Infertility is not a sentence. It is assumed that one in five women who plan to have a baby have problems with the onset of pregnancy. But the vast majority of them eventually succeed. Correct modern diagnostics and treatment effectively help to solve such a problem as impaired fertility and infertility.
When is it time to go to the doctor?
As a rule, a woman becomes pregnant within a year after the beginning of regular sexual intercourse without the use of contraceptives. If the time does not work in your favor (you are more than 30 years old and you have not been pregnant, you have had gynecological problems or operations in the past), after this period, do not hesitate to visit a gynecologist specializing in the treatment of infertility. In the case of very young women, such a visit can be postponed for one year. Many couples become parents without any medical assistance for the second year of joint attempts to get a child.
Remember that life is created together, so to the doctor you must go along with the partner. If your husband urges you to first contact yourself - convince him otherwise. Many men decide to go to a doctor very hard. They think about the diagnosis, believing that this is a terrible idea. According to experts, up to 15% of married couples face certain difficulties to become pregnant. There are several reasons for this, and sometimes the reasons are for both partners. A common cause of treatment failure is the focus on one problem. But you need to always look for new solutions without getting any effects after the treatment. Time goes, and the possibilities of the organism are not infinite.
Male infertility is the reason for almost half of couples, and according to experts, these indicators are constantly growing. Diagnosis of partners should be carried out simultaneously. Bad ecology, wrong way of life lead to the fact that infertility cases are increasingly in the representatives of both sexes.
Where can I get help?
You can go to the gynecologist in the clinic, and he will, if necessary, direct you further. The decision to diagnose and treat infertility is usually taken by a gynecologist and endocrinologist, as well as an expert on hormonal disorders in men andrologist (specialist in diseases of the male reproductive system) or urologist (specialist in diseases of the genitourinary system).
If you have the opportunity (including financial) - it is better to get professional infertility treatment in the clinic. There are specialist consultants, professional and analytical laboratories, all of them in one place. Diagnosis and treatment will be done more carefully and you will save a lot of time. When you find that your task is trivial, you will probably end up with one or two visits at a low cost of services. In case of serious trouble, it is likely that the trusted doctor will guide you through all the stages of treatment to a happy ending.
The question of the possibility of financing part of the research and treatment is increasingly being considered in private institutions under appropriate agreements with the fund. A lot of useful information, including about the best centers of infertility treatment in your area and the opinions of doctors you can find in the Association for the Treatment of Infertility.
Remember that such a delicate issue as the treatment of infertility, it is important to trust only a highly qualified doctor. Therefore, everything is important here - and the feedback of other patients, and even your own first impression. Do not hesitate to ask the doctor for confirmation of his qualifications - this is your right.
What does the diagnosis of a woman include?
Experts point out: there is no reason for the evaluation of your reproductive performance to last longer than three months. At the same time, if you deal with professionals, you can actually see everything and decide what to do. Most qualified doctors have a reasonably good conversation with their future mother in order to have reasonable suspicions about the problem. This does not change the fact that intuition is not enough. This is necessary to complete the main stages of diagnosis.
In women, the diagnosis includes gynecological examination, ultrasound examination of the patency of the fallopian tubes, laparoscopic examination. The latter allows you to check whether the cause of infertility is some post-inflammatory syndrome - spikes or endometriosis. If the doctor observes problems in the uterine cavity, such as polyps, he can recommend sonography or ultrasound after injecting saline through a catheter. This research is cheap and painless.
An important element of diagnosis is the definition of the period of ovulation and its quality. These ovulation studies are very popular, but no less important is the evaluation of cervical mucus. For this purpose, not only a standard ultrasound is performed, but, above all, a series of hormonal tests to evaluate the function of the thyroid gland. The levels of androgens, adrenal function and pituitary ovarian function are also evaluated.
Bacteriological testing is required. Bacterial infection is a frequent cause of infertility, but still underestimated in our country. It is necessary to exclude diseases such as chlamydia. The usual "smear" is not enough - special tests are needed, which make it possible to evaluate the drug resistance of microbes.
Very rarely, all these studies do not give an answer about the causes of infertility. If you and your partner are externally healthy, doctors sometimes recommend the further study of genetic and immunological tests. Such problems arise from time to time, access to research results is difficult, and their cost is relatively high. But the result is worth it.
