Infertility is the situation where couples are not successful in achieving pregnancy for at least a year even though they use regular intercourse methods. Considering female infertility, male infertility, or a combination of the two, an estimated 10 to 18 percent of couples have difficulty getting pregnant or having a successful birth.
As much as one-third of infertility is due to female factors and one-third to male factors. The other third part; The cause is unknown and a combination of male and female factors. Causes of female infertility can be difficult to diagnose. There are many treatments that will depend on the cause of infertility.
Symptoms
The most important symptom of infertility is not getting pregnant. Having periods that are too long (35 days or more), too short (less than 21 days), or an irregular or missing menstrual cycle may mean that you are not ovulating. There may be no other outwardly obvious signs or symptoms.
When to See a Doctor?
When to get help sometimes depends on your age:
•Up to age 35, most doctors recommend trying to get pregnant for at least one year before testing or treatment.
•If you are between 35 and 40, six months Discuss your concerns with your doctor after one trial.
•If you are older than 40, your doctor may want to start testing or treatment right away.
Your doctor is your doctor. or if your partner has fertility problems, irregular or painful menstrual periods, pelvic inflammatory disease, repeated miscarriages, or a history of precancerous or endometriosis, he or she may want to start testing or treatment immediately.
Causes
Each of these factors is essential to getting pregnant:
•Ovulation required. To become pregnant, your ovaries must produce and release an egg, known as ovulation. Your doctor can help evaluate your menstrual cycle and confirm ovulation.
•Your partner's sperm must be healthy and sufficient. Your doctor may perform some simple tests to evaluate the health of your partner's sperm.
•Make sure you have regular intercourse. You need stubble. You need to have regular sexual intercourse during your fertile times. Your doctor can help you better understand when you are most productive. It is best to have intercourse every other day on the bleeding-free days between two periods.
•The fallopian tubes should be open and the uterus should be normal. Eggs and sperm collect in the fallopian tubes, and the embryo needs a healthy uterus in which to grow.
For pregnancy to occur, every step of the human reproductive process must occur correctly. Steps in this process:
•One of the two ovaries releases a mature egg.
•The egg is collected through the fallopian tube.
•To reach the egg for fertilization, the sperm swims through the cervix, through the uterus and into the fallopian tube and fertilizes the egg in the ampulla region of the tube.
•The fertilized egg moves from the fallopian tube to the uterus.
•The fertilized egg implants (settles) and grows in the uterus.
In women , a number of factors can disrupt this process at any stage. Female infertility is caused by one or more of the following factors.
Ovulation Disorders
Ovulation disorders mean that you ovulate infrequently or not at all. One in four infertile couples has an ovulation disorder. Problems with the regulation of reproductive hormones by the hypothalamus or pituitary gland, or problems in the ovaries, can cause ovulation disorders.
We can list these as follows;
Polycystic Ovary Syndrome (PCOS): PCOS causes a hormone imbalance that affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. This condition is the most common cause of female infertility.
Hypothalamic Dysfunction: FSH and LH, two hormones produced by the pituitary gland, are responsible for stimulating ovulation every month. Excessive physical or emotional stress, very high or very low body weight, or recent significant weight gain or loss can disrupt the production of these hormones and interfere with ovulation. It may affect . Irregular or missing menstrual periods are the most common signs.
Premature Ovarian Failure: Also called primary ovarian failure, this condition is usually caused by an autoimmune response or premature ovarian failure (possibly caused by genetics or chemotherapy). causes loss. The ovary no longer produces eggs and reduces estrogen production in women under 40.
Too Much Prolactin: The pituitary gland may cause excess prolactin production (hyperprolactinemia), which reduces estrogen production and can cause infertility. Often related to a pituitary gland problem, this may also be caused by medications you are taking for another disease.
Damage to the Fallopian Tubes (Tubal Infertility): Damaged or blocked fallopian tubes prevent sperm from reaching the egg. or prevents the fertilized egg from passing to the uterus.
