INFERTILITY

If achieving a pregnancy has been a great challenge for you and your partner, you should know that you are not alone. About 10 – 15% of couples suffer from infertility.

Infertility is defined as the inability to conceive a pregnancy despite unprotected sexual relations for at least one year straight, or 6 months in some circumstances.

Usually, consultation with a gynecologist should be done after 1 year

Female patients should turn to an obstetrician gynecologist for consultation after 6 months of unprotected sexual relations if:

1. Age 35 – 40 years old who have not achieved a pregnancy after 6 months.
2. Age over 40 years old.
3. Have irregular menstrual cycles or none at all.
4. Have previously been diagnosed with fertility issues.
5. Have been diagnosed with pelvic inflammatory disease or endometriosis.
6. Have had more than one miscarriage.
7. Have received medication or radiation for cancerous diseases.

Male patients should turn to a doctor for consultation after 6 months of unprotected sexual relations if:

1. Spermiogram with abnormal changes.
2. Feel swelling in the scrotum.
3. Have had a previous surgical intervention such as vasectomy or scrotal, inguinal surgery.
4. Have small testicles.
5. Have low sexual desire or sexual function disorders, ejaculation disorders.
6. Have received medication or radiation for cancerous diseases.

The factors that increase the risk of having infertility problems for both men and women are:

1. Age – The fertility of both women and men decreases with age. This factor becomes more important in women after the age of 30 because we have changes in the number and quality of egg production as well as in men after the age of 40.
2. Smoking.
3. Exposure to pesticides and other toxins.
4. Alcohol use.
5. Drug use.
6. Being overweight or obese.
7. Being underweight, malnourished, or on extreme diets.
8. Excessive physical exertion.

The causes of infertility are divided according to statistics into three major groups:

• 1/3 of the cases the problem is only female
• 1/3 of the cases the problem is only male.
• 1/3 of the cases the problem is of both or the cause is not found.

The causes of female infertility are:

1. Ovulation disorders or egg production issues – for example polycystic ovaries, increased production of prolactin hormone- a hormone that stimulates breasts for milk production, amenorrhea or absence of menstrual cycle, oligoamenorrhea or a small amount of menstrual cycle which come as a result of hormonal changes.
2. Disorders of the shape or structure of the uterus or cervical neck – for example congenital anomalies of the uterus shape, benign masses of it such as fibromyomas, changes in the opening of the cervical neck (stenosis), changes in the mucus and sperm-mucus interaction.
3. Sexually transmitted infections that bring changes in the quality of mucus.
4. Blockages of the Fallopian tubes from salpingitis or the inflammation of the tubes that come from pelvic inflammatory diseases and endometriosis.
5. Pelvic adhesions of the abdominal layers that come as a consequence of pelvic infections, appendicitis, peritonitis or previous abdominal surgical interventions.
6. Early menopause before the age of 40 years.
7. Thyroid diseases such as hyper or hypoproduction bring changes up to the interruption of the menstrual cycle leading to infertility etc.

The causes of male infertility:

1. Abnormal sperm production in quantity and quality – comes from congenital defects, undescended testicles, previous infections, diseases like diabetes, hormonal disorders, previous surgical interventions, enlarged veins of the testicles (varicocele) etc.
2. Problems in sperm transportation – premature ejaculation, problems of the sperm transporting structures due to surgical interventions, genetic defects, infections, traumas etc.

Before going to consult with a doctor about infertility problems, you as a patient should be careful in collecting these personal information:

1. Ensure a complete history of menstrual cycles, sexual relations, frequency and time for all the months you have tried to achieve a pregnancy.
2. Have a complete history of your known health problems, examinations you have had or surgical interventions.
3. Make a list of all medications, drugs or vitamins you take as well as an overview of your lifestyle.
4. Make a list of questions you want to ask your doctor.

Treatment of infertility:

1. Treatment of infections.
2. Treatment of problems in sexual act itself.
3. Use of hormonal and medicinal treatments.
4. Stimulation of egg production with drugs.
5. Surgical intervention.
6. Use of assisted reproduction technology.

THE MAIN STEP IN THE TREATMENT OF INFERTILITY IS TO MAINTAIN A HEALTHY, CALM RELATIONSHIP, CONTINUOUS COMMUNICATION, THE DESIRE TO HAVE A PREGNANCY TO BE STRONG AND TRIUMPHANT OVER ANY SACRIFICE YOU WILL MAKE TOGETHER TO HAVE ONE, MANAGE STRESS AND LIVE HEALTHILY.