Infertility Diagnosis and Treatment
Infertility Diagnosis and Treatment; Infertility is defined as the inability of a couple to achieve pregnancy despite having regular and unprotected sexual intercourse for one year. This waiting period is shorter in women with advanced age or low ovarian reserve. Infertility is 1/3 male, 1/3 female and 1/3 either unexplained or caused by both partners.
What are the Female Causes?
Infertility Diagnosis and Treatment Methods; In order for a woman to have regular menstruation and ovulate, the hormonal cycle between the brain and ovaries must first be working in harmony and regularly. LH (Luteinizing hormone) and FSH (Follicle stimulating hormone) are secreted from the pituitary gland in the brain and reach the ovaries with blood circulation and regulate the production of hormones secreted from the ovary such as estrogen and progesterone and initiate the process of egg selection, development and hatching.
Ovulation and the menstrual cycle are very complex and delicate. Eggs are selected just before menstruation and begin to develop on days 6-7 of the cycle, with the healthiest of these becoming fully mature on day 14 on average, and are captured by the fallopian tube, which joins the uterus and ovary by hatching the egg sac (follicle) in which it resides.
The egg can remain viable for about 24 hours, during which time fertilization takes place in the fallopian tube by sperm. Sperm can remain viable in a woman’s body for 2 or 3 days, so intercourse 1-2 days before and 1-2 days after ovulation increases the chances of fertilization of the egg and consequently the chances of becoming pregnant. The fertilized egg, now called a zygote, divides and multiplies and passes through the tube into the uterus and implants in the uterus. Causes of female infertility can generally be listed as follows.
- Hormonal disorders; Thyroid Diseases, Hyperprolactinemia (High Milk Hormone), PCOS (Polycystic Ovary Syndrome)
- Closed or damaged tubes
- Adhesion, space-occupying lesion in the uterus (polyp, fibroid) or congenital deformity of the uterus (such as curtain, double uterus)
- Low ovarian reserve (advanced age, premature ovarian failure, chemotherapy, radiotherapy)
- Endometriosis (Chocolate Cysts)
- Vaginismus
What is Male Infertility?
Infertility Diagnosis and Treatment Methods; Sperm production and maturation in male reproductive organs takes approximately 10 weeks. The fluid containing sperm that is expelled from the body during ejaculation is produced by different glands in the testicles. Each milliliter of this fluid should contain approximately 15 million sperm cells. Sperm must be suitable for reproduction in terms of number, shape and motility. With the mobility of their tails, the sperm reach the uterus and then the tubes, and fertilization takes place if an egg is found in the tube.
Some of the causes of male infertility can be listed as follows:
- Congenital blockage of the sperm ducts
- Disorders in sperm morphology (Teratozoospermia)
- Low sperm count (Oligospermia)
- Low number of high motile sperm (Asthenozoospermia)
- No sperm cells in the seminal fluid (Azoospermia)
- Genetic Diseases (such as Klinefelter Syndrome, Y Chromosome Microdeletions)
- Chronic diseases (such as Diabetes, Chronic Renal Failure)
- Hormonal disorders
- Use of drugs, narcotics and alcohol
- Sexual dysfunction
Infertility Diagnosis and Treatment Methods
What are the Diagnosis and Treatment Methods for Infertility?
It is appropriate for couples to consult a physician together for infertility diagnosis and treatment methods. First, the ovarian reserve is evaluated by examination (follicle count by ultrasound on the 3-4th day of menstruation, Anti-Müllerian Hormone test), the tubes and uterus are evaluated by Hysterosalpingography (uterine film), sperms are examined by spermogram and the cause is investigated by laparoscopy, hysteroscopy, saline infusion sonography if necessary. Treatment is planned taking into account other factors such as the woman’s age, the couple’s expectations, financial and social situation.
Although in-vitro fertilization (IVF) is the most well-known treatment method, there are other and simpler treatment methods that can be recommended before IVF for some couples who have difficulty conceiving naturally. Stimulation of the ovaries with pills or injections and timing of intercourse in diseases where ovulation is not regular, such as Polycystic Ovary Syndrome, and insemination in mild sperm disorders are methods that increase the chance of conception without resorting to IVF treatment.
Surgical interventions for some detected diseases can increase the chance of pregnancy before infertility treatment. Examples of these surgical interventions include laparoscopy to evaluate intra-abdominal adhesions and removal or ligation of damaged tubes, myoma surgery, endometriosis surgery, hysteroscopy to remove fibroids, polyps, adhesions, septum (curtain) opening.
In vitro fertilization (in vitro fertilization) is recommended in cases where both tubes are blocked, there are severe sperm disorders, there is no response to simpler treatment methods or in the presence of low ovarian reserve.
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Infertility Diagnosis and Treatment