INFERTILITY TREATMENTS
Treatment of infertility may vary depending on the cause, how long you have been infertile, the age of the couple and many other personal characteristics. Some causes of infertility cannot be corrected. However, it is still possible to get pregnant with assisted reproductive techniques.
Treatment for Couples
These approaches may concern men, women or both.
Increasing the number of sexual intercourses. Having intercourse 2 or 3 times a week can increase fertility. However, ejaculating too much can also reduce the quality of a man's sperm. Sperm can live in the woman's reproductive system for up to 72 hours, and the egg can be fertilized for up to 24 hours after ovulation.
Treatment for Men
- General Sexual Problems: Diagnosis of impotence or premature ejaculation increases fertility. Treatment of these can generally be with medication or behavioral approaches.
- Absence of Sperm: If the absence of sperm is suspected, surgery, hormones or assisted reproductive techniques are used to correct the problem. For example, varicocele condition is usually corrected by surgery. If there is an obstruction that prevents ejaculation or if there is reflux, sperm is removed from the testicles during the operation and injected directly into the egg in a laboratory environment using the microinjection method.
Treatment for Women
Fertility drugs are the most commonly used treatment method for infertile women with ovulation problems. These medications regulate or stimulate ovulation. In general, they work similarly to natural hormones such asFSH, LH. Commonly used fertility drugs are as follows:
- Clomiphene Citrate: This medication is taken orally and stimulates ovulation in women with polycystic ovary syndrome or other ovulation problems. They stimulate the pituitary gland to secrete FSH and LH.
- Human menopausal gonadotropin (hMG): This drug is a defect of the pituitary gland. It is given as an injection to women who cannot ovulate spontaneously as a result. Unlike Clomiphene, which stimulates the pituitary gland, hMG and other gonadotropins directly stimulate the ovaries. This was medicine a both FSH and LH are present.
- Follicle Stimulating Hormone or FSH : FSHstimulates the ovaries to mature the ovarian follicles.
- Human Chorionic Gonadotropin, (HCG): Used together with clomiphene, hMG, FSH; It stimulates the ovary to release the egg.
- Gonadotropin-releasing hormone (Gn-RH) analogues: This treatment is used for women with irregular ovulation function or who ovulate before the main follicle is mature enough during hMG treatment. is for. Gn-RH analogues continuously send Gn-RHto the pituitary gland.
- Aromatase Inhibitors : Letrozole (Femara) This class of drugs, such as and Anastrozole (Arimidex), is approved for the treatment of breast cancer. Doctors can sometimes prescribe Letrozole to women who cannot ovulate spontaneously and who do not respond to Clomiphene Citrate treatment.
- Metformin (Glucophage): This medication is used to support ovulation. It is used when insulin resistance is a known or suspected cause of infertility. Insulin resistance may also play a role in polycystic ovary syndrome.
- Bromocriptine (Parlodel): It is used for women whose ovulation cycle is irregular due to high prolactin level. Bromocriptine restricts prolactin production.
Operation
Depending on the situation, infertility can be treated with surgery. Blockages and other problems in the tubes can usually be treated with surgery. It is possible to perform delicate operations on the tubes with laparoscopic techniques.
Treatment of infertility caused by endometriosis is generally difficult. Although it is not used in the treatment of infertility, it is effective in treating and relieving pain thanks to the hormones in birth control pills. If you have endometriosis, your doctor may treat you with ovulation therapy, in which medications regulate or stimulate ovulation, or with in vitro fertilization, in which the egg and sperm meet in a laboratory environment and are fertilized, and then the resulting embryo is injected into the mother's uterus.
Assist. Reproductive Techniques
Assisted reproductive techniques infertility It is a revolutionary method in treatment. In our country, thousands of families have babies using this method every year. As a result of medical developments, many couples have their own biological children. The assisted reproduction team is a professional team consisting of doctors, psychologists, embryologists, laboratories, nurses and health professionals.
The most commonly used forms of assisted reproductive techniques are:
- In VitroFertilization (Tube) Baby Treatment): It is the most effective assisted reproductive technique. The woman's eggs are collected, combined with the sperm taken from the man in the laboratory environment, and the fertilized eggs, that is, the embryos, are placed in the uterus within 3 - 5 days after fertilization. In vitro fertilization is recommended when both of the woman's tubes are blocked. It is also used in many conditions such as endometriosis, unexplained infertility, cervical infertility, male infertility and ovulation disorders. With in vitro fertilization treatment, the chance of multiple pregnancy increases because usually more than one embryo is transferred to the expectant mother. In addition, blood values and hormone values are frequently checked in this treatment.
- Electro or Vibrating Stimulation to Achieve Ejaculation: This method is used to obtain sperm. This treatment is applied to men who have a spinal cord injury and cannot otherwise produce sperm.
- Obtaining Sperm by Operation: This technique is based on the principle of obtaining sperm from the testicles by operation. It can be used when the sperm duct is blocked.
- Microinjection (ICSI) : It is based on the principle of injecting a sperm into the resulting egg, as in normal in vitro fertilization treatment. Microinjection can be applied to couples who cannot achieve pregnancy with other methods. Microinjection is a factor that increases success in men with low sperm count.
- Assisted Hatching: This technique helps the embryo attach to the uterus. It can be applied in cases of repeated failures.
Assisted reproductive techniques are best used when the woman has a healthy uterus, responds positively to fertility drugs, and ovulates naturally. For men, their sperm must be healthy. The success rate gradually decreases in patients after the age of 35.
ComplicationsSome complications may develop during treatment;
- Multiple Pregnancy: This is the most common complication. It is up to the couple to decide how many healthy embryos they will keep and deliver. If many babies are pregnant, removing 1 or 2 of them increases the chances of survival of the others.
- Ovarian Hyperstimulation Syndrome (OHSS): If the woman's eggs are overstimulated, they grow too much and cause pain. They may be. Mild to moderate symptoms usually go away without treatment, but pregnancy may delay recovery. Rarely, fluid can accumulate in the abdomen and chest cavity, causing abdominal swelling and shortness of breath. Severe cases need urgent treatment. Young women and women with polycystic ovary syndrome are more likely to have OHSS than other women.
- Bleeding or Infection: As with every invasive procedure, there is a risk of bleeding and infection in assisted reproductive techniques. >
- Low Weight Birth: The biggest trigger for this is multiple pregnancy.
- Birth Defects: Some concerns about the relationship between assisted reproductive techniques and birth defects. available. However, more research is needed to confirm this.
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