Infertility Treatment

Infertility - What is Infertility?

Infertility is the inability of a couple who wants to have a child and do not use any birth control method to achieve pregnancy for more than 12 months. If the woman has never had a pregnancy before, this is primary infertility ; If pregnancy occurs, regardless of whether it results in birth or not, it is called secondary infertility .

If the couple is under 35 years of age, if they have tried sexual intercourse without protectio for 12 months, and if they are over 35 years of age, if pregnancy has not occurred despite trying unprotected sexual intercourse for 6 months, they should consult a doctor Infertility evaluation is made by investigating the health status of the woman and man, taking their sexual history , and performing a general physical examination and special examinations.

Infertility is observed in 10 to 15 percent of couples . It is widely thought that infertility means infertility . However, this is incorrect information. Infertility is the inability to have children at all. However, infertility can end with pregnancy with various treatment methods and support programs.

What are the Causes of Infertility?

The cause of infertility may be a deficiency in the reproductive organs of a woman or man, a genetic disorder or various acquired diseases that cause the person to not be able to fully perform reproductive functions. Only one or a combination of these factors causes infertility. In 10 or 15 percent of this disease group, the couple may not be able to have children, although no factor has been found to prevent infertility as a result of the research.

Lack of health, quality and sufficient number of eggs, which are female reproductive cells, and sperm, which are male reproductive cells; The causes of infertility are the presence of a factor in the anatomical structure of the female body that prevents the sperm from reaching the egg or fertilizing the egg , and in the final stage, the fertilized egg not being able to hold on to the uterus , or the health of the formed embryo is not being good enough to lead to birth.

What are the Causes of Female Infertility?

Some disorders in the female reproductive organs can make pregnancy difficult. This requires receiving supportive treatment for pregnancy. The most common cause of infertility in women is ovulation disorders. If the egg cell produced in the ovaries is not expelled from there, fertilization cannot occur. Infrequent or absent menstrual bleeding is an indication of ovulation disorder. If the ovulation disorder is caused by a hormonal reason, the woman does not experience any menstrual bleeding.

Infection or tumors called polyps in the cervix area, which is the entrance area, is a cause of infertility as it will prevent the sperm from reaching the egg .

There is a layer called endometrium in the uterus where the fetus is located. Endometriosis is the formation of endometrium outside the uterus. If a tissue is seen in another place in the body where it should be found, it causes many diseases. Places where endometriosis is seen; The ligaments that fix the uterus , the ovaries, the fallopian tubes and the tissue covering the pelvis . In endometriosis, bleeding occurs during menstruation, just like normal endometrium. However, since the bleeding occurs in the abdomen, not in the uterus, an infection -like situation occurs over time and adhesions are observed. Cysts formed by endometriosis in the ovaries are called endometriomas . Endometriosis is present in 25% of infertility cases in women , and 50% of this segment needs supportive treatment for pregnancy. Things that cause blockage or narrowing of the fallopian tubes also prevent the egg from being fertilized by the sperm , making pregnancy impossible. Damage to the tubes; It may be caused by a sexually transmitted infection encountered by the body or tuberculosis acquired in childhood, or it may be the result of an ectopic pregnancy.

Polycystic disease is an other cause of infertility Policyctic Ovarian Syndrome is typical with irregular and infrequent menstrual bleeding. However, there are also cases of the disease that do not menstruate at all or whose menstrual bleeding is completely normal. These patients have more eggs than normal in their ovaries, and these eggs disrupt the normal development process of the eggs by increasing the secretion of the male hormone called testosterone.

What are the reasons that create the risk of female infertility?

Myoma occurring in the woman's uterus, ovaries or tubes; Infection or tissue disorders pose a risk of infertility. Previous surgical operations may also prevent fertilization by causing some structural disorders . Methods such as chemotherapy or radiation therapy used in cancer treatment cause negative effects on reproductive organs and pose a risk for infertility.

The use of antibiotics is another issue that women who want to become pregnant should pay attention to. Antibiotics can make it difficult to get pregnant if used in high doses and for a long time.

