Dr. Paulo Tudech Salgueiro
CRM-SP 84.484
Human Reproduction
Medical specialty
Human reproduction and infertility: individualized assessment and care
When pregnancy does not occur within the expected time, a specialized assessment can help investigate factors related to fertility and guide next steps based on your history, health and reproductive goals.
In-person care in São Paulo and guidance on teleconsultations for patients in other cities, provinces, states and countries.
Specialized human reproduction care
Medicina da Mulher provides individualized assessments for patients and couples with fertility questions, difficulty conceiving, endometriosis, gynecological factors or a need for guidance in human reproduction.
The assessment aims to understand each person's or couple's situation before discussing tests, follow-up or treatment possibilities.
What is infertility?
Infertility is a condition in which pregnancy does not occur after a period of trying without contraception. The investigation may consider female, male or combined factors, as well as situations where a cause is not initially identified.
Infertility is not an individual failure. It is a health condition that may involve different factors and deserves careful, inclusive and individualized assessment.
This information does not replace an individualized medical assessment.
When should you see a human reproduction specialist?
Assessment may generally be considered after 12 months of trying without contraception for patients under 35 and after 6 months from age 35. It may be recommended earlier when a known condition could affect fertility.
- Trying to conceive for an extended period.
- Age or medical history suggesting earlier assessment.
- Endometriosis diagnosis or suspected endometriosis.
- Menstrual or ovulatory changes.
- Previous gynecological surgery.
- Previously identified male factors.
- Recurrent pregnancy loss, when applicable.
- Questions about fertility or reproductive planning.
- A need for a second opinion.
The right time to investigate depends on age, history and other clinical factors. Guidance should be individualized.
What can affect fertility?
Fertility may be influenced by more than one factor. An investigation should consider each patient's or couple's context without assigning responsibility to one person.
Female factors
Age, ovarian reserve, ovulation, hormonal changes, endometriosis and conditions affecting the fallopian tubes or uterus may be considered.
Male factors
Health history and factors related to male fertility may also be assessed, with referral when needed.
Combined or unidentified factors
More than one factor may be present. In other cases, a cause may not be identified at first.
Time and reproductive history
Time trying to conceive, previous pregnancies, treatments and pregnancy losses may guide the investigation.
Health conditions and surgery
Health conditions, surgeries and previous treatments should be considered individually.
Habits and overall health
Relevant health and lifestyle factors may be discussed without judgement or generic recommendations.
How is infertility investigated?
Assessment begins with reproductive, medical and family history. Previous tests, symptoms, menstrual cycles, time trying to conceive and reproductive goals help guide the investigation.
Initial consultation
Review of history, health conditions, previous tests, time trying and reproductive goals.
Focused investigation
Review or request of tests and complementary assessments when needed. No single test list is mandatory for everyone.
Discussion of possibilities
Next steps are defined according to findings, clinical context and each person's or couple's goals.
What care options may be considered?
The plan depends on identified factors, age, time trying, health history and reproductive goals. Not everyone needs the same care, and in vitro fertilization is not an automatic step.
Guidance and follow-up
Care may begin with organizing clinical information, cycle guidance and individualized follow-up.
Clinical treatment
May be discussed when indicated, considering benefits, risks and reproductive goals.
Surgery when indicated
Selected situations may involve gynecological surgery or robotic surgery.
Intrauterine insemination
May be considered in selected cases after an individualized investigation and discussion.
In vitro fertilization
IVF is one possibility in some clinical contexts, but it is not automatically recommended for everyone.
Integrated care
Other specialists may contribute when gynecological, male, genetic, hormonal or nutritional factors are involved.
Endometriosis and fertility
Endometriosis may be associated with difficulty conceiving for some patients, but every case requires individual assessment. Care may consider symptoms, disease location, age, ovarian reserve, pregnancy goals and previous treatments.
The investigation may integrate endometriosis care, endometriosis mapping and surgical assessment when indicated.
How does a human reproduction consultation work?
Understanding your situation
The visit considers your questions, attempts, symptoms, medical history and goals.
Organizing clinical information
Previous tests and documents may be reviewed to guide the investigation.
Defining next steps
Follow-up possibilities are discussed according to the individualized assessment.
In-person care and teleconsultations
Medicina da Mulher provides in-person care in São Paulo and guidance on teleconsultations for patients elsewhere, according to each case and applicable medical-care rules.
Learn about our international patient service.
Related specialties
Gynecology
Gynecology and obstetrics may contribute to cycle, symptom and history assessment.
Endometriosis
Endometriosis care may participate when there is a diagnosis, suspicion or related symptoms.
Genetic counselling
Genetic counselling may be discussed in some contexts.
Endocrinology
Endocrinology may contribute when metabolic or hormonal factors require integrated care.
Nutrition
Nutrition may support overall health according to the individual plan.
Second opinion
Previous tests and treatments can be reviewed without a commitment to continue a specific plan.
Frequently asked questions about human reproduction and infertility
Infertility is a condition in which pregnancy does not occur after a period of trying without contraception. It may involve female, male or combined factors, or a cause may not be identified initially. The appropriate timing for assessment varies according to age, history and health conditions.
Assessment may generally be considered after 12 months of trying under age 35 and after 6 months from age 35. Endometriosis, menstrual changes, previous surgery or known factors may justify an earlier visit. Timing should always be individualized.
Yes. An investigation may consider female, male or combined factors. Sometimes a cause is not immediately identified. Care should consider the health and history of the people involved without assigning blame or individual responsibility.
No. IVF is one possibility and is not automatically recommended. Care may involve guidance, clinical treatment, selected surgery, insemination or other approaches. The choice depends on the investigation, clinical context and reproductive goals.
Tests depend on history, symptoms, time trying and previous assessments. Laboratory, imaging or complementary evaluations may be discussed, but no single list is mandatory for everyone. Requests should be focused and individualized.
Endometriosis may be associated with difficulty conceiving for some patients, but not everyone will experience infertility. Assessment may consider age, symptoms, ovarian reserve, disease extent, previous treatments and pregnancy goals.
Yes. A second opinion may review your history, tests, diagnoses and proposed treatments. Bring available documents so the specialist can understand the path so far and discuss possibilities independently.
A teleconsultation may help organize history, review previous tests and guide next steps according to applicable rules. Physical examinations, sample collection or procedures may require in-person care.
Gather reports, images, laboratory results, procedure notes and a medication list if available. The visit can still proceed without every document, and the team will advise what may be helpful next.
No. The plan depends on identified factors, age, time trying, health history and family-building goals. Options should be explained clearly, without promises of results, and should respect the preferences of the people involved.
Yes. The clinic offers guidance on teleconsultations for patients in other cities, provinces, states and countries. The team can explain document sharing and when an in-person step may be needed.
Booking can begin through the clinic's WhatsApp. Indicate whether you want a fertility assessment, second opinion or teleconsultation information. You do not need to send detailed medical information before the visit.
Your reproductive plans deserve an individualized assessment
A specialized consultation can help organize your history, previous tests and reproductive goals and guide next steps.