Infertility, that is, the inability to have a child even if desired, is an important problem in many societies.
By definition, pregnancy can occur despite sexual intercourse 2-3 times a week without using any contraceptive method for at least 1 year. Failure to achieve this is called infertility. The incidence of infertility does not vary greatly between societies. Approximately fifteen percent of couples worldwide have to resort to assisted reproductive techniques due to infertility. While there may be reasons to explain why most of these couples cannot conceive, no pathology can be detected in approximately 10-12 percent of them. These couples are called unexplained infertility.
In order to understand the causes of infertility and plan its treatment, it is necessary to first understand how the reproductive cycle works in men and women and the mechanism of pregnancy.
“When are you planning to have children? ?” is the question that many newlywed couples encounter most often. In fact, this question is one of the first questions that newlywed couples ask themselves. There are many young couples who dream of getting pregnant on their honeymoon, especially in couples with traditional family structures where the woman does not work. Children are important for the family's livelihood and business, and in rural areas, there are a significant number of women and men who marry just to have children. In societies like ours, where having children is seen as a privilege and prestige, infertility is almost of vital importance. Another group consists of individuals who have not had time to get married due to the difficulties of working life, but who are considering getting married and having children as soon as possible because they are getting older. The common mistake of all these individuals is that they think they can get pregnant whenever they want, perhaps even on their honeymoon. While in many movies and novels the hero can get pregnant with a single relationship or whenever he wants, this is not the case in real life. When we consider a completely normal couple with no health problems, the probability of the woman getting pregnant in a single menstrual period is only 25%, even if they have intercourse every day. This situation, which shows the fertility potential of the couple, is called "fecundity". human, organism It is not a creature with a very high reproductive potential. There are many reasons for this. Some eggs are not fertilized, and even if some are fertilized, they cannot develop during the embryo period. Pregnancy is, in a sense, a matter of luck. It is possible to roughly compare this to Russian roulette. It is impossible to predict which couple will be able to conceive and which will not! The chance of getting pregnant, which is 25% in a single intercourse, increases to 85% at the end of one year. In other words, at the end of one year, pregnancy will be achieved in 85 out of every 100 couples. The remaining 15 couples are facing infertility. According to some authors, if pregnancy does not occur at the end of the first year, it is not correct to call the couple infertile. For this, it is necessary to wait 2 years. Indeed, the pregnancy rate, which is 85% at the end of the first year, is found to be around 92% at the end of the second year.
The chance of becoming pregnant in a single menstrual cycle is under the influence of many factors. If we examine these factors:
Age of the woman: As the biological clock progresses, the woman's chance of getting pregnant gradually decreases. The most important reason for this is that the number and quality of eggs in the ovaries decrease with age. While the difference between the chances of pregnancy between a 20-year-old woman and a 21-year-old woman is not very large, this difference becomes more significant in the 30s.
Frequency of sexual intercourse: Normal or abnormal in terms of frequency of sexual intercourse It is not right to make a classification like this. What is important is not the number or small number of relationships, but their adequacy. The optimum number for this is 3 intercourses per week.
Timing: In addition to the frequency of sexual intercourse, the timing of intercourse is also important. Intercourse on the days of ovulation will increase the possibility of pregnancy.
Duration:How long the couple has wanted a child is an important point. The longer the time passes for couples trying to conceive, the less likely they are to achieve a successful pregnancy without medical help.
Pathology: The presence of a pathology that may cause infertility also reduces the chance of pregnancy. . The best examples of these are previous surgeries or endometriosis.
If a couple has a fertility problem, how does this affect the pregnancy? Conception is under the influence of many factors. ir. For example, in a couple consisting of a man and a normal woman whose sperm count is half of what it should be, the chance of pregnancy is halved. This is not the case for every factor that affects pregnancy. For example, if both tubes are blocked in a woman, the chance of pregnancy is almost non-existent. Similarly, it would be a great surprise if men who do not produce sperm in their testicles or whose channels that carry sperm from the testicle to the outside world do not function, can have children naturally. From this perspective, both men and women in couples who apply to a doctor with the desire to have children should be examined in detail. When both couples have problems, the chance of pregnancy decreases not by their sum but by their multiplication. If the human lifespan could be increased to 300-400 years and if the woman could produce eggs and the man could produce sperm during this period, almost all cases of unexplained infertility could become pregnant. This is a phenomenon that clearly demonstrates the importance of time in infertility. The possibility of pregnancy should be increased, and this is only possible with medical treatment.
