What is Infertility?

What Does Infertility Mean?

One in every 10 couples may experience infertility. Both spouses should be examined and tested, and if necessary, treated. Infertility is the inability to conceive despite 1 year of regular intercourse. However, if the woman is under the age of 35 and cannot conceive despite 6 months of unprotected intercourse if she is over the age of 35, the spouses should be examined in detail. Apart from this, infertility tests should be performed immediately for women who have irregular menstrual periods, have had surgery due to gynecological diseases (ovaries, uterus, cervix, tubes) and want to have children.

As a result of examinations and tests, some surgeries can increase the chance of pregnancy before IVF treatment. These are;

In women;

• Opening of intrauterine adhesions
• Removal of the uterine septum
• Removal of polyps and myomas in the inner layer of the uterus where the embryo (fetus) is likely to attach
• Treatment of endometriosis or chocolate cysts
• In cases where there is suspicion of blocked fallopian tubes (to check whether the tubes are blocked or to remove the tubes in the presence of hydrosalpinx, a fluid accumulation in the tubes)
• Problems in the cervix or vagina, hymen: septum, mass, etc.

In men;

• Surgical removal of sperm from the testicles with TESE, TESA, from the epididymis with MESA, PESE methods can be applied to infertile patients.

Does Polycystic Ovary Syndrome Cause Infertility?

There is a connection between polycystic ovary syndrome and infertility. Polycystic ovary syndrome is a disease that causes ovulation disorders in women and can lead to problems with fertility.

Women with polycystic ovary syndrome may experience irregular menstrual cycles. In addition to ovulation problems, it can cause other symptoms such as changes in insulin levels and obesity. Problems such as premature birth, miscarriage, and gestational diabetes during pregnancy can also occur with polycystic ovary syndrome.

Some couples who cannot conceive despite 1 year of unprotected intercourse may benefit from surgical procedures. However, in our patients over the age of 35, this period is 6 months in order not to be late in terms of egg reserve. Women who have irregular menstrual periods, painful menstruation, increased body hair or other complaints and who want to get pregnant should be investigated earlier.

Polycystic Ovary Syndrome is an important factor that increases the risk of infertility. PCOS is a condition that causes ovulation disorders and hormonal imbalance in women. These hormonal disorders can reduce or completely stop ovulation, making it difficult to conceive.

Women with PCOS often experience irregular menstrual cycles. In some cases, menstrual cycles can stop completely. When ovulation does not occur, the likelihood of pregnancy also decreases. Women with PCOS may also have other symptoms such as high insulin levels, obesity, and hair growth. These PCOS symptoms can further increase fertility problems.

Women with polycystic ovary syndrome can have a chance to get pregnant with the right treatment methods. For example, if a woman with polycystic ovary syndrome is overweight due to the disease, she should first lose her excess weight. In this way, pregnancy can be accelerated and problems that may occur during pregnancy can be prevented.

Polycystic ovary is a condition that can cause infertility. Click for more detailed information.

Infertility Treatment of Polycystic Ovary Patients

Infertility caused by polycystic ovary syndrome is a treatable problem. First, drug treatment is started. Ovulation and egg development are accelerated when drug treatment is used regularly.

If this treatment method does not work, insemination treatment can be used. It is the process of placing sperm into the uterus by giving a sperm sample to help women's natural ovulation cycle.

In vitro fertilization treatment can be used for infertility treatment for women with polycystic ovary syndrome. The possibility of pregnancy can be increased by collecting, fertilizing and placing the embryo into the uterus.

High Prolactin and Infertility

What Causes High Prolactin? Prolactin hormone, which causes the breast tissue to develop and become ready for milk production during pregnancy, helps the breast to secrete milk by stimulating the breast after birth. However, when it increases in women outside of pregnancy and the puerperium period, it causes irregular menstrual periods, cessation of menstruation, infertility, decreased sexual desire and milk discharge from the nipple. It also causes conditions such as transparent or white discharge, painful sexual intercourse due to vaginal dryness.

In men, it causes sexual reluctance due to hyperprolactinemia. It causes erection problems, infertility, and loss of body hair. Rarely, it can also cause discharge from the nipples of men. In addition, it can cause the individual to experience extreme headaches and visual impairment.

Infertility and Stress

Infertility is the inability to conceive despite 1 year of regular sexual intercourse. If you are under the age of 35 and cannot have a baby despite 1 year of regular intercourse, you should consult a gynecologist. If you are over