Causes of fallopian tube damage or blockage may include:
• Pelvic inflammatory disease, Infection of the uterus and fallopian tubes due to chlamydia, gonorrhea, or other sexually transmitted infections or previous surgery in the pelvis
•Pelvic tuberculosis is rare in developed countries. However, it is one of the main causes of tubal infertility worldwide.
Endometriosis
Endometriosis is the settling and growth of the endometrium, which normally forms the uterine lining, into other tissues and organs. This extra tissue growth – and its surgical removal – can cause scarring, which can block the fallopian tubes and prevent an egg and sperm from uniting.
Endometriosis can also disrupt the lining of the uterus, affecting the implantation of a fertilized egg. . This condition also appears to affect fertility in less direct ways, such as damage to sperm or eggs.
Causes Originating in the Uterus or Cervix
Some uterine or cervical causes fertility by interfering with implantation or increasing the chance of miscarriage It may affect:
•Benign polyps or tumors (fibroids or fibroids) in the uterus are common. Some can block the fallopian tubes or interfere with implantation, affecting fertility. However, many women with fibroids or polyps do become pregnant.
•Scarring or inflammation in the uterus from endometriosis can prevent implantation.
•Uterine anomalies, such as a congenital abnormally shaped uterus, can cause problems getting pregnant or loosening.
•Narrowing of the cervix may result from an inherited malformation or damage to the cervix.
•Sometimes the cervix cannot produce the best type of mucus to allow sperm from the cervix to enter the uterus.
Unexplained Infertility
Sometimes the cause of infertility is is never found. A combination of several small factors in both partners can cause unexplained fertility problems. While it can be frustrating not getting a specific answer, this problem can improve with time. However, you should not delay treatment for infertility.
Risk Factors
Some factors may put you at higher risk of infertility, including:
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•Age: The quality and quantity of a woman's eggs begin to decline as she gets older. In the mid-30s, follicle loss slows down, resulting in lower-quality eggs. This makes it harder to get pregnant and increases the risk of miscarriage.
•Smoking: In addition to damaging the cervix and fallopian tubes, smoking also increases the risk of miscarriage and ectopic pregnancy. It is also thought to age the ovaries and consume eggs prematurely. You should quit smoking before starting fertility treatment.
•Weight: Being overweight can affect normal ovulation. Achieving a healthy body mass index can increase the frequency of ovulation and the likelihood of pregnancy.
•Past Sexual Diseases: Sexually transmitted infections such as chlamydia and gonorrhea can damage the fallopian tubes. Having unprotected sex with multiple partners, sexually transmitted infection It increases the risk of causing fertility problems later.
•Alcohol: Do not consume more than one alcoholic drink per day.
Prevention
If you are a woman considering getting pregnant soon or in the future, you can increase your chances of normal fertility if:
•Have a normal weight: Overweight and underweight women do not ovulate are at high risk for disorders. If you need to lose weight, exercise moderately. Vigorous, intense exercise lasting more than five hours per week has been associated with decreased ovulation.
•Quit smoking: In addition to its detrimental effects on your overall health and the health of the fetus, tobacco has many negative effects on fertility. If you smoke and are considering pregnancy, quit immediately.
•Stay away from alcohol: Heavy alcohol use can cause a decrease in fertility. And any alcohol use can affect the health of a developing fetus. If you are planning to get pregnant, stay away from alcohol and do not drink alcohol while pregnant.
•Reduce stress: Some studies have shown that couples experiencing psychological stress have worse outcomes with infertility treatment. If you can, find a way to reduce stress in your life before trying to get pregnant.
•Limit caffeine: Research shows that reducing caffeine intake to less than 200 milligrams per day should not affect your ability to conceive. This is about one or two coffees a day.
Diagnosis
If you have not managed to get pregnant within a reasonable period of time, seek help from your doctor for evaluation and treatment of infertility.
Fertility tests may include:
•A Detailed Gynecological Exam
•Transvaginal Ultrasonography
• Hormone Analysis: Pituitary, ovarian, adrenal and thyroid hormones are checked to understand whether a woman is ovulating.
• Hysterosalpingography: During hysterosalpingography, X-ray contrast material is injected into your uterus
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