What is infertility?

In spite of an effective prevention method and regular sexual intercourse (the ideal frequency of intercourse is 2-3 times a week for pregnancy to occur), couples who cannot get pregnancy within 1 year should be included in the study for infertility.
Female age 35 and over, menstrual irregularity, uterus, ovaries or tubes, a known disease, male infertility problems, such as in cases where the investigation should start without waiting for 1 year.
A couple without a problem of infertility have a 20% chance of pregnancy per month. Approximately 57% of unprotected couples can become pregnant in the first 3 months, 72% in 6 months and 85% in 1 year.

INVESTIGATION OF EFFICIENCY

INVESTIGATION OF EFFICIENCY

The first test is semen analysis and should be repeated at least twice at 2-month intervals. If the semen analysis is normal, it is accepted that there is no problem in male infertility.

Simen analysis should be performed to determine whether the woman ovulates. For this purpose, 19-21. A simple hormone test (progesterone) can be performed between the days of ultrasound or LH measurements in urine can be done.

95% of women who have regular menstruation normally lay eggs. Therefore, even a good questioning of menstrual order will be enlightening in terms of ovulation alone.

One of the most important tests in women is the determination of ovarian capacity. For this purpose, during the menstrual period, an ultrasound is performed by vaginal route and the primordial follicles in the ovaries (tiny cysts suitable for development containing eggs) are counted.

Presence of less than 6 primordial follicles in two ovaries is a strong finding that ovarian capacity is decreased. In women, the ovarian capacity begins to decrease from the age of 37, and it becomes very difficult for a woman to have children after 44 years of age. Sometimes ovarian capacity decreases earlier.

Ovarian capacity needs to be carefully evaluated, especially in women with early menopause in the family, women who have had cysts from their ovaries, women with single ovaries, women with a history of endometriosis, young vicious couples, and couples with recurrent abortions.

In couples whose semen analysis and ovulation are evaluated, it is investigated whether the tubes are open or not. For this, the uterine tube film (HSG-hysterosalpingography) should be taken.

Although HSG is a simple and often painless procedure, it can technically cause uterine cramps due to the rapid and pressurized administration of the drug. The procedure should be done immediately after the end of the period. In this way, the intrauterine is better seen and the possibility of a very early pregnancy after the ovulation period is eliminated.

The uterine cavity and tubes are evaluated with HSG. It can be understood whether the tubes are open and if they are closed at what level they are closed. In particular, the fact that a single tube is closed from where it is adjacent to the uterus is sometimes due to contraction of the tube as a result of the prescribed pressure of the drug. In this case there is a false congestion, not real.

HSG is less likely to understand the adhesions and their severity in the abdomen. HSG does not provide information about whether tubes are open or not, but does not provide information about the function of the tubes.

Laparoscopy can be performed in a woman who does not have any history and physical examination for abdominal pain.

Although laparoscopy is a frequently used technique in the past, it is now more limited in diagnostic use.

There are also tests that have been used in infertility studies but have not been proven.

These include immunological investigations (antisperm antibodies) and postcoital testing (examination of the cervix for the presence of sperm after intercourse).

As the results do not change the treatment approaches, they are almost never used today.

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