Infertility is not a judgment, but a problem to be solved
The diagnosis of “infertility” is made if the pregnancy does not occur for a year without regular love and without using contraception.
Globally, the diagnosis affects about 9% of couples, but it is not yet a verdict that they can never have children.
In 97% of cases, we can solve the problem of infertility – either with the help of medication or by some medical manipulation. But we must certainly not hesitate and expect the problem to resolve itself.
When should you think about infertility tests?
If a year has passed and the baby does not apply, it would be advisable for both the woman and the man to have a health check.
Sometimes the reason for not getting pregnant can be, for example, an infection or myoma, ignoring which can lead to other health problems besides infertility.
However, it may also turn out that the couple is healthy and only needs a little medical help to conceive.
If a woman is over 36 years of age, it would be advisable to consult a gynecologist or reproductive doctor if the pregnancy has not occurred after 6 months.
Sometimes a woman already knows that she has problems that prevent her from becoming pregnant, such as myoma, endometriosis, tubal problems or a chlamydial infection.
Here, too, it is not worth waiting a year and should contact a specialist as soon as the couple has conceived a baby.
Investigations to be performed if infertility is suspected
For a woman
- Hormone tests
- The presence of infections in the body,
- Uterine (hysteroscopy) and abdominal (laparoscopy) examinations may sometimes be needed.
For a man
- Sperm analysis or spermogram. If the spermogram is within normal limits, it does not mean that the man is fertile. There are several in-depth sperm tests that show, for example, that the sperm are not mature enough or that the sperm clump when they enter the woman’s body and that we cannot perform the function of fertilization. Therefore, it would be advisable for a man to go to an andrologist and perform in-depth examinations.
For both partners
- It is important that we inform the doctor about the general health of both partners and their illnesses.
Depending on the results of the basic test and the partner’s medical history, your doctor may order additional tests.
Psychosomatics is of great importance. It is not always possible to find a cause for infertility. Sometimes both a man and a woman are physiologically fine, but pregnancy does not occur.
Among the unexplained reasons, psychosomatics can be the fault in about 30% of cases, ie the great desire for the baby causes anxiety and stress. Chronic stress alters our hormonal balance and can be the reason for not getting pregnant.
Causes of male infertility
- Semen non-liquefaction. In a woman’s body, the sperm is liquefied, the unnecessary part flows out, and the healthy and moving part goes further towards the egg. If the sperm does not liquefy, the sperm does not reach the egg.
- Too low sperm concentration in semen. The normal concentration of sperm in semen is 5%, the rest is protein and other substances. Sometimes this concentration is too low for men. The concentration of sperm must be high enough, because on the way to the egg, part of the sperm dies, releasing nutrients so that the most mobile and strongest sperm are fed.
- Sperm motility. If a man’s sperm are sedentary or morphologically altered, such as those with two tails, they cannot reach the egg.
- Immature sperm. In order for a sperm to fertilize an egg, it must be mature. To encourage this, it is important not to make love every day, but to do it every second or third day. Only the heads of mature sperm have receptors that sense the “magnetism” of the egg and make it run towards it.
- Sperm clump when they enter a woman’s body. Sometimes this problem is caused by an immunological disorder, but it can also be because the man has had an injury to the testicles.
- Altered DNA in male semen. This can be not only the cause of infertility but also one of the most common reasons why pregnancy stops developing and miscarriage occurs.
- There is no sperm in the semen. This problem can occur after you develop various serious illnesses. That there is no sperm in the ejaculate does not mean that it is not in the testicles. To obtain sperm, the testicles are punctured by aspirating (withdrawing) the most mature sperm, or by surgical or microsurgical aspiration of sperm.
- Ejaculation takes place towards the bladder, not outwards. Here, the man’s semen does not come out, but enters the urine. The embryologist can solve this problem relatively easily by separating sperm from urine with a special method.
The frequency of pregnancy depends on various factors, but the age of the woman is decisive!
