What are the causes of female infertility?


Female fertility begins to decline significantly over the age of 35. As can be seen in the picture below, a decrease in fertility is noticeable in women all over the world after the age of 35. It is clearly seen that this decrease is much higher after the age of 40. We are trying to slightly increase this pregnancy rate by using assisted reproductive techniques (such as vaccination and in vitro fertilization). It is currently impossible to stop this decline in fertility.

Every month, a woman loses an average of 1000 eggs. It is not possible to replace them. For this reason, if it is best to have a baby before reaching the advanced age of women, detailed information should be obtained from an infertility specialist and planning should be done.

Hormonalproblems (Ovulation problems)

A woman who has a regular period will throw an egg each month.

How does a woman menstruate? Click to watch.

A woman’s regular menstruation can be compared to an orchestra. The orchestra needs a good conductor (pituitary gland in the brain) and musicians (many hormones in the ovary) to play good-sounding music. If you do not have regular hormone increases and decreases, ovulation will not occur. If there is no ovulation, even if your partner’s sperm values ​​are normal, even if your sexual intercourse is regular, pregnancy cannot occur because there is no egg to be fertilized. Polycystic ovary syndrome (PCOS) is the most common cause of hormonal dysfunction in women. Polycystic ovary syndrome is seen with different frequencies in societies. Its incidence in America is between 5% and 10%. As Hacettepe Polycystic Ovary Study Group, we carried out the first and only study on this subject in our country. In our study with a budget of approximately 100 thousand dollars, we found that PCOS is seen in 15-20% of Turkish women.

Click here for detailed information about polycystic ovarian disease.

Another hormonal disorder is that the pituitary gland, which is the conductor of the orchestra, does not work due to the diseases, and the first menstruation is not usually seen in these girls. They can be menstruated with medication.
The third hormonal disorder is early menopause, in which the woman’s ovaries are depleted. Another hormonal situation is the high level of milk hormone. At the height of the milk hormone, milk-like fluid may come from the nipples spontaneously. High levels of milk hormone prevent pregnancy. A woman’s thyroid hormones are also impaired, which can cause difficulty in conceiving.

Congenitaluterine injuries

The uterus is like a pear in size and shape. The place where the baby sticks and develops is the part of the pear where the seeds are. This region is a vital place for the formation and continuation of pregnancy.

In congenital uterine injuries, the uterine structure is impaired. Double uterus can be observed, one-sided small uterus can be observed, there may be a curtain inside the uterus. All these conditions can prevent pregnancy from occurring, as well as prevent the continuation of the already established pregnancy. In other words, they can cause miscarriage.

The picture below shows a curtain inside the uterus.

The image below shows a unilateral uterus.

Laterdeveloping uterine problems

Conditions that disrupt the shape and structure of the uterus can prevent pregnancy. They can cause miscarriages. In particular, myomas, polyps, adhesions to the uterus due to previous abortions, and intrauterine adhesions due to tuberculosis may prevent pregnancy.
In the examination of the couple who have difficulties in conceiving, the uterus and especially the inside of the uterus is evaluated by USG examination. In doubtful cases, treatment is planned. Fibroids that press into the uterus or fibroids in the uterus must be removed. Hysteroscopy method is the most appropriate treatment for this. Again, in the above-mentioned cases, 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 is intrauterine adhesions. Adhesions in the uterus usually develop after the abortion procedure. If the abortion procedure was done for an empty sac, if the baby died in the uterus and abortion was required, intrauterine adhesions can be up to 30% in these cases. Intrauterine adhesions can occur even in the best hands, even if the adhesion after abortion is minimal, as the doctor is experienced. For this reason, before having an abortion, you should definitely discuss with your doctor about the development of intrauterine adhesions. The most common indicator of intrauterine adhesions after abortion is a decrease in the amount and duration of menstruation after the procedure or no menstruation. After the hysteroscopic opening of the intrauterine adhesions, adhesions will probably form again. Therefore, repeated hysteroscopic interventions may be required.

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