Infertility is a common problem for 10-15% of families. If a couple has unprotected sexual intercourses and woman cannot get pregnant in one year, the couple is tested and starts the treatment.
CAUSES OF INFERTILITY:
Infertility in men is related with the changes in amount and quality of sperm. The quality of sperm can be unsuitable due to the lack of spermatozoa in testicles, cryptorchidism, infectious diseases in the past, testicular cancer.
Infertility in women might be caused by ovulation disorders and pathology of the fallopian tubes.
Fertility in men and women is influenced by emotional and psychological stress, tension at work, poor nutrition, overweight, environmental contamination, smoking and alcohol consumption.
Testing for infertility is applied for both partners at the same time.
Testing for women include collecting detailed anamnesis, inspection, echoscopic examination, ultrasound assessment of the fallopian tubes. After the mentioned testing, method of treatment is selected: medication treatment, surgical treatment or artificial insemination procedures.
For men, sperm quality testing is applied. In most cases, the quality of sperm can be adjusted by starting treatment.
- Surgical. Hysteroscopy and laparoscopy are minimally invasive, gynecological endoscopic procedures, which help to examine and evaluate changes in the uterine cavity. These procedures are applied in diagnostic purposes and for treatment. Infertility might be caused by uterine anomalies, intrauterine adhesions, uterine septum and myomas, which deform the uterine cavity. Women can successfully get pregnant if these causes are eliminated.
- Artificial insemination procedures. According to the place of insemination, artificial insemination procedures can be divided into two groups: 1. Insemination inside a woman’s body, intrauterine insemination (IUI). It is performed during the ovulation of a natural cycle or stimulated ovulation. A soft catheter is introduced into the uterus and prepared sperm is injected into the uterine cavity. After this type of artificial insemination, 10-15% of women successfully get pregnant. It is recommended to repeat this procedure for 4-6 cycles. Intrauterine insemination does not require surgical invasion and anesthesia, it is a simple and painless procedure. 2. Insemination outside of a woman’s body, in vitro fertilisation (IVF). This method involves uniting the retrieved egg from a woman’s body with the purified spermatozoon in the laboratory. Insemination happens in a special tube.
- Applied method of artificial insemination depends on the quality of a man’s sperm. In a case of average quality, intrauterine insemination (IUI) is applied. In a case of poor quality, in vitro fertilisation (IVF) is applied. In a case of very bad quality, micro-insemination or intra cytoplasmic sperm injection (ICSI) is applied. If there is no spermatozoa in the sperm, then spermatozoa are taken from epididymis or testicles (TESA microsurgery, testicular sperm extraction).