Infertility, which is defined as infertility in medicine, can be defined as the inability of the couple to have children naturally despite their wishes. If healthy couples have regular and unprotected sexual intercourse, the monthly pregnancy rate is approximately 25%. At the end of 1 year, this rate rises to 85%, and at the end of the second year, it rises to around 90%.
What is Infertility?
In order to be able to talk about infertility by definition, the couple must have regular and unprotected sexual intercourse for one year and be unable to conceive. The waiting period required to be able to talk about infertility in couples aged 35 and over is 6 months. Infertility, which is seen at a rate of approximately 15% all over the world, may develop depending on the woman and / or man. In other words, 1/3 of infertility problems are caused by men, 1/3 by women and 1/3 by both couples.
Therefore, if pregnancy cannot be achieved despite being sexually active for one year and not using any birth control method, it is recommended that couples consult a physician together. "What is infertility?" It is necessary to answer the question. According to the World Health Organization (WHO, WHO) criteria, infertility is defined as the absence of pregnancy despite regular and unprotected sexual intercourse for one year.
This reproductive problem, which is seen equally in men and women, can be seen in both couples without any health problems. However, advancing age is among the most common causes of infertility. Therefore, it is recommended that couples who want to have a child after the age of 35 should consult a doctor if they cannot have a baby despite having sexual intercourse for 6 months.
Informing the couples who are planning to have children about sexuality can increase their chances of conceiving both naturally and with assisted reproductive treatment techniques. Therefore, infertility should be evaluated separately for male and female genders.
What is Female Infertility?
In order for a woman to become pregnant, the brain, endocrine and reproductive systems must be healthy and compatible. It should work in harmony with First of all, the hypothalamus and pituitary glands, which are endocrine glands in the brain, need to function properly.
In order for pregnancy to occur, the hypothalamus is only 0.5 gr. Stimulates the pituitary gland with weight. As a result, the pituitary gland secretes LH (Luteinizing hormone) and FSH (Follicle stimulating hormone) hormones. The ovaries are stimulated by the hormones that reach the ovaries through the blood circulation.
Thus, some of the small sacs (follicles) in which the eggs are contained enter the maturation process. The maturation process, which starts on the 6th day after the first menstrual bleeding, lasts until the 14th day. The most mature and healthy of the 3 to 30 mature eggs hatch at the end of this period.
It is released into the fallopian tubes, which is a channel between the uterus and ovaries. Also known as the ovulation period, this period coincides with the middle of the menstrual cycle, which occurs on average every 28 days. After the egg is released into the fallopian tubes, the follicle from which the egg comes out secretes estrogen against the possibility of pregnancy and the endometrium, known as the intrauterine wall, thickens. The egg that needs to be fertilized in the fallopian tubes can remain alive in the female body for about 24 hours.
Sperm, which is a male reproductive cell, can stay alive in the female body for 4 or 5 days. Therefore, fertilization can occur with sexual intercourse in a few days before ovulation or on the day of ovulation. A single cell that occurs with fertilization multiplies rapidly by dividing. In this period, the so-called zygote descends from the fallopian tubes and attaches to the uterus and forms the embryo after the 3rd week. Thus, pregnancy is achieved.
What are the Causes of Female Infertility?
Some of the causes of female infertility can be listed as follows:
- Thyroid hormone disorders,
- Hyperprolactinemia,
- Ovulation (ovulation) irregularities,
- Endometriosis (chocolate cyst),
- Polycystic ovary syndrome (PCOS),
- Attachments in the uterus (Asherman syndrome),
- Pathologies in the uterus such as endometrial ossification,
- Fallopian tubes to be closed,
- Low egg reserve (Amh),
- Traumas of reproductive organs,
- Advanced age,
- Early menopause.
What is Male Infertility?
Sperm production is very important in the male reproductive system. Sperm production and maturation takes approximately 74 days. The semen that is thrown out of the body during ejaculation is produced by different glands in the testicles. There should be more than 15 million sperm cells in each milliliter of semen. It should be suitable for reproduction in terms of criteria such as sperm count, shape and mobility. The semen contains lubricating organic substances that increase the motility and fertilization ability of the sperm.
Sperms in the semen content released into the vagina during ejaculation, with the help of the secretions in the vagina, move their tails first to the uterus and then to the fallopian tubes where fertilization takes place. If an egg, a female reproductive cell, is found in the fallopian tubes, the egg is fertilized. In the absence of an egg, the sperm stay alive here for 4-5 days. If the egg reaches the fallopian tubes during this period, fertilization occurs.
What are the Causes of Male Infertility?
Some of the causes of male infertility can be listed as follows:
- Congenital occlusion of sperm ducts
- Presence of varicocele,
- Problems with sperm morphology (deformities),
- Sperm count is low
- Poor sperm quality,
- No sperm in the semen,
- Exposure to chemical substances,
- To be in extremely hot environments for a long time,
- Sitting to work,
- Consumption of alcohol and cigarettes.
What are the Factors that Trigger Infertility?
Many health problems in men or women can lead to infertility. In addition to these, there are many factors that can lead to infertility. Some of the factors that trigger infertility are:
How to Diagnose Infertility
A full systemic examination is required for the diagnosis of infertility. sow. In this process, the physician questions and examines the person in detail. It is recommended that couples consult a physician together for the diagnosis of infertility. Thus, the history of the couple can be taken accurately. The diagnosis of infertility requires different tests in men and women. For men, a physical examination is performed first. The penis and testicles are examined. The presence of varicocele is investigated. It is checked whether there is growth in the breasts (gynecomastia). Body hair is examined for hormonal reasons.
After the examination, the person is asked to abstain for 3 to 5 days. After this period, the person is given a spermiogram or sperm test as it is known among the people. Thus, the reproductive ability of the sperm cells in the semen is examined. According to the results of the analysis, the person is diagnosed with infertility. In women, first of all, gynecological examination is performed. The menstrual order is questioned. Ultrasonography examines the ovaries and uterus of the person. Additional laboratory and radiological imaging tests are performed. In the light of the data obtained, the problem of the female reproductive system is determined and infertility is diagnosed.
What are Infertility Treatment Methods?
Infertility can occur for many different reasons. Infertility treatment is also done after the focus causing infertility is determined. In some cases, IVF treatment, which is one of the double reproductive assisted treatment methods, is recommended. In this treatment method, fertilization is achieved by bringing the male reproductive cell sperm and the female reproductive cell egg together in a laboratory environment. The resulting embryo is left in the uterus of the expectant mother and pregnancy is ensured. Some of the methods frequently used in the treatment of infertility are:
- In vitro fertilization treatment,
- Egg rejuvenation (PRP),
- Immunization (IUI),
- Microinjection,
- Egg freezing,
- Embryo trimming,
- Assisted budding (Assisted hatching),
- Mitochondria transfer.
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