Age
Female fertility begins to decrease significantly over the age of 35. As seen in the picture below, the decrease in fertility becomes noticeable in women all over the world after the age of 35. It is clearly seen that this decrease is much greater over the age of 40. We are trying to increase this pregnancy rate slightly by using assisted reproductive techniques (such as insemination and in vitro fertilization). It is currently impossible to stop this decrease in fertility.
Every month, a woman loses an average of 1000 eggs. It is not possible to replace them. For this reason, it is best to get detailed information from an infertility specialist and plan if you want to have a baby before reaching the advanced age of a woman.
Hormonal problems (Ovulation problems)
A woman who menstruates regularly releases an egg every month.
A woman's regular menstruation can be compared to an orchestra. In order for the orchestra to play pleasant music, it needs a good conductor (pituitary gland in the brain) and musicians (many hormones in the ovary). If you do not have regular hormone increases and decreases, ovulation will not occur. If ovulation does not occur, even if your partner's sperm values are normal and your sexual intercourse is regular, pregnancy cannot occur because there is no egg to fertilize. The most common cause of ovulation disorders due to hormones in women is polycystic ovary syndrome (PCOS). Polycystic ovary syndrome occurs with different frequencies in different societies. Its incidence in America is between 5% and 10%. We, as the Hacettepe Polycystic Ovarian Study Group, conducted the first and only study on this subject in our country. In our study with a budget of approximately 100 thousand dollars, PCOS was seen in around 15-20% of Turkish women.
Another hormonal disorder is that the pituitary gland, which is the conductor of the orchestra, does not work due to diseases, and these girls usually do not have their first menstrual period. They can menstruate with medication.
The third hormonal disorder is early menopause, which means that the woman's ovaries are depleted. Another hormonal situation is high milk hormone. When the milk hormone level is high, milk-like fluid may spontaneously come out of the nipples. High milk hormone levels prevent pregnancy. Disruption of a woman's thyroid hormones may cause difficulty in getting pregnant.
Congenital uterine deformities
The uterus is like a pear in size and shape. The place where the baby attaches and develops is the part where the seeds of the pear are located. This region is a place of vital importance for the formation and continuation of pregnancy.
In congenital uterine injuries, the structure of the uterus is damaged. A double uterus can be observed, a single-sided small uterus can be observed, and there may be a curtain inside the uterus. All of these conditions may prevent pregnancy from occurring, or they may prevent the continuation of the existing pregnancy. In other words, they may cause miscarriage.
Uterine problems that develop later
Situations that disrupt the shape and structure of the uterus may prevent pregnancy. They can cause miscarriage. In particular, myomas, polyps that put pressure on or inside the uterus, adhesions to the uterus due to previous abortions, and intrauterine adhesions due to tuberculosis can prevent pregnancy. During the examination of a couple who have difficulties in getting pregnant, the uterus and especially the inside of the uterus are evaluated with USG examination. In doubtful cases, treatment-oriented procedures are planned. Myomas that put pressure on the uterus or fibroids inside the uterus must be removed. feel for it roscopy method is the most appropriate form of treatment. Again, in the cases mentioned above, hysteroscopy is the most appropriate treatment method. Intrauterine adhesions are cut with hysteroscopic scissors. Polyps can be cut from the root with scissors. The most troublesome of these pathologies are intrauterine adhesions. Adhesions in the uterus usually develop after an abortion. If the abortion is performed for an empty sac, if the baby dies in the uterus and an abortion is necessary, the incidence of intrauterine adhesion can reach up to 30%. Although post-abortion adhesion is less common the more experienced the doctor is, intrauterine adhesion may occur even in the best hands. For this reason, before having an abortion, you should discuss the possibility of intrauterine adhesions with your doctor. The most common indicator of intrauterine adhesions after abortion is a decrease in the amount and duration of menstrual periods after the procedure or no menstruation at all. Adhesions will probably reoccur after hysteroscopic removal of intrauterine adhesions. Therefore, repeated hysteroscopic interventions may be required.
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