Infertility, that is, infertility, is the absence of pregnancy despite having unprotected intercourse. If pregnancy does not occur despite regular intercourse for the first 12 months after having a child, there may be an infertility problem. In this case, it is necessary to start researches. If there are conditions known to be at risk of infertility in women or men, such as polycystic ovaries, blockage in the tubes, chocolate cyst, endometriosis It is not expected for 12 months, as if the woman is over 35 years old, it is necessary to consult a doctor earlier in the process.
In recent years, infertility, that is, infertility rates, has been increasing. Chemical effects, malnutrition, magnetic environments and drugs are the main causes.
WHAT AFFECTS FERTILITY?
MATHER'S AGE: As age progresses, the number and quality of eggs in women decrease. The most important criterion in female fertility is age. The risk of infertility and diseased babies are higher over the age of 35, and menopausal changes begin around the age of 38 on average.
FATHER'S AGE: Age is also important in men, but the danger is less than in women. After the age of 40, testosterone production decreases in men.
TIME OF SEXUAL COMMUNICATION: As the frequency of intercourse increases, the probability of pregnancy also increases. If the female egg release is calculated from the first day of menstruation, it varies from person to person, between 12-26 days.
WORKING ENVIRONMENT- PROFESSION: Egg and sperm quality may deteriorate in men or women working in a chemical environment. Factories, pharmaceutical laboratories, dyestuffs, environments with high temperatures are examples of these. The chemical effect is more common in men.
NUTRITION: Malnutrition can impair ovulation functions. Excess weight can increase diabetic risk and prevent egg hatching, polycystic ovaries is an example for this.
HABILITIES: Cigarette consumption can cause both male infertility and female infertility. Smoking is the cause of premature aging of the ovaries. In women who smoke, menopause comes earlier can. No increased risk was found between alcohol consumption and infertility.
Excessive caffeine consumption can cause miscarriage. It can trigger problems such as growth retardation and premature birth that endanger the pregnancy.
STRESS: Although there is no scientific evidence, it has been observed that fertility increases in men or women with reduced stress.
FIRST INTERVIEW WITH INFERTIL DOUBLE
Both a man and a woman should be present at the first meeting. First, the frequency of sexual intercourse is asked, usually 2 times a week is sufficient. Women's age is a very important factor, it is necessary to elaborate the studies on women over 35 years old. In women over the age of 40, the definition of infertility is the inability to conceive despite 6 months of unprotected intercourse. In other words, if a woman who got married after the age of 40 does not become pregnant within 6 months, she must consult a doctor.
In the first interview, the above-mentioned risk factors that may affect fertility are questioned.
WHAT ARE INfertility TREATMENTS?
OVULATION INDUCTION (ovulation THERAPY): In infertile couples, ovulation disorder which causes strong> infertility is seen in 20%. Ovulation disorder, that is, the reasons for not hatching eggs regularly every month are very diverse. It is a very broad related problem, starting from the hormone center (pituitary) in the brain, to the ovary, adrenal gland and fat layer in the body. There may be ovarian failure, or there may be a malfunction in the central hormone-secreting mechanism in the brain. Sometimes all these systems work normally, but the patient's excess weight can prevent conception. In early menopause or in advanced ages approaching menopause, it is difficult, sometimes impossible, to respond to medical treatment.
Ovulation therapy, that is, stimulating egg growth, is done with various drugs. Needles are used as well as tablets.
FSH INJECTION DRUGS: These are drugs in needle form used for egg development. Most are done by subcutaneous injection. It starts on the 3rd day of menstruation, injections are made every day, and egg growth is followed by ultrasound control every 3-4 days. p is done. When the egg reaches 16-18 mm in size, the cracking needle is made. After 36 hours, vaccination is done. It is necessary to be more careful in the use of these drugs compared to tablets, because excessive egg growth may occur, the patient may have pain and water collection in the abdomen. Multiple pregnancy is more common with this treatment. Sometimes, in cases where a large number of eggs grow, the treatment can be canceled or converted to in vitro fertilization.
ORAL HYPOGLYCEMIC AGENTS (Blood sugar taken by mouth) lowering agents): In women with polycystic ovary syndrome , there is insulin resistance, in which case a condition similar to diabetes occurs. With this imbalance, excessive amounts of male hormones are secreted from the ovaries and adrenal glands, and there are disruptions in female hormones secreted from the brain. As a result, ovulation functions are impaired, the egg may not develop, or the developing egg may not hatch. It is necessary to regulate blood sugar with metformin in patients with polycystic ovary syndrome. In the case of high blood sugar, along with internal medicine, it may be necessary to conduct a diabetes analysis.
