The inability to have a child despite wanting a child and having regular sexual intercourse for a year is called infertility. The rate of encountering infertility problems in society is around 15%. Even though couples without any problems have regular intercourse, monthly pregnancy rates vary between 12-25%.
In general, the causes of infertility are 30-40% related to the woman, 30-40% related to the man, and 20-30%. They are grouped as unexplained reasons.
Factors effective in having a child;
- Normal functioning of the ovaries in women and the absence of pathology in the ovaries,
- Female age,
- The man can produce healthy sperm,
- There is no abnormality in the uterus that would prevent pregnancy,
- At least one of the uterine canals is open,
- Normal sexual life and frequency of intercourse,
CAUSES OF INFERTILITY IN WOMEN
The most important reasons that lead to infertility in women; Menstrual irregularity and ovulation disorders, endometriosis, polycystic ovary disease, early menopause, closed tubes and congenital structural anomalies in female organs. There is also infertility of unknown cause, that is, unexplained.
It is the most common cause of infertility in women, and it is understood that ovulation is absent or irregular and infrequent. Under normal conditions, every month one of the immature eggs in the ovaries develops, grows and hatches, and ovulation occurs. One of the most important causes of menstrual irregularity and infertility is the absence of ovulation. Ovulation disorders are examined in 4 main groups:
- In the first group, there is a deficiency of hormones that stimulate the ovaries.
- In the second group, there is a deficiency of hormones that stimulate the ovaries.
- In the second group, there are people with polycystic ovary syndrome. patients are included. In addition to amenorrhea and infrequent menstruation, skin changes characterized by excess androgen hormones in women (increased hair growth, oily skin, acne) are observed.
- The third group includes early menopause patients. All kinds of egg stimulating drugs and protocols are unsuccessful in this group. However, some of these patients (10%) may experience a return of ovarian functions in the first 5 years.
- In the fourth group, There is an excess of the milk-forming hormone called rolactin. Ovulation does not occur in the excess of prolactin hormone. Ovulation function can return with prolactin-lowering treatment.
2. If the tubes are blocked;
In case the tubes are completely or partially blocked, sperm and egg Pregnancy cannot be achieved by preventing fertilization in the tube. It constitutes 30% of the causes of infertility in women. Adhesion in the tubes; It may be due to previous infection, endometriosis (chocolate cysts) or intra-abdominal adhesions due to previous surgery. In developed countries, sexually transmitted diseases are the most important cause of damage to the tubes.
3. Intrauterine adhesions and masses;
Reasons such as previous curettage, infections, and myoma surgery may lead to adhesions. Intrauterine masses are myomas and polyps. It is very important to be able to visualize the inside of the uterus before in vitro fertilization. For this reason, hysterosalpigography (uterine film) and hysteroscopy (imaging the inside of the uterus with a camera) procedures are performed. With hysteroscopy, intrauterine adhesions can be opened, polyps (benign mass that causes bleeding) and myomas can be treated.
4.Cervical factor;
Infertility in women Cervical problems that cause deformities, infections, poor mucus (uterine secretion) quality, and cervical polyps (benign mass that causes bleeding). In different stages of menstruation, cervical secretion changes in quantity and consistency under the influence of hormones. Lack of proper quality of this secretion prevents the sperm from progressing in the female reproductive tract.
5. Endometriosis;
Endometrosis; It is defined as the development of the tissue lining the uterus outside the uterus. These foci, located outside their normal location, cause adhesions or disruption of ovulation over time. 70% of patients with endometriosis suffer from infertility problems. Endometriosis, just like the tissues lining the uterus, is sensitive to hormones and bleeds during menstruation. These bleedings in the abdomen cause adhesions over time. Laparoscopy is a method used in the diagnosis of this disease and allows imaging of the inside of the abdomen. It is also used for therapeutic purposes. When endometriosis settles in the ovaries, it is called chocolate cyst. These cysts, which cause serious ovulation problems, must be treated.
6. Causes related to the immune system:
A number of antibodies that the body produces itself, which kills sperm on the way to the uterus. These substances can also be found on the surface of substances or sperm. These can be detected in the mucus structure obtained from the woman or on the surface of the sperm.
7. Unexplained infertility:
Infertility, the cause of which cannot be revealed with the medical possibilities today, is called unexplained infertility. It constitutes 1/3 of the reasons for couples who cannot have children. No reason can be found in these couples.
8. Female age:
As the woman ages, the frequency of ovulation and egg quality decrease. Pregnancy success decreases, especially in women over the age of 35. Over the age of 40, the pregnancy rate drops below 10%.
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