Infertility is the lack of pregnancy for 1 year without adequate protection and adequate sexual intercourse. Infertility is seen in 10-15 % of married cuoples. Family history is an important rsik factor in the diagnosis of infertility.

What is infertility? What are the reasons?

Infertility can be divided into two;  primary and secondary infertility.

Primary infertility; for those who do not have any children

Secondary Infertility; who have been able to have children before, but now can not conceive.

Fecundability: ıt is possibility og getting pregnancy in a menstrual period. This is 20-25% in normal couples.

Fecundity: The possiblity of having a live birth in an menstrual period. When all couples are considered,it is impossible for all to conceive during the first mensrtual period.

A certain time must be passed before pregnancy. Ath tyhe end of 3 months who wants to have pregnancy 57% of pregnancy occurs. After 6 months 72% and at the end of 1 year 85% pregnancy occurs.

At the end of the second year pregnancy occurs 93%. 30-40% of infertilite pairs are male and 40-50% are female.

Some couples have problems with both. In 10-15% of the couples neither women nor men have problems.

The cause cannot be found is called “unexplained infertilite”. Therefore, infertile couples should be investigated together. It is not enough to investigate only the woman.

Even if one of the couples has problems the other may have problems at the same time.

Causes of Infertility ın Women

• Ovaluation disorders 40%
• Disordes due to tubes&Abdominal adhesions 40%
• Endometriosis 5-15%
• Infertility of unknown causes 5-15%
• Other reasons 5%

Causes of Infertility in Men

• Varicocele 15%
• Endocrin hypogonadiasm 9%
• Subclinical ınfections 8%
• Undescended testicle 8%
• Erection problems and hypospadias 6%
• Immunological causes %
• Systemic diseases 3%
• Obstructive pathologies 2%
• Other reasons 13%

After questioning the past for reasons that lead to infertility ,an examination is performed to evaluate not only the reproductive organs but also the entire body. In addition to hormonal tests,methods, such as HSG, laparoscopy and hysteroscopy can be used.

Sperm test  (semen analysis) is very important for the evaluation of men besides the history and examination findings. Sperm analysis is performed after 2-5 days of sexual abstinence. If sperm analysis is abnormal,it should be repeated after 1-2 months.

What are the other factors related to ınfertility?

• Smoking
• Excess weight
• Close of cervix
• Lack of regular sexual ıntercourse
• Vaginismus
• Chemotherapy and radiotherapy treatment
• Early menopause

When should couples consult to a doctor?

Cuoples under the age of 35 should consult a doctor if pregnancy has not occured,even though they have been in regular contact for 12 months without protection. In couples over the age of 35 this period is 6-8 months.

In the following cases, an investigation can be initiated without waiting for 1 year.

Women;

• Women age over 35
• If they have irregular menstral period of amenore.
• If they have a history of pelvic infection or endometriosis
• If they have abdomin or pelvic surgery
• If they have abnormal examination findings

Men;

• If tehy have urogenital durgery
• If they have a history of sexualy transmitted disease
• If they have abnormal examination findings they have to consult a doctor.

İnfertiliteye yol açan nedenlere yönelik geçmişle ilgili sorgulama sonrasında, sadece üreme organlarının değil tüm vücudun değerlendirilmesine yönelik muayene yapılır. Hormonal testlerden başka histerosalpingografı (HSG), laparoskopi ve histereskopi gibi diğer inceleme yöntemleri kullanılabilir.
Erkek değerlendirilmesi için öykü ve muayene bulgularından başka sperm testi (semen analizi) çok önemlidir. Sperm analizi 2-5 günlük cinsel perhiz sonrası yapılır. Sperm analizi anormal çıkarsa 1-2 ay sonra tekrarlanmalıdır.