregnant, then the chances of a healthy pregnancy and a healthy child are greatest. But how do you best prepare for your pregnancy? In the children’s consultation hour, the midwife gives you personal advice about  healthy living and being pregnant and being.

Prepare for the consultation hour

The midwife gives you specific information that applies to your personal situation. A good preparation for the consultation is therefore necessary. Therefore think hard about (possible) hereditary disorders that occur in your family. A handy help is the Zwangerwijzer website. Fill in the  questionnaire on this website and take a print of it to your midwife (or mail this in advance to your appointment to your midwife).

Centering Pregnancy

If you are pregnant, a lot changes. Your baby is developing and your body is changing. But not only that. Pregnancy is often also a period in which you will make other choices. Where and how do you want to give birth? Which food will you give your baby soon? Are you going to work more or less? There are many more things that you need to think about. And of course you also want to know if your baby is growing well and the other medical checks are good. Centering Pregnancy is a program that combines medical checks and all information relating to pregnancy, childbirth and the first baby time. In addition, there is also time to ask all your questions and share your experiences with women who have been calculated for the same period.

The first conversation

At CenteringPregnancy, the first consultation (consultation) takes place individually. During this interview the midwife asks specific questions about, for example: your health, your lifestyle and the health of your partner and family members.

After the first call

The subsequent checks are no longer offered individually, but in groups. You form a session group together with a group of women, who have been calculated for about the same period. During a session, medical care, such as monitoring of blood pressure and the growth of the baby, is discussed. In a session you will talk to women who can experience and experience their pregnancy in a different way. You support each other in this. You will also learn how to walk through your pregnancy in a healthy way. The sessions take place in a group of 8 to 12 women. During the sessions you play a major role in your own care process: You learn to measure your blood pressure yourself, weigh yourself and keep track of your own file. The meetings always take place on fixed days and times. These are known in advance until the end of your pregnancy. The meetings last about 2 hours per meeting. This is much longer than the (first) personal conversation. This takes 15 minutes on average. As a result, the interaction time between the care provider and the pregnant woman is greater and it is better possible to discuss more and more extensive factors that influence the pregnancy and the health of mother and child.

February 21, 2019