When to worry, when to see a doctor?
If you have not been ovulating for more than a year. If you have regular sexual intercourse every 2-3 days on the same days and cannot get pregnant even though you do not use any contraceptive method, you are in the infertile class. This does not mean that you can never get pregnant naturally, but statistically speaking, the chances are reduced. You now need medical help. There is no specific time for this help. When you start worrying about not having a baby, you should see a gynecologist. Many couples see infertility as something to be afraid of or even ashamed of, and they feel alone. However, the situation is not that bad. Many couples all over the world experience the same problem, and a significant number of them can become pregnant with very simple treatments. What restricts couples here lies in the fact that although infertility is always an important problem, it is not urgent. Generally, people postpone going to the doctor by hiding it behind any excuse and always say next month. However, everything in life can be compensated for except time.
Some situations It is not necessary to wait 1 year before consulting a doctor.
Very frequent or infrequent menstruation
History of previous pelvic infection
More than 2 miscarriages
Advanced age in women
Small testicles in men
History of prostate infection.
To get professional help or advice without delay, if any. It would be wise to take the initiative.
Before consulting a doctor, keep in mind that you can increase your reproductive potential with some simple measures. One of the most important measures is to maintain the balance between body weight, diet and exercise. Proper diet and exercise are extremely important for optimal reproductive function. Women who are underweight or overweight may have difficulties conceiving. Most of the female hormone estrogen is produced in the ovaries. However, fat tissue is also a source of estrogen that cannot be underestimated. Fertilization is a complex event involving delicate hormonal balances. A stable hormonal state is required for this event to be successful. Therefore, it is not surprising that being under or overweight can cause infertility. Body weight that is 10-15% below or above normal can radically affect the reproductive system. The best example of this is irregular menstrual bleeding in extremely thin people with malnutrition. These irregular bleedings usually occur together with anovulation, that is, the absence of ovulation. Many women who engage in heavy sports such as marathon runners and swimmers have menstrual irregularities and therefore infertility problems.
Another factor that affects fertility is smoking and alcohol. While smoking reduces sperm count in men, it also impairs egg quality in women. Similarly, alcohol is a substance that has been found to play a negative role on sperm count.
Drugs used for various diseases also affect fertility. It is known that especially ulcer and blood pressure medications are effective on sperm counts. Reducing caffeine intake increases the chance of conception.
The frequency of sexual intercourse is one of the most important factors that directly affects reproductive ability. The more frequent intercourse, the higher the chance of pregnancy. becomes extremely high. What is meant here is not a relationship that is entered into every day. This reduces sperm count and quality. The ideal is to have intercourse every other day in the days close to ovulation. Nowadays, a common complaint of most couples is that both men and women are in working life, and decreased sexual motivation and desire due to occupational stress and anxiety. For these reasons, intercourse occurs mostly on weekends. Naturally, it will be delayed for these couples to achieve pregnancy and the couple will most likely have to consult a physician due to infertility.
In addition to the frequency of intercourse, its timing is also extremely important. Almost all living things, except humans, know the ovulation period. During this period, called estrus or estrus period, their sexual desire increases and they mate. In fact, this feature of cats is the subject of many jokes. However, the situation is different in humans. There is no obvious estrous period in women, and many women cannot notice their ovulation period. A woman's menstrual cycle is determined by various methods and the ovulation period can be determined. For this reason, intercourse every other day is recommended during the period called the fertile period, when the probability of becoming pregnant is high.
The final point regarding the connection between sexual intercourse and fertility is to have appropriate intercourse. There are many different animal species in nature, and each of them has developed different mechanisms to continue its lineage. For example, pigs are very stingy with sperm. The male's penis is spiral-shaped and virtually screws into the female's vagina. In this way, not even a single sperm is wasted. Such mechanisms do not exist in humans. In reality, there is no need for such techniques. It is extremely normal for semen to leak out of the vagina after intercourse. Although many women interpret this as a negative factor in terms of pregnancy chances, this is not the truth. The ejaculation of semen is an indication that intercourse has been carried out properly. Positions in which the man is on top are generally recommended for couples who want children. Other recommendations include that the woman lie on her back for at least 5 minutes after intercourse and avoid vaginal showering. Artificial substances used to provide lubrication during intercourse are not recommended as they may have a fatal effect on sperm. It is very much needed
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