In addition to these reasons, it is important for the person to organize their daily life and determine a lifestyle that will support pregnancy. Because smoking, being overweight or underweight, and consuming excessive amounts of alcohol pose the risk of infertility. Being exposed to sexually transmitted infections that have harmful effects on the reproductive system, such as gonorrhea and chlamydia, is a more serious risk factor.

Finally, advanced age is a risk factor in pregnancy as it reduces egg quality and the efficiency of the endometrium for fetal development and many other pregnancy process disruptions may occur.

What are the symptoms of infertility in women?

Menstrual bleeding is the situation where we can observe a woman's reproductive health at a very high rate and to reach an accurate result. In other words, a woman can obtain an idea about her reproductive health by observing the frequency, amount, and whether it is painful or painless of menstrual bleeding, without consulting a physician. Since irregular, infrequent or delayed menstrual bleeding may be a sign of infertility, it should be examined by a doctor as soon as possible and treated if necessary.

What are Female Infertility Tests?

A female patient with infertility When a patient consults a physician with a complaint, a verbal anamnesis is taken , such as the patient's history, the regularity of menstrual bleeding and sexual intercourse . The patient's reproductive system is observed with ultrasonography. Answers are sought to questions such as the patient's estimation, whether there is a disorder in the shape of the ovaries, and what the status of the ovarian reserve is. Hysterosalpingography , one of the types of ultrasound It is based on the principle of injecting a colored liquid into the uterus and observing the progress of the liquid through the tubes. In this way, information is obtained about possible blockages in the tubes. Hysteroscopy method is the examination of the uterus without any surgical procedure by taking an imaging device called a hysteroscope into the uterus, that is, a uterine film. Myomas, polyps or unexpected bleeding in the patient can be diagnosed this way. saline Infusion With the sonography method, saline is injected into the vagina to investigate pathologies such as the vagina, the internal cavities of the uterus , myomas and lesions. Hormones, which are of great importance for pregnancy, are also indispensable in infertility tests. Anti- müllerian hormone, follicle such as stimulating hormone, estrogen, progesterone ; The amount of hormones that ensure healthy ovulation, development of the inner wall of the uterus and fertilization are examined with blood tests.

What are the Causes of Male Infertility?

A problem with the production or excretion of sperm, the male reproductive cell, may be the cause of male infertility . If we examine the effect of sperm, which is the male reproductive organ, on infertility under three headings, these are; sperm concentration , sperm motility and change in sperm shape.

The physiological amount of sperm that should be found naturally in a healthy man is between 15 and 200 million in 1 millimeter of semen. If there are fewer than 15 million sperm in 1 millimeter of ejaculate, it is considered low sperm count. In order for the sperm to fertilize the egg, it must have progressed into the fallopian tube in the female body and encountered the egg. Insufficient sperm motility is one of the causes of infertility. According to the acceptance of the World Health Organization, the lower limit of sperm motility present in a semen sample should be 40%. The movement of only the tail of the sperm or its ability to make circular movements is insufficient for fertilization . Fast and forward moving sperm have the capacity to fertilize the egg . Hormonal disorders can also make it difficult or hinder fertility in men. Erectile dysfunction, which are among the sexual dysfunctions, premature ejaculation or ejaculate called retrograde , which is not expelled but fills the bladder, are important problems that prevent the sperm and egg from uniting. Infections such as mumps, syphilis and gonorrhea can also completely disrupt testicular function and cause infertility. As a result of the testicle rotating around itself, called testicular torsion, the perfusion of the blood vessels feeding this area is prevented and the testicle becomes dysfunctional. In addition to all these reasons, the number of unexplained infertility cases cannot be underestimated.

What are the reasons that create the risk of male infertility?

Environmental factors such as smoking, alcohol consumption, and unhealthy diet pose a risk for infertility. Varicocele, the most common cause of infertility, is the enlargement of the veins leading to the testicle, resulting in blood pooling there and the accumulated blood causing an increase in temperature. Varicocele is not an irreversible event and the risk can be eliminated with appropriate treatment.

Stress, which has serious effects on all functions of the body, can also disrupt a person's reproductive ability.

What are the symptoms of male infertility?

Sexual dysfunctions in men; For example, conditions such as difficulty in ejaculation or impotence, lump, pain and swelling in the testicle area may be signs of infertility. Hormonal disorders or sperm count, structure and motility disorders are also among the symptoms of infertility.

What are Male Infertility Tests?

Infertility testing in male patients is done by semen analysis. Sperm count and quality are investigated. Hormonal levels are checked with hormonal tests.

What are the Imaging Methods for Male Infertility?

scrotal With ultrasound , testicles and testicular supporting structures can be visualized using sound waves. transrectal In the ultrasound method, the prostate and semen-carrying ducts are visualized with a small, lubricated device inserted through the rectum.

Is Infertility Inharited?

There are 46 chromosomes in the cells of the human body. Half of these chromosomes come from the egg cell and half come from the sperm cell, forming the zygote. Disorders related to chromosome number or structure can cause infertility. In addition, in a study conducted by the Vrije University of Brussels, data obtained from 54 male patients born with the microinjection method were examined. In other words, reproductive fertility was observed twice as often in men whose fathers needed supportive treatment to have children, compared to boys born naturally. These studies have not yet been based on definitive facts. For this reason, it is important to evaluate patients in detail and consider the factors required to have children one by one . Because it is a common situation that fathers who have had children through infertility treatment do not observe any factors preventing infertility in their sons.

When Should Infertility Treatment Begin?

If couples cannot conceive within a year despite regular sexual intercourse without using a birth control method, they are recommended to consult a doctor and undergo the appropriate treatment process. However, in cases where time may cause a decrease in egg and sperm quality, such as advanced age, there is no need to wait a year to start treatment. If structures such as cysts are observed in the ovaries, infertility treatment should be started early in case the reproductive organ may be damaged in the future.

Unexplained Infertility 

Unexplained infertility (UI) is the most common infertility diagnosis, accounting for approximately 15-30% of all infertility diagnoses. It is the situation where the cause of infertility cannot be found after all standard tests applied. No abnormality was detected in sperm values in men; It is a situation in which a woman's ovulation and uterine structure are normal and couples who have unprotected interaction with the tubes open cannot achieve pregnancy for a year. Approximately 20% of married couples face unexplained infertility problems. The inability of these couples to achieve pregnancy when their standard evaluations are normal and there is no medical factor that would prevent them from having children is called unexplained infertility , as it cannot be clearly clarified with today's knowledge and technologies .

Couples without any medical disabilities have a 20% chance of natural pregnancy every month. But this occurs in approximately 3-5% of couples with unexplained infertility.

unexplained infertility increases significantly in women aged 35 and over and increases significantly in women aged 38 and over. Because advanced age causes a serious decrease in female reproductive organs and egg quality.

Age on Infertility

The aging can be the reason if infertilitç The effect of age on the likelihood of infertility in women occurs much faster than in men. Because egg quality in women deteriorates faster than sperm quality in men. However, as men get older, the likelihood of problems increases.

Stress on Infertility

For couples who want to have children, prolonging this process causes them to experience stress. Men often tend to trivialize the problem by denying it or reflecting on the problem on other issues. Women, on the other hand, unintentionally expose themselves to much greater stress by keeping track of their cycle days every month , choosing the right timing for intercourse, tracking ovulation , and monitoring whether their menstrual cycles are normal or different. This causes couples' quality of life to decrease and paves the way for situations that increase stress.

unexplained infertility are insemination treatment and in vitro fertilization treatment.

Infertility Treatment Ankara

Dr. Aslı Yücetürk continues her infertility treatment studies meticulously. If you are searching for a gynecologist for infertility treatment, Dr. Aslı Yücetürk is with you with years of experience...

Gynecology and Obstetrics Specialist Aslı Yücetürk provides services in her own practice in Mahall Ankara , in areas of expertise such as birth , pregnancy follow-up , abortion , vaginismus and infertility. For information and to make an appointment, you can call 0552 328 9989.