The most common causes of female infertility
Often ultrasound and a blood test can help detect the cause of infertility. In 30-35% of cases, female infertility is associated with tubal occlusion, and another 25% is associated with hormonal disorders. The cause of tubal infection, as a rule, are microorganisms that cause venereal diseases, such as chlamydia or gonorrhea. Acute or chronic inflammation can lead to the formation of scarring, the formation of an abscess and even tubal atresia.
Hormonal disorders of childbearing function associated with the lack of ovulation or inappropriate ovulation (the follicle does not burst, the egg is not released at the time of ovulation). There are also symptoms of a genetically inherited disease called polycystic ovary syndrome. In the ovaries, there is an excess of male hormones, which leads to the death of follicles and the formation of cysts. Another problem is hyperprolactinemia (high prolactin level), which can lead to amenorrhea. It can also directly affect the sex glands, reducing the secretion of progesterone in women, preventing the development of the embryo.
Hormonal imbalance leads to many factors, often associated with lifestyle. Malnutrition, overweight, chronic stress, alcohol abuse and even professional sports can all "bring to naught" new efforts to have a child. Negative consequences also cause a disruption in the functioning of the thyroid gland, pituitary gland and adrenal glands.
The culprit of infertility (or an additional factor in reducing fertility) is sometimes endometriosis. This disease is associated with the implantation of fragments of the endometrium (the mucous membrane of the uterus) into the organs of the abdominal cavity. Endometrium is located in that place and the same way as with cyclic changes in the uterus. It expands, causing inflammation and scarring. It is most difficult to get pregnant if the disorders are related to the operation of the ovaries or the fallopian tubes.
Sometimes the cause of temporary infertility are various pharmacological agents used to treat many diseases, especially antidepressants, hormones, as well as antibiotics and analgesics. Among them are those that are available without a prescription (such as aspirin and ibuprofen, if taken in the middle of ovulation). Sometimes infertility is caused by radiation therapy and antitumor drugs that can damage the follicles.
Another cause of infertility in women, as a rule, are some disorders in the formation of reproductive organs. These include congenital defects of the uterus and vagina, as well as all types of fibroids and postoperative adhesions in the abdominal cavity and pelvis. Definitely worth a closer look at the cervix. The so-called factor of infertility in women is often associated with changes in the body of the uterus. The most common anomalies are associated with the position of the cervix. Under normal conditions, it is aimed at the back wall of the vagina. Changes in the position make it difficult to contact the male cervical sperm.
The cause of infertility is sometimes inflammation of the cervix. It affects the properties of cervical mucus, making it a real "enemy" of sperm. This usually involves a change in acidity and the presence of various sperm killers. As a result, they have no chance of achieving their goal.
Duration of treatment
It's a myth that doctors almost always offer children from a test tube. This method is considered as an extreme measure. The most commonly used tablets are designed to remove hormonal disorders, or fight infection. Sometimes surgical treatment is necessary: usually laparoscopic, allowing even to cure ovarian or uterus cysts, endometrial cancer, or to remove another obstruction in the reproductive tract.
When the diagnosis of "impairment of the childbearing function" can not reveal the obvious causes of infertility, and the nature of support is necessary (for example, when future fertility is naturally reduced due to old age) - then special measures are needed. You should often visit a doctor to monitor the effectiveness of treatment. If nothing helps, expensive means are powerless - you can talk about the need for IVF.
At this stage, some doctors suggest a method of artificial insemination. Sperm injection of the partner is made using a special catheter, directly into the uterus. It is much cheaper than in vitro, and is justified in case of problems with the cervix and sperm of the partner. At the same time, it should be remembered that its effectiveness, even in the most optimistic studies, does not exceed 15%.
Method of IVF
The decision to use in vitro fertilization should be based on accurate diagnosis. If the traditional treatment time has exceeded the acceptable limit for partners, as well as in cases with women over the age of 35, threatening the ultimate loss of fertility. In general, the IVF method is not recommended for women younger than 35 years with impaired fertility and infertility.
This method is based on the selection in the laboratory of artificially impregnated ovules and their introduction into the uterus. So a ready-made embryo is placed in the uterus, bypassing all stages of natural fertilization. The effectiveness of the method is estimated up to 30% compared with the traditional method of conception.