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Infertility reasons, treatment methods, fertility specialist
Difficulties with conception, according to statistics, are experienced by 15 percent of married couples. The reasons may vary. What and how to deal with them, said Yulia Tsoraeva, a gynecologist-reproductologist at the Nova Clinic network of reproduction and genetics centers.
Infertility can be associated with both female and male reproductive disorders. And sometimes a decrease in fertility – the ability to conceive a child – is diagnosed in both spouses. In order for the long-awaited pregnancy to occur, it is necessary to detect all pathological changes and eliminate them.
There are many factors that can affect fertility: obstruction of the fallopian tubes, infectious diseases, anomalies in the development of the uterus and pathology of its mucous membrane (endometrium), a decrease in the ovarian supply of the ovaries (a genetically programmed supply of eggs in a woman’s ovaries in the absence of changes in the woman’s reproductive system), immunological disorders and even psychological problems.
In order not to miss anything, the doctor must prescribe a thorough examination.
However, there are 6 main reasons that provoke infertility in women.
Tubal peritoneal infertility
Pregnancy may not occur due to problems with the fallopian tubes.
Infertility can be based on:
— pipe factor – obstruction of the fallopian tubes;
— peritoneal factor – the formation of adhesions between the fallopian tube and the ovary or dysfunction of the fimbriae (special growths at the end of the tube, which help to capture the egg released from the ovary and direct it inward);
— tubo-peritoneal factorwhen both problems converge.
To restore reproductive function, the doctor may prescribe surgical treatment (laparoscopy), after which pregnancy occurs at about 35 percent cases. If the operation does not work, IVF will help – fertilization of eggs outside the woman’s body and further transfer of embryos directly into the uterine cavity. Since the pipes are not involved in this process, their condition does not affect the success of the procedure.
Uterine infertility occurs due to anatomical anomalies and deformations of the organ, which can be either congenital or acquired: the absence or underdevelopment of the uterus, adhesions in its cavity, the formation of myomatous nodes.
Surgery can restore fertility in about 17 percent cases. Sometimes the use of methods of assisted reproductive technologies is required. In particular, women who do not have a uterus can enroll in a surrogacy program. The patient’s eggs are fertilized with the sperm of her husband or donor, and the embryos are transferred to a surrogate mother who bears a child who has no genetic relationship with her. After the baby is born, it is transferred to the biological mother.
Endometriosis is the spread of cells in the lining of the uterus outside of its cavity. Every third woman with this diagnosis faces infertility.
To restore natural reproductive function, doctors perform endoscopic coagulation of endometriosis foci. In other words, surgeons excise pathological areas under the control of video equipment. After the operation, medications are prescribed.
It is possible to achieve pregnancy in 35 percent cases.
Immunological infertility
Immunological infertility is caused by the production of antisperm antibodies in the body.
Normally, sperm cells, moving along the female genital tract, are not attacked by immune cells. However, sometimes it happens differently, and then the sperm fail to meet with the egg. As a result, fertilization does not occur.
To prevent this development of events, doctors may recommend the method of intrauterine insemination. In this case, specialists use a catheter to place specially processed sperm directly into the uterine cavity. It is possible to achieve the onset of pregnancy in about 40 percent cases.
Infertility can be due to two reasons:
1) the process of maturation of the egg is disrupted;
2) ovulation does not occur in the menstrual cycle.
Ovulation is the process of the release of an egg from the ovary into the abdominal cavity. After that, it goes to the fallopian tube, where a meeting with the sperm occurs.
Lack of ovulation can be associated with hormonal imbalance, PCOS (polycystic ovary syndrome), inflammatory processes and a number of other factors.
To restore reproductive function, it is necessary to normalize hormone levels and stimulate ovulation. Doctors may recommend maintaining a diet (sometimes just this is enough), various methods of physiotherapy, and the use of hormonal drugs.
It is possible to achieve the onset of pregnancy in about 75 percent cases.
Sometimes it is not possible to identify the reasons for the decrease in fertility. In these cases, the doctor diagnoses idiopathic infertility, which can be overcome with the help of methods of assisted reproductive technologies.
If you are planning to have a baby for more than a year, and pregnancy does not occur in any way, be sure to make an appointment with a fertility specialist. If you are already 35 years old, it is recommended to seek help after 6 months. The sooner all possible violations that prevent pregnancy are discovered, the sooner you can become a happy mother.