Infertility: causes, diagnosis and treatment

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Infertility is defined as the inability to become pregnant after 12 months of unprotected intercourse. There are a number of tests that can be performed to determine the cause of fertility problems. They usually include a physical examination, semen analysis, blood tests, and special procedures.

The causes of female infertility

The most common causes of female infertility include:

1. Woman’s age: when you turn 35, your chance of conceiving is naturally half that of 20-year-olds. By the age of 41, this chance drops to just 4%.

2. Fallopian tube problems: the most common cause of obstruction of the fallopian tubes is inflammatory disease within the appendages. Other potential causes include:

  1. current or past sexually transmitted disease, in particular chlamydia or gonorrhea;
  2. uterine infection due to miscarriage;
  3. endometriosis or uterine fibroids.

Check if it is easy to diagnose endometriosis

3. Ovulation disorders: may be caused by:

  1. hormonal imbalance;
  2. a tumor or cyst;
  3. eating disorders such as anorexia or bulimia
  4. alcohol or drug abuse,
  5. overweight,
  6. constant stress,
  7. intense exercise that causes significant fat loss,

4. Endometriosis: This occurs when cells that line the womb or the endometrium form outside the womb (such as the pelvis).

5. Polycystic Ovary Syndrome (PCOS): is a common hormonal problem that can affect fertility. It is a combination of polycystic ovaries (diagnosed by ultrasound) with symptoms of hormonal imbalance such as irregular periods, hirsutism, acne or weight gain.

6. Myomas: These are benign tumors of the muscle tissue that form in the uterine wall.

7. Inflammation of the fallopian tubes: caused by a sexually transmitted disease.

Causes of male infertility

The most common causes of male infertility include:

  1. obstruction or lack of vas deferens,
  2. low sperm count and / or poor sperm production
  3. a large number of abnormally shaped sperm,
  4. abnormalities in sperm production,
  5. antibodies against sperm
  6. sperm DNA fragmentation,
  7. genetic diseases such as cystic fibrosis or chromosomal mutations
  8. disorders of the hypothalamus or pituitary gland.

Diagnosing infertility – medical history and physical examination

Your doctor may ask you many of the following questions: How long have you been trying to get pregnant? How often do you have intercourse? Do you have any pain during your period or intercourse? Have you been pregnant before? Have there been any miscarriages? Have you had any sexually transmitted infections or abnormal Pap smears? How often do you have your period? Do you have any medical problems? Have you ever had any operations? Have you had problems conceiving in your family?

In addition to an in-depth history, your doctor will most likely perform a thorough physical examination.

  1. Find out more about the physical examination

Diagnosing infertility – pelvic ultrasound

He checks the size and structure of the uterus and both ovaries. It can check the condition and size of the ovaries during fertility treatment. It can also be used to check the egg supply (ovarian reserve).

Diagnosing infertility – laboratory tests

Your doctor may order the following blood tests:

  1. estradiol,
  2. FSH,
  3. luteinizing hormone (LH),
  4. progesterone,
  5. thyroid function tests (FT3, FT4 and TSH),
  6. prolactin,
  7. Anti-Műllerian Hormone (AMH) allows you to estimate the number of eggs you have in your ovaries.

Diagnosing infertility – Hysterosalpingogram (HSG)

This is a x-ray test that checks the inside of the uterus and fallopian tubes. May show obstruction of the fallopian tubes. It also allows you to detect problems on the inside of the uterus that make it difficult to get pregnant.

  1. Find out more about the HSG study

Diagnosing infertility – semen analysis

It accurately measures sperm count, sperm mobility (ability to move), morphology (size and shape), and sample volume and consistency. Semen analysis is the most important test for male infertility.

  1. Read more about semen analysis

Infertility treatment – drugs that induce the development of the egg and ovulation

They help stimulate the ovaries to develop mature follicles for ovulation. Your doctor may prescribe pills to be taken by mouth or injections.

Treatment of infertility – laparoscopy

It allows you to check the patency of the fallopian tubes and the condition of the uterus and ovaries. It can also treat problems such as:

  1. endometriosis,
  2. fallopian tube microsurgery,
  3. removal of fibroids,
  4. correction of uterine abnormalities.

The laparoscope is inserted through a small incision in the abdomen. A video camera is attached to the endoscope for a specialist to monitor the situation. Laparoscopy is performed under general anesthesia and takes approximately one to two hours. You may experience symptoms such as muscle pain, tiredness, mild nausea, incision pain or discomfort, cramps, a small amount of vaginal discharge or bleeding, or a swollen abdomen after surgery. They usually last for several days.

Infertility treatment – insemination

Intrauterine insemination, also known as IUI, is the process by which sperm are properly prepared to be placed into the uterine cavity, bypassing the cervix and increasing the concentration of motile sperm closer to the ovulatory follicle. For this purpose, the sperm is washed with a solution that is safe for sperm and egg cells. Then the specialist spins them. In this way, it separates live, mobile sperm from immobile and other cells.

They are then placed in a very small amount of solution and then gently and painlessly injected into the uterine cavity using a thin, soft and flexible catheter.

  1. Find out more about insemination

Infertility treatment – In vitro fertilization

It’s a procedure that helps you overcome a number of fertility problems. Egg and sperm are combined outside the body in a specialized laboratory. A fertilized egg (embryo) can grow in a protected environment for several days before it is transferred to the uterus, increasing the chance of becoming pregnant.

  1. Also read: How does IVF work?

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