WHAT IS INTRAUTERINE INSEMINATION (VACCINATION)?
It is also used when there is an unexplained situation as the reason for infertility.
The woman is given egg-enhancing medication, and when the eggs reach a diameter of 16-18 mm, a cracking injection is made. 36 hours after the cracking needle, the sperm prepared for inoculation are passed through the cervix with a thin plastic cannula and given into the uterus. It is a painless procedure.
IVF TREATMENT
What is IVF Treatment?
Infertilityi.e. infertility means not being able to get pregnant for one year despite regular sexual intercourse. In vitro fertilization is the last stage in infertility treatments. In this treatment, the eggs collected from the woman are combined with the sperm taken from the man in the laboratory environment, the resulting embryo is placed in the mother's womb.
How is IVF done?
In vitro fertilization treatment both men and women are evaluated together at the first application.
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If the woman has ovulation problem,
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Egg reserve, that is, if the existing egg number is insufficient,
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Endometriosis patients,
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Tubes clogged, if tubing is removed or connected
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Repetitive low and if there are pregnancy losses (in such a case, in vitro fertilization is required for embryo transfer that has been genetically examined and thought to be healthy),
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In case of infertility due to advanced age,
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Unexplained infertility,
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In cases of low motility of male sperm, deformity in sperm or absence of sperm in semen (azoospermia)
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● It is used in congenital uterine disorder, absence of uterus and severe adhesions in the uterus, in patients requiring surrogacy (it is not legal in our country).
Patients who cannot undergo IVF treatment are as follows:
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Unmarried infertile couples,
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menopausal woman or the patient whose egg insufficiency is severe enough to prevent in vitro fertilization,
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Conditions in which no sperm can be obtained in men despite the surgical method (TESE or TESA).
WHAT IS IVF TREATMENT PROCESS? WHEN DOES IT START, HOW MANY DAYS IT TAKES?
The purpose of IVF treatment is to ensure egg development in the mother. Egg enlargement drugs are started on the second or third day of the menstrual cycle at the latest. For follow-up, the patient should come for examination at regular intervals.
During the menstrual period, ovulation hormone and thyroid tests are checked (FSH, LH, TSH, E2). According to the hormone result, the drug dose is determined, the drug is started to grow eggs for 3 days, egg development in ultrasound, s bear and diameter are measured. Frequent examination may be required at 3-4 day intervals during egg follow-up. The diameter at which the eggs should grow is 16-18 mm, when this size is reached, cracking needle is made. The cracking needle is usually applied subcutaneously.
HOW IS EGG COLLECTION DONE IN IVF TREATMENT?
Fracture injection on average 36 hours after eggs are collected. This process is done from the bottom, that is, vaginally. The inside of the eggs, which are seen with the help of ultrasound, are emptied with a thin needle. Rarely, laparoscopic collection from the abdomen may be required.
The eggs are collected 36 hours after the injection. During the egg collection, the patient is put to sleep and does not feel pain. Collected eggs are taken to the laboratory. After fertilization, the growing embryo within 3-5 days is transferred to the mother guess, this process is called embryo transfer. The entire treatment takes an average of 10-15 days.
What are IVF needles?
In vitro fertilization needles are used for egg development and cracking used. In cases where a large number of eggs develop, other injections may be included so that the treatment does not have side effects. Almost all of the IVF needles are applied subcutaneously, usually the belly area is an easy and less painful area. The patient can inject himself, rarely bleeding, bruising at the injection site may occur.
How is IVF placed in the mother's womb?
The maturing embryo reproduces within 3-5 days and enters the womb of the mother will be inserted. Embryo transfer is a painless procedure, it does not require anesthesia. On the day of transfer, the expectant mother is asked to be constricted with urine, so that embryo transfer from the cervix will be easier. The embryos, which are transferred from the cervix to the inner cavity of the uterus with a thin, plastic cannula, are followed by ultrasound and the transfer process is completed.
What should be considered after IVF transfer?
After embryo transfer, the patient can go home. It is recommended to spend the same day resting. There may be minimal bleeding, fear
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