Infertility is defined as the absence of pregnancy within one year despite regular unprotected intercourse. It is thought to occur in approximately 10-15% of the population. Contrary to the popular belief that the cause of infertility is women, this problem can also be caused by men.
Infertility is the absence of pregnancy even though the couples want a child within a year and do not use contraception. About 15% of couples in Turkey and around the world have infertility problems. Pregnancy occurs with a combination of many factors. The monthly pregnancy rate of the couple without any problem is 20-25%, this rate reaches 85% at the end of one year and exceeds 90% at the end of 2 years. For the formation of pregnancy; A healthy egg released from the ovary must combine with the male’s healthy sperm, which is the sperm. Normally, this event occurs in the woman’s ovary (fallopian canal) and is called fertilization. The fallopian canals must be open and healthy for the egg and sperm to meet and for the fertilized egg to reach the uterus. For this reason, if pregnancy does not occur after 1 year, it is beneficial to consult a doctor.
There are various causes of infertility, depending on the woman and the man. In addition to these two groups, in 20-25% of couples, the cause of infertility belongs to both women and men. Ovulation problem and low sperm count, inflammation in the tubes and sperm structure disorder and similar conditions can be seen in couples together. Apart from all these situations, there is no reason to explain the reason for infertility in approximately 10-15% of infertile couples. When men and women are investigated in this group of patients, it is seen that no problem that may prevent pregnancy can be detected.
Ovulation disorders are the most common cause of infertility in women, and when ovulation disorder is said, it is understood that ovulation is absent or irregular and infrequent. Infrequent or absent menses often indicate an ovulation disorder, but ovulation disorders can also be encountered in cases where menstruation is completely regular.
Partially or completely blocked tubes prevent the sperm and egg from meeting, making fertilization and pregnancy impossible. This damage to the tubes may be due to many reasons such as previous infection, endometriosis or intra-abdominal adhesions after a previous surgery. In developed countries, sexually transmitted infections are the most important cause of damage to the tubes. Tuberculosis microbe acquired in childhood in our country can also cause irreversible damage to the tubes.
Endometriosis is defined as the development of the tissue lining the uterus outside the uterus. Endometriosis, like the tissue lining the uterus, is sensitive to hormones and bleeds during menstruation. These micro hemorrhages in the abdomen cause inflammation of the inflammatory glands over time and cause adhesions. When endometriosis settles in the ovaries, it causes cyst formation. These cysts are called endometriomas. Endometriosis is found in approximately 25% of women who apply for infertility.
Structural, infectious or mucus-related disorders in the cervix may be the cause of infertility. The mucus secreted in the cervix facilitates the transport of sperm through the genital tract. Under the influence of estrogen and progesterone hormones, the amount and quality of mucus changes during the cycle. Benign tumors such as polyps or surgical interventions applied to this area may cause infertility.
Although allergic causes can be the cause of infertility, their diagnosis and treatment are difficult. The necessity of routine measurement of allergic conditions is discussed, since the efficacy of treatment is not clear and pregnancy rates are very different in treated and untreated patients.
In couples who apply with infertility problems, some tests should be done to explain the reason for infertility. The first of these is sperm analysis in men and uterine film in women to evaluate the permeability of the uterus and tubes. In addition, hormone tests to evaluate the hormonal status of the woman and the capacity of her ovaries are performed on the third day of menstruation. Recently, the place of diagnostic laparospin may be controversial, and it can be used in some special cases. Infertility has occurred in families over the age of 35, the cause of infertility should be investigated without waiting for a year and without wasting any time. The waiting period in this group can be 3-5 months. Because in this period, especially since there will be a decrease in the quality of the eggs, examinations should be done and treatment should be started without losing time.