What is infertility?
Infertility is the inability to conceive a child. Approximately 20% of couples are a problem. Such a diagnosis is made when during the whole year, with constant sex life and without the use of contraceptives, pregnancy does not occur.
Causes of infertility
Previously transmitted genital infections, diseases of the internal genital organs, various diseases. So, if we are talking about endocrine infertility, then the cause may be:
- Polycystic ovary syndrome, when a dense membrane is formed around the ovaries, which prevents the release of the egg;
- Hyperprolactinemia (an increase in the blood level of prolactin, which is a consequence of some functional disorders or the presence of a pituitary tumor);
- Hypothyroidism (inability of the thyroid gland to work normally);
- Ovarian exhaustion syndrome, which may be caused by heredity, strict diets, depression and other factors;
- Luteal phase deficiency, expressed in a decrease in the corpus luteum functionality, lack of progesterone;
- Hypoplasia of the uterus, which is known to many under the name of the "children's" uterus, when there is an underdevelopment of the female reproductive system;
- Various malformations of the reproductive system.
Often the cause of infertility is endometriosis. We are talking about the growth of tissue, which in its structure is similar to the endometrium of the uterus, in atypical places. This leads to inflammation, the formation of adhesions and other problems.
The cause of the inability to conceive a child may be uterine fibroids. It is a benign mass that grows in the muscle tissue of the uterus. Myomatous nodes not only prevent pregnancy, but also interfere with the safe bearing of the fetus.
Forms of inability to conceive a child:
- Male infertility (inability of male germ cells to fertilize an egg);
- Immunological infertility (the presence of interfering MAR conception of antibodies in the patient’s cervical mucus or in the male vas deferens);
- Endocrine infertility, which can be a lot of reasons;
- Tubal infertility (pathology of the fallopian tubes).
Diagnostics
If there is a suspicion of male infertility, a spermogram is performed, which involves the process of studying the ejaculate using a microscope. Carrying out such a study allows you to determine:
- Volume of ejaculate;
- Sperm count;
- Concentration of male germ cells;
- Sperm motility and viability;
- Number of normal forms, white blood cells.
To diagnose immunological infertility:
- MAR test
- Samples of Shuvarsky, Kurzrok-Miller or the Cramer test.
Endocrine infertility is accompanied by violations of the cycle of menstruation, anorgasmia, lack of sexual desire. In order to accurately determine whether this particular diagnosis has a place, the specialists of Clinic K+31 conduct a comprehensive examination, including:
- Ultrasound examination of the pelvic organs;
- Measurement of rectal temperature, which can be done within six months;
- Studies to evaluate hormonal status;
- Various analyzes.
When diagnosing tubal infertility, the following studies are carried out:
- A smear is taken on the flora from the vagina and an analysis of the number of leukocytes is done;
- PCR is performed to detect genital tract infections;
- An ELISA is made to detect antibodies to infectious agents;
- A sowing tank is performed to detect the number of pathogens, as well as sensitivity to drugs belonging to the antibiotic group;
- Ultrasound with parallel sampling of special samples.
Screening for endometriosis includes:
- Ultrasound of the pelvic area;
- MRI to detect an ovarian tumor;
- Hysteroscopy, as well as separate diagnostic curettage, if there is a suspicion of internal uterine endometriosis;
- Conducting research to detect cancer cells;
- Laparoscopy
If there is a suspicion of uterine fibroids:
- Ultrasound examination of the pelvic organs;
- Dopplerometry;
- MRI, if it is established that the myoma is large;
- Hydrosonography and hysteroscopy.
Infertility treatment
If after conducting a spermogram when diagnosing male infertility, deviations are detected, then the treatment is performed by a urologist or an andrologist. In the absence of treatment results, a decision is made on the use of assisted reproductive technologies. Including in vitro fertilization (IVF) - when in a test tube a sperm is introduced into the egg, after which the resulting embryo is transferred to the uterus of the patient.
If immunological infertility is detected, intrauterine insemination can be performed when sperm is injected directly into the uterus, which makes it possible to conceive a child.
Treatment of endocrine infertility is usually based on the elimination of its causes:
- With polycystic ovary syndrome, a special operation is performed, the result of which allows the egg to exit the ovaries normally;
- With hyperprolactinemia, cabergoline is prescribed, the tumors are removed;
- If the malfunctioning of the thyroid gland is to blame for infertility, hormone replacement therapy is used;