Causes of female infertility
If a woman does not ovulate, the most common cause is hormonal changes. In most cases, we can prevent these changes with medication. Sometimes it is enough to take a dietary supplement that balances our hormonal cycle, make a small lifestyle change, or lose weight.
What affects ovulation
- Regular night’s sleep.
- Balanced diet.
- Emotional and physical well-being.
- Age of woman.
- Lactation period.
- Significantly increased or insufficient body weight.
- Polycystic ovary syndrome (PCOS) is a chronic disease of the endocrine system that affects an average of 35% of women. Hormonal imbalances cause it. In cases of the disease, women often have elevated levels of the male hormone testosterone. We characterize this syndrome by irregular and rare periods, sometimes only 1-2 times a year.
- Premature ovarian failure when a woman is menopausing very early.
- Hormonal changes caused by thyroid disease, pituitary formation or imbalance, congenital or gained adrenal cortex pathology, or hormone-producing formations such as in the ovaries.
Problems with the fallopian tubes
Tubal health is essential for a woman’s fertility. The primary function of the fallopian tubes is to provide sperm with a way to the egg and to carry the fertilized egg to the uterus.
If the fallopian tubes are impermeable, the egg is not fertilized, but if they are partially permeable, there may be a situation where the egg is fertilized but not to the uterus, resulting in an ectopic pregnancy.
The most common causes of tubal occlusion
- Infection or endometriosis.
- Ectopic pregnancy can also occur if the fallopian tubes are baggy after a small pelvic infection. Such fallopian tubes do not have circular muscles and fringes that can deliver the fertilized egg to the uterus.
- Inflammation of the fallopian tubes can also be a cause of an unfavorable pregnancy outcome – miscarriage or premature birth.
Ultrasound is used to check the permeability of the fallopian tubes, and laparoscopy is used to get more detailed information. X-rays are being used less and less because other, more informative methods of examination are available.
- Endometriosis, which is the growth of the inner layer of the uterus in other organs, causes immunological problems in a woman’s body. Symptoms may include severe pain before menstruation and the first day of menstruation, increased bleeding, spotting between periods, as well as pain in loving positions and fertility problems. In endometriosis, the quality of the egg is reduced. Depending on the stage, endometriosis may be treated with medication or surgery, or medical or in vitro fertilization may be required.
- Morphological changes of the uterus. Infertility can be caused by a polyp or myoma inside the uterus, which is a benign tumor, but when it grows in the uterine cavity, it can cause infertility by mimicking the effects of a foreign body or intrauterine coil. Polyps up to the age of 35 can be treated with medication, but after the age of 35, atypical or cancer-like cells tend to form at the base of the polyps, so it is mandatory to operate on them before treatment to determine the nature of the cells. However, in situations where fertility is impaired, polyps should be operated on regardless of their nature. Myoma must also be operated on if it is growing rapidly, otherwise there is a risk that the uterus will need to be removed over time.
- Uterine growths. Adhesions in the uterus are most often formed after various procedures performed in the uterine cavity, such as after abortion, uterine abrasion, as well as after inflammation. There are methods by which it is possible to remove adhesions, but sometimes there is no longer an inner layer of the uterus instead of adhesions, and then there is very little chance to change anything.
- Uterine pathologies. Sometimes women have some congenital uterine abnormalities that prevent them from becoming pregnant, such as the uterine septum. It can be removed surgically, and later pregnancy is possible without medical intervention.
There are few couples who cannot be helped. Infertility is mostly a problem to be solved.
Sometimes infertility results from our own actions
A woman’s age can increase the risk of infertility, as nowadays women increasingly think about conceiving a child after the age of 35. Unfortunately, the incidence of chromosomal as well as other diseases that affect a woman’s fertility increases over the years.
Abortions performed during adolescence, and sexually transmitted diseases, which can lead to tubal adhesions, also affected fertility.
Because of insufficient sex education, some young people are not aware of the importance of protection and the consequences of abortion. It is very important to educate the younger generation about healthy sex.