WHAT IS INFERTILITY?
Not being able to have a child despite wanting a child and having regular sexual intercourse for a year is called infertility. The rate of encountering infertility problems in society is around 15%. Even though couples without any problems have regular intercourse, monthly pregnancy rates vary between 12-25%. In general, the causes of infertility are grouped as 30-40% due to women, 30-40% due to men, and 20-30% as unexplained reasons.
Factors effective in having children;
- Normal functioning of the ovaries in the woman and the absence of pathology in the ovaries,
- Woman's age,
- The man's ability to produce healthy sperm,
- It will prevent pregnancy from occurring in the uterus. Absence of any abnormality,
- At least one of the uterine canals is open,
- Normal sexual life and intercourse frequency..
INFERTILITY IN FEMALE REASONS
The most important reasons that cause infertility in women are; Menstrual irregularity and ovulation disorders, endometriosis, polycystic ovary disease, early menopause, closed tubes and congenital structural anomalies in female organs. There is also infertility of unknown cause, that is, unexplained.
1. Ovulation disorder;
It is the most common cause of infertility in women and is understood as the absence of ovulation or irregular and infrequent ovulation. Under normal conditions, every month one of the immature eggs in the ovaries develops, grows and hatches, and ovulation occurs. One of the most important causes of menstrual irregularity and infertility is the absence of ovulation. Ovulation disorders are examined in 4 main groups:
• In the first group, there is a deficiency of hormones that stimulate the ovaries.
• In the second group, patients with polycystic ovary syndrome. takes place. In addition to amenorrhea and infrequent menstruation, skin changes characterized by excess androgen hormones in women (increased hair growth, oily skin, acne) are observed.
• The third group includes early menopause patients. All kinds of egg stimulating drugs and protocols are unsuccessful in this group. However, in some of these patients (10%), ovarian cancer occurs in the first 5 years. There may be a return of breast functions.
• In the fourth group, there is an excess of the milk-forming hormone called prolactin. Ovulation does not occur in the excess of prolactin hormone. Ovulation function can return with prolactin-lowering treatment.
2. If the tubes are blocked;
In case the tubes are completely or partially blocked, fertilization of sperm and egg in the tube is prevented. cannot get pregnant. It constitutes 30% of the causes of infertility in women. Adhesion in the tubes; It may be due to previous infection, endometriosis (chocolate cysts) or intra-abdominal adhesions due to previous surgery. In developed countries, sexually transmitted diseases are the most important cause of damage to the tubes.
3. Intrauterine adhesions and masses;
Causes such as previous curettage, infections, and myoma surgery may lead to adhesions. Intrauterine masses are myomas and polyps. It is very important to be able to visualize the inside of the uterus before in vitro fertilization. For this reason, hysterosalpigography (uterine film) and hysteroscopy (imaging the inside of the uterus with a camera) procedures are performed. With hysteroscopy, intrauterine adhesions can be opened, polyps (benign mass that causes bleeding) and myomas can be treated.
4.Cervical factor;
Infertility in women. Cervical problems that cause deformities, infections, poor mucus (uterine secretion) quality, and cervical polyps (benign mass that causes bleeding). In different stages of menstruation, cervical secretion changes in quantity and consistency under the influence of hormones. Lack of proper quality of this secretion prevents the sperm from progressing in the female reproductive tract.
5. Endometriosis;
Endometrosis; It is defined as the development of the tissue lining the uterus outside the uterus. These foci, located outside their normal location, cause adhesions or disruption of ovulation over time. 70% of patients with endometriosis suffer from infertility problems. Endometriosis, like the tissues lining the uterus, is sensitive to hormones and bleeds during menstruation. These bleedings in the abdomen cause adhesions over time. Laparoscopy for this disease It is a method used in the diagnosis of cancer and allows visualization of the inside of the abdomen. It is also used for treatment purposes. When endometriosis settles in the ovaries, it is called chocolate cyst. These cysts, which cause serious ovulation problems, must be treated.
6. Causes related to the immune system:
A number of antibodies that the body produces itself, which kills sperm in the uterus. These substances can also be found on the surface of substances or sperm. These can be detected in the mucus structure obtained from the woman or on the surface of the sperm.
7. Unexplained infertility:
Infertility whose cause cannot be revealed with today's medical possibilities is called unexplained infertility. It constitutes 1/3 of the reasons for couples who cannot have children. No reason can be found in these couples.
8. Female age:
As a woman ages, the frequency of ovulation and egg quality decrease. Pregnancy success decreases, especially in women over the age of 35. Over the age of 40, the pregnancy rate drops below 10%.
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