infertility; It is defined as the inability to become pregnant within 1 year despite regular sexual intercourse without using any birth control method. About 15% of married couples face this problem. Infertility can be of male or female origin. Men-related causes are 30-40%, women-related causes 40-50%, and both causes 20%. However, no cause can be found in 10-15% of couples. This last group is called ‘unexplained infertility’.
In young couples who want a child, at the end of 1 year, the couples are evaluated and the necessary examinations are started. However, if the age of the woman is more than 35, if there is a previous disease, operation, etc. related to the uterus, tubes and ovaries, and if the man has had problems with the reproductive organs, the examinations should be started without waiting for 1 year.
TREATMENT OF INFERTILITY IS PERSONAL.
When many couples apply to our clinic for treatment, they act hastily to start treatment. Impatience and environmental pressure play an important role in the long-awaited baby not coming. Instead of starting treatment immediately; It is best to start after the necessary tests are completed by evaluating all the factors that may negatively affect the process. Saying “let’s do these tests too” in the middle of the treatment or after a failed result is the biggest injustice done to the couple. Most of the time, listening to and understanding the couple, who comes before us with great stress, knowing the processes they have gone through, evaluating the examinations, is the best start. Infertility treatment is a personalized treatment. Not everyone can be given the same treatment. If there are negative trials before, it is necessary to learn from them. The research should be started with the simplest examinations that will cause the least harm to the couple and will give the least tiring. The first and most important step in the research is to meet with the couple at the same time, give enough time and get information about what has been done until that time. Previous health problems of the couple, diseases, health problems in the family, whether there was a previous pregnancy, the treatments received, menstrual irregularities are very important in the diagnosis. In the light of this information, the woman is taken to a gynecological examination and evaluated by ultrasonography. While evaluating the vagina, cervix, uterus and ovaries, the tubes (ducts) cannot be evaluated. Since having a baby is an issue that concerns both men and women, a sperm test should be done to investigate whether there is a problem in the man. The sperm sample is examined by the embryologist and a blood sample is taken from the woman in the morning on an empty stomach for hormonal evaluation at the beginning of the menstrual period. HSG (canal/uterus film) is taken to evaluate the canals near the end of menstruation. This movie gives information about the internal structure and channels of the uterus. It is likened to a severe menstrual cramp by patients. We recommend that patients with low pain threshold have this film taken under anesthesia. Those who want to have the film taken with anesthesia should not eat or drink anything, including water, 6 hours before. These tests are the basic tests in infertility. Further testing may be required in patients with recurrent pregnancy loss and reduced ovarian capacity. These tests are in order;
Genetic examination tests from mother and father candidates
blood coagulation tests
immune system tests
Investigation of systemic diseases in the mother
Examination of organs through a camera called laparoscopy / hysteroscopy, if necessary
The treatment decision should be made according to the cause determined as a result of all these tests. It should not be forgotten that in vitro fertilization is not the only solution for all couples who want a baby. The problem can be solved by itself by detecting the problem without the need for IVF. Results can also be obtained by methods such as vaccination and egg tracking. Infertility treatment is personalized. Evaluating and understanding the patient well and a personalized approach are essential for a positive outcome.