Infertility - the inability to conceive after a year of unprotected intercourse. About 10% of couples are infertile. Infertility is both male and female. About a third of cases, the absence of children the couple infertility caused by man, in the third - the infertile women, the remaining third - a combination of factors.
How age affects infertility?
The number of infertile couples increases with age. Women have a finite number of eggs. Thus, over time, their quantity and quality is reduced. The chances of getting pregnant are reduced by 3-5% every year since 30 years. After 40 years of decline in the probability is much stronger.
What causes female infertility?
The factors that cause female infertility may be:
- Damage to the fallopian tubes. This may prevent the contact of sperm with the egg. Infections, endometriosis and gynecological surgery can lead to scarring and damage to the fallopian tubes.
- Hormonal causes. Some women may have problems with ovulation - there is no simultaneous change in hormones, which leads to the output of egg from the ovary and the thickening of the endometrium. This problem can be determined by measuring the basal temperature or using Test ovulation
Ovulation Test - the exact calculation?
- Problems cervix. Occasionally it happens that sperm can not penetrate the cervix. The reason for this may be abnormal mucus production and the effects of surgery. In this case helps intrauterine insemination.
- Unexplained infertility. Approximately 20% of couples the cause of infertility can not be identified.
How is the cause of infertility?
To find out the causes of female infertility, the doctor may prescribe the following examinations:
- Blood test to determine the hormonal
- Endometrial biopsy to determine its condition
- To determine the scarring or blockage of pipes can be used hysterosalpingography and laparoscopy.
- Hysterosalpingography - a procedure which includes an ultrasound or X-ray examination of the reproductive organs. Dye and saline or air is introduced into the cervix, moving from the fallopian tubes. This allows you to see whether the tubes are passable.
- Laparoscopy - an operation in which a laparoscope (a thin tube with a camera) is inserted through a small incision in the abdomen. The laparoscope allows you to see the outside of the uterus, ovaries and fallopian tubes, and to find out if there are any abnormal growths.
How is female infertility?
Female infertility can be treated in several ways, including:
- Laparoscopic surgery. In the case of diseases of the reproductive organs may be assigned or reconstructive surgery performed in vitro fertilization. Tools in this operation are introduced through a small incision during surgery can remove scar tissue, endometriosis, ovarian cysts, or open pipe impassable. Using hysteroscope introduced into the cervix, can remove polyps or fibroid tumor, scar tissue, or to open the tube.
- Medication. Women who have problems with ovulation
Ovulation - How to determine as accurately as possible?
May prescribe medications such as clomiphene citrate or gonadotropins that lead to ovulation. Gonadotropins can also cause simultaneous ovulation of multiple eggs, which increases the likelihood of conception. Also gonadotropins used when the cause of infertility is not clear. Another drug to restore ovulation - metformin, which can be used in women with insulin resistance or polycystic ovary syndrome.
- Intrauterine insemination. This is a procedure in which semen is collected, washed with a special solution and placed in the uterus during ovulation using a catheter.
- In vitro fertilization (IVF). This is a procedure where the egg is fertilized in the laboratory and then placed into the uterus. Woman takes gonadotropin to stimulate ovulation of multiple eggs ripened egg is removed and collected separately fertilized by sperm. After a few days the fertilized eggs are placed in the uterus. Some of them can be frozen and later used as desired pair.
- Egg donors. If a woman's ovaries are functioning properly, but the queen is all right, it can be used egg donation. In this case, the donor are retrieved from the ovary ovules that are fertilized through IVF and then placed into the uterus of the recipient.
Blocking the fallopian tubes
Blocking the fallopian tubes helps to identify hysterosalpingogram (HSG), but to confirm this diagnosis should be made laparoscopy.
The most common reason for blocking the fallopian tubes - infection and the most common pathogen infection - chlamydia. Approximately 70% of women who have been diagnosed blocking the fallopian tubes are infected hlamidoznoy infection, though they can do not even suspect until after the examination to determine the cause of infertility.
The normal menstrual cycle - is, above all, regular ovulation and hormonal changes that it causes. Thus, irregular menstruation indicates that the egg will appear in a woman every month.
Sometimes a woman has no problems with the menstrual cycle, but, nevertheless, do not ovulate each month. The test of ovulation can serve as a secretion of the hormone progesterone
Progesterone - norm and pathology
21 day cycle (for a twenty-eight day menstrual cycle). The medical term "anovulation" refers to the absence of ovulation. In some cases, ovulation does not occur because of excessive activity of the pituitary gland to produce more (even excessive) amounts of the hormone prolactin (mammotropina).
Polycystic ovarian syndrome - another reason anovulation. Sometimes, during the surveys reveal hormonal disorders, and the picture at the edges of ovarian cysts are seen small. By themselves, they are completely safe and threats to health are not, however, indicate that the egg begins to develop, but never released.
Endometriosis - a pathological process by which tissue similar to the lining of the uterus (the endometrium) begins to grow outside its normal position. Obviously, extensive endometriosis, exciting fallopian tubes and ovaries, violates the movement of the egg and ovulation, but it is not clear how easy or moderate endometriosis can affect fertility.
Treatment for endometriosis is aimed at the complete elimination of any of his surgically or by burning endothermy or laser therapy, the destruction of all adhesions and adhesions and maximum preservation of ovarian tissue in a normal state. Light and medium endometriosis can be identified and cured with laparoscopy, but more severe cases require surgery.
Unexplained infertility is a very negative impact on the mental health of the woman, because this diagnosis means that treatment is very difficult, because the cause of infertility can not be determined. However, approximately 60% of couples who have been diagnosed with "unexplained infertility" and who have lived with this diagnosis less than three years, in the next three years have successfully become pregnant without any treatment. Recent studies of the effect of clomiphene did not confirm its efficacy in the treatment of infertility
Infertility Treatment - What principles are priority
For the treatment of infertility recommend ovarian stimulation (stimulation of the ovaries) in combination with direct fertilization and pre-cooked "optimized" sperm partner. To do this, carry out routine control of ovarian stimulation and fertilization in the expected time of ovulation, that is, with the help of vaginal speculum (as when taking a smear) is introduced into the uterus of a sperm sample. The probability of conception in this case is usually 15% per cycle. If this procedure is ineffective and after 6 cycles is recommended to conduct in vitro fertilization (IVF).