What is infertility?
Infertility is the inability of pregnancy to occur despite the adequate number of regular sexual intercourse, without sterility for 1 year.
Infertility is seen in 10-15% of married couples. We can divide infertility into two: primary and secondary infertility. The primary infertile is those who have never had children, but those who have been able to remain pregnant but can not become pregnant now are called infertile.
Fecundity: It is possible to get pregnancy in one period ie menstrual cycle, which is 20-25% in normal couples
Fekundite: The possibility of obtaining live birth within one period.
When all couples are considered, it is impossible for them to become pregnant during the first menstrual period, and a certain period of time must elapse before pregnancy can occur. At the end of 3 months of pregnancy, only 57% of pregnancies occur. At 6 months, 72% of pregnancies occur. At 1 year, 85% of pregnancies occur. At the end of 2 years, 93% of pregnancies occur.
Approximately 30-40% of infertile couples are male and 40-50% are female. Some pairs have problems in both. 10-15% of couples can not be found in neither women nor men. Infertility is an unexplained condition that can not be found. Therefore, infertile couples must be investigated together, it is not enough to investigate only the woman or only the man. Even if there is a problem in one of the couples, there may be a problem in the other.
As the age progresses, the chances of becoming pregnant diminish. Progression of age also reduces the success of IVF. There is also a higher chance of abortion during pregnancy in advanced age.
Reasons for infertility in women:
- ovulation (ovulation) disorders 40%
- Causes attributable to adhesions in the scar and the skin 40%
- Endometriosis 5-15%
- Unexplained (unexplained) infertility 5-15%
- Other causes 5% (eg Endometrial ossification)
Reasons for infertility in men:
- Unexplained group 30%
- Varicocele 15%
- Endocrine hypogonadism 9%
- Subclinical infections 8%
- Undescended testis 8%
- Erectile (curing) problem and hypospadias 6%
- Immunological reasons 5%
- Systemic diseases% 3
- Obstructive pathologies 2%
- Other reasons 13%
After questioning about the causes leading to infertility, examination and ultrasonography (USG) are performed to evaluate not only the reproductive organs but also the whole body. Other examination methods such as hysterosalpingography (HSG), laparoscopy and hysteroscopy can be used in addition to hormonal tests.
For male evaluation, other sperm tests (skein analysis) are very important from the history and examination findings. Sperm analysis is done after 3 days of sexual abstinence. If the sperm analysis is abnormal, it should be repeated after 1 month.
How long do couples need to see a doctor if pregnancy does not occur?
Couples under the age of 35 have tried unprotected regular relationship for 12 months, but they still have to see a doctor if pregnancy does not occur. This time is 6 months for couples over 35 years old.
An unexpected investigation can be initiated for one year in the following cases:
Woman
- Female age> 35
- If they have Amenore (irregularity) or irregularities
- If there is a history of pelvic infection or endometriosis
- If there is a previous history of abdominal or pelvic surgery
- If there are abnormal exam findings
Male
- If there is a history of previous urogenital surgery
- If there is a history of a sexually transmitted disease
- If there are abnormal exam findings
Treatment:
Treatment depends on the condition leading to infertility. Drug, hormone or surgical (surgical) treatment may be required depending on the cause. Assistive reproductive techniques such as insemination (vaccination) or IVF can be applied.
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