What is infertility?
Infertility, also known as infertility, is defined as the failure of a woman to become pregnant or the failure to conceive another pregnancy even if a pregnancy has been achieved before. Approximately 25% of women experience infertility at some point in their lives. At the same time, the most productive age for every woman in terms of fertility is around the age of 25. In general, after the age of 35, the fertility function in women decreases significantly.
The average chance of a married couple getting pregnant in a 3-month period is around 57%. At the same time, these rates increase to 72% in a 6-month period. However, this rate is around 85% after 1 year, and this rate drops significantly after 2 years.
What are the causes of infertility in women?
Irregularities in ovulation
Blocked tubes
Antisperm antibodies
Endometriosis
Pathologies found in the uterus
Thyroid hormone disorders (goiter, hypothyroidism, hyperthyroidism)
Past infections related to genital organs
Previous surgeries related to the uterus and ovaries
High milk hormone levels
Decreased ovarian capacity associated with advanced age
Causes related to the cervix, cervical factor
Although 10% to 15% of couples have infertility, this condition cannot be attributed to any cause. This is called unexplained infertility.
What other factors are associated with infertility?
Smoking
Being overweight
The cervix is closed
Not having regular sexual intercourse
Vaginismus
Adhesion formation inside the uterus
Luteal phase insufficiency
Receiving chemotherapy and radiotherapy treatment
Entering menopause early
Allergic causes: If allergic causes are found, it can cause infertility. However, this condition is difficult to detect and treat. The possibility of treating these allergic conditions, known as antisperm antibodies, may vary depending on the level of the condition.
Damaged and blocked tubes: If some or all of the tubes are blocked, it prevents the sperm and egg from uniting. In this case, fertilization and pregnancy cannot occur. This damage to the tubes can occur due to many reasons, such as a previous infection, endometriosis, or intra-abdominal adhesions left after a previous surgery. The tubes can also be damaged as a result of an ectopic pregnancy.
In developed countries, sexually transmitted infections are one of the most important causes of damage to the tubes. In Turkey, tuberculosis microbes acquired during childhood can also cause irreversible damage to the tubes.
Ovulation disorders: The most common cause of infertility in women is disorders that occur in ovulation. Without ovulation, fertilization and pregnancy cannot be achieved. Ovulation disorder is the absence of ovulation, irregularity or infrequency. Infrequent or absent cycle periods usually indicate the presence of a disorder in ovulation. However, ovulation disorders are also encountered in cases where menstruation is completely regular.
Ovulation disorders are examined in 3 groups. These are;
– Inability to secrete hormones that stimulate egg production in the ovaries from the brain stem due to a congenital deficiency: In this case, the woman does not experience any menstrual bleeding from puberty onwards.
– Higher than normal secretion of the milk hormone prolactin from the brain stem (pituitary gland): This usually indicates that there is a benign tumor in this area. Benign tumors can be removed with surgical intervention.
– Polycystic ovary syndrome: In the typical form of this disease, menstruation is generally irregular and infrequent. This infrequency does not occur once every few months, but 2 or 3 times a year. While some patients do not menstruate at all, others may have completely normal periods. Patients tend to be more obese. Problems such as oily skin and hair, acne are very common. There are more eggs than normal in the ovaries, and these prevent normal egg development by secreting male hormones.
Endometriosis: Endometriosis is the condition in which the tissue surrounding the inside of the uterus (endometrium) continues to develop outside the uterus. Endometriosis mostly settles on the ligaments that hold the uterus in place. Another area where it is most commonly encountered is the surface of the uterus, the tubes and the ovaries.
The most important symptoms of endometriosis include pain before and during menstruation, pain during or after intercourse, irregular bleeding, and infertility. Other symptoms that are less common than these are fatigue, increased bowel movements during menstruation, diarrhea, and constipation, as well as other symptoms related to the digestive system. Apart from these, endometriosis can progress without any symptoms in some women. Almost half of women with endometriosis need treatment in order to have children. Similarly, endometriosis is detected in approximately 25% of women who apply to centers for infertility.
Having problems with the cervix: Disorders related to the secretions in the uterine region caused by infection can be the cause of infertility. The mucus secreted from the cervix makes it easier for sperm to be transported through the genital tract. The amount and quality of mucus, which is under the influence of estrogen and progesterone hormones, changes during the menstrual period. Benign tumors such as polyps or surgical interventions applied to this area can cause infertility.
How long do infertility treatments take?
For infertility treatments, a treatment protocol must be continued for at least 6 months. The most important thing that couples who will undergo infertility treatment should know is to always be patient. Male fertility is at its highest until the age of 35. It decreases after the age of 45, but men who can become fathers even in their 80s are also seen. For this reason, although the opposite is true for women, the age of the man does not have much importance.
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