What is Infertility? Reasons ?

Regular and unprotected for one year after marriage

If pregnancy is not achieved despite intercourse, infertility is mentioned.

can be done. Because in this period, 85% of couples achieve pregnancy.

is done. In other words, about the number of couples of reproductive age in the society.

15% face this problem. However, female age

In the group with over 40, this rate rises to 25%.

What are the causes of infertility in men and women?

The cause of infertility is about 50% women and 50% men.

To reveal the cause of male infertility;

Urological examination is performed with spermiogram, testosterone, FSH and Prolactin measurement in the blood.

Spermiogram – A normal semen is 2-5 ml, with at least 20 million sperm per milliliter

and more than 50% of them are mobile. May contain very few white blood cells. if

If sperm values ​​are below normal, then hormone analyzes are also performed. urological

In the examination, the condition of the testicles and whether there is a varicocele are checked. Varicocele blood to testicles

This causes the blood vessels to dilate and slow the blood flow. This is in the testis

temperature increases and sperm quality and motility are adversely affected.

Evaluation of the woman

Cervix – This is the opening between the inside of the uterus (endometrium) and the vagina. clear from here

A sticky liquid, such as egg white, is secreted, and at the time of ovulation, the sperm are easily

allows it to reach the endometrium. Other times it thickens and forms a plug. if

If the consistency of this liquid is not thinned at the time of ovulation, it is very difficult for the sperm to reach the egg.

it gets harder.

Tubes – Located on either side of the uterus and carry eggs ready for fertilization into the uterus.

A medicated film called an HSG (Hysterosalpingogram) to see if these are clear

must pull. This process is done within a few days after the end of menstruation.

A drug that can be seen on X-ray film is given through a cannula inserted and the film is taken.

Normally, the uterus looks like a white triangle with white lines on both sides.

shows the tubes. Failure to see the tubes or dissemination of the drug into the abdominal cavity

It may indicate that it is clogged. Any filling defect in the uterus, an adhesion there

or may suggest a space-occupying lesion.

Peritoneal factor – Sometimes based on the HSG or USG result, your doctor

He or she may want to do a laparoscopy to see if there is adhesions or endometriosis.

Again, the best time for this is a few days after the end of menstruation. Procedure anesthesia

done under. A trocar inserted into the abdomen through a 1 cm incision in the navel.

with a telescope, the uterus, tubes, ovaries, intestines, liver, stomach, appendix are observed.

In addition, with the help of instruments passed through the half-cm auxiliary trocars inserted through the groin.

Other surgical procedures can be performed. It also comes from a cannula inserted into the uterus.

It can also be checked that the tubes are not open by giving dye. Intrauterine cavity with hysteroscopy

by observing with the help of a camera, it is understood whether there is a pathology here as well.

treated at the same time.

Evaluation of the ovaries – There are two and are located on either side of the uterus. Inside

They contain eggs and play an important role in hormonal function. Eggs are called FSH.

and grows under the influence of a hormone released from a gland in the brain called the pituitary gland.

It secretes another hormone called estradiol. It matures around the 14th day of menstruation.

becomes ready for fertilization. LH, on the other hand, cracks the egg that is ready to be fertilized.

allows it to be thrown into the cavity. If there is a sperm in the environment at that time, the egg is fertilized. in woman

FSH, LH and progesterone hormone levels in the blood to determine if ovulation occurs

measurable. In addition, it is possible to understand with a biopsy made from the uterus.

Causes of female infertility

Fibroids – These are benign tumors that originate from the muscles of the uterine wall. single or more

they may be numerous. Its size can reach from the size of a pea to the size of an orange.

sometimes it can be even bigger. They usually grow outside the uterine wall, but

There are also those that grow in the wall or into the uterus. They are quite common tumors and

The incidence is very high in women aged 45 years. growing into the uterus

Fibroids can cause miscarriage, premature birth or infertility. Fibroids during pregnancy

they can grow. Before in vitro fertilization, especially fibroids growing inwards should be removed.

Endometriosis – It is the condition that the tissue covering the inside of the uterus is also outside the uterus.

By sticking to the ovaries or other organs in the abdomen, it is filled with blood during each menstrual period.

dollar. Because this blood is trapped in the tissue, first vesicles and then cysts form. In advanced stages

scar tissue and adhesions occur. This can cause chronic groin pain.

Endometriosis is one of the leading causes of infertility and infertility of reproductive age.

It is seen in about 40% of women with the problem. What mechanism causes infertility?

Although it is not known exactly today, it was caused by the damage it caused in the tubes.

of the sperm-egg relationship with obstructions or some substances secreted by the tissue.

Failure of fertilization and fertilization are among the possible mechanisms. This

Patients can be treated medically or surgically. Medical treatment – ​​false pregnancy or

By creating false menopause, the patient’s ovulation function is stopped and menstruation is stopped.

is not visible. Thus, the activation of endometriosis foci is prevented. This treatment

takes about 6 months. However, it may recur when the drugs are discontinued. This treatment is more

It is applied to patients who do not want. Surgical treatment is usually given to patients who wish to have children.

It is performed under anesthesia by a method called laparoscopy. Here, 1 cm made at the navel level

A telescope with a camera behind is inserted into the abdomen through a one-inch incision and all organs are removed.

pathologies detected by observation, 2 pieces of 5 mm wide instruments inserted through the groin

through treatment. The aim is to destroy the endometriosis foci by burning or cutting.

and opening of adhesions, if any.

Ovarian cysts – are fluid-filled sacs. It is quite common, the majority of cases are well

are benign and under the age of 35. In the presence of these cysts, ovulation may stop or the cyst may enter the tubes.

The mechanical effect caused by the pressure it makes prevents the egg and sperm from uniting, leading to infertility.

can open. Cysts that have reached a certain size can be examined under ultrasound guidance or laparoscopically.

It can be drained and the cyst content removed for cytopathological examination and the cyst wall for histopathological examination.

leaves for review. Some cysts tend to recur and after evacuation if IVF

birth control pills can be used until this time.

Polycystic Ovary Syndrome – These patients suffer from menstrual irregularity, hair growth, obesity and infertility.

They can come with their complaints. In addition, acne on the face is a sign of increased male hormone in the blood.

could be an indicator. Sometimes when the adrenal gland and thyroid gland are not working well and

It can also be seen in patients with insulin resistance. Diagnosis of menstrual irregularity, blood tests and

ultrasonography is helpful. The patient takes longer to ovulate than other women.

becomes pregnant in time.

Intra-abdominal Adhesions – Between the internal reproductive organs or between these organs and the intestines

band-shaped tissues. These are usually a previous surgery.

(appendicitis, ovarian cyst, etc.), post-infection (chlamydia, gonorrhea) or endometriosis

due to their development. Adhesions cause kinks in the tubes, causing the egg and sperm to enter the tube.

they prevent it from moving in. They are usually treated surgically, if unsuccessful

in vitro fertilization is started.

Decreased Ovarian reserves – Ovarian reserves normally begin to decline after age 35

and at 48, the average age of menopause in our country, functions have come to a standstill.

comes and the woman enters menopause. Sometimes this happens in women in their 20s and 30s.

begins to form. Especially those who have had previous ovarian surgery (cyst or

due to endometriosis) are at risk. Decreased ovarian reserves mean

means fewer eggs. In this case, the FSH level rises in the blood, two

The period between the two first shortens and then lengthens and the amount of menstruation decreases. In the blood taken on the 3rd day of menstruation

You can get an idea by measuring the level of FSH and estradiol hormones.

Ovarian reserve is measured by measuring the ovarian volume and the amount of follicles in the ultrasonography.

assessable. Such patients should be taken to IVF treatment without waiting too long.

Premature ovarian failure – It is in case of entering menopause before the age of 40.

Although the cause is generally unknown, chromosomal disorders, immune system

diseases and thyroid diseases can cause. This is also revealed by blood tests.

removable. If there is no egg left in the patient, IVF treatment cannot be applied.

Conditions That Cause Infertility and Can Be Treated

 Ovulation disorder

 Unexplained infertility

 Recurrent pregnancy loss

 Fibroids

 Endometriosis

 Ovarian cysts

 Polycystic Ovary Syndrome

 Intra-abdominal masses or adhesions

 Cervical mucus problems

 Immune system problems

 Tubal diseases

 Men-related reasons

 Cases resistant to clomiphene

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