'Why do so many couples have infertility problems?', 'Was it easier to have children in the past?' are some of the most common questions we encounter today. While infertility treatments are becoming more successful thanks to technological developments, unfortunately the number of couples needing treatment is increasing day by day. The main reason for this increase is the postponement of marriage and childbearing ages due to changing living conditions. As it is known, pregnancy rates decrease dramatically as women age, rather than men. Because with age, the number and quality of eggs, which have a very complex structure and are one of the largest cells in the body, decrease. What is meant by the concept of quality; It is the fertilization potential of the egg and the capacity of the fertilized egg to progress into healthy embryos (the most basic cell or group of cells that form the baby). Pregnancy rates begin to decrease when a woman's age exceeds thirty-five, and the chance of pregnancy drops considerably at forty and beyond. Of course, reproductive potential varies from woman to woman. What determines this potential is the genetic inheritance he inherits from his family and environmental factors such as nutrition and toxins he is exposed to (cigarettes, alcohol, drugs, etc.). For example, it is known that the age of menopause is reduced approximately 3 years earlier due to smoking exposure. Although male age does not cause a problem at this rate, we know that sperm disorders in men are much more evident than fifty years ago. So, if age is not the issue for men, why does this sharp decrease in sperm count and quality occur? Here too, environmental factors come to the fore. Due to the greater number of male cells and the fact that they are easier to obtain, except in exceptional cases, male-related infertility problems can be solved more easily in most cases with the technologies we have. In cases where there is no sperm in the semen, sperm can be obtained from the testicles by surgical methods. Again, quality embryos can be obtained even in couples with a very small number of sperm cells in the semen. These two patient groups are among the patient groups that are impossible to have children spontaneously, and they can experience this happiness with in vitro fertilization technologies. Nowadays, sperm selection is done carefully under a microscope and sperm are microchiped, which removes cells with damaged genes. With the use of sperm, high pregnancy rates are also achieved in families with a milder male factor. With a microchip, sperm are sorted under a microscope before being selected by embryologists, and higher quality sperm that manage to pass through the chip can be used for fertilization.
The most common problems in women are ovulation problems, blocked tubes, acquired or congenital anatomical disorders in the uterus, ovarian reserve. are problems. While it is possible to find solutions to most of these problems with in vitro fertilization treatments, older women with exhausted ovarian reserves are the most challenging cases for us. Nowadays, we can offer new treatment options to patients in this problematic group.
So when should couples who have difficulty having children consult a reproductive medicine specialist? Our main area of interest is couples who cannot conceive despite trying for a year. If women have had previous ovarian surgery, known tube diseases, a history of cancer treatment, or women over the age of 35, they should apply earlier, that is, after 6 months. We do not consider in vitro fertilization or advanced treatments necessary for every couple.
Polycystic ovary syndrome is relatively common in our society. Many of these patients experience weight problems and have ovulation problems. While those whose ovulation problems are not obvious can become pregnant, other patients are treated either with ovulation monitoring and treatments that enable ovulation (some of which are supported by inseminations) or with in vitro fertilization. It is generally possible to get answers in these patient groups.
Endometriosis is another problem we frequently encounter in women who apply to us. The special cell layer that lines the inside of the uterus is outside the uterus (such as ovaries, tubes, the space behind the uterus, urinary tract and intestines). This presents with cysts and masses in abnormal locations. What happens in the ovaries can disrupt ovarian functions in the long term. These patients are included in the clinic in a wide range of cases, from very mild forms to severe endometrisis. In severe cases, it is possible to get a response with in vitro fertilization treatments. In mild forms, simpler treatments or just follow-up can be applied.
The most important message we can give to our patients is reproductive health. They should not hesitate and should not delay in obtaining consultancy services regarding their health from the institution closest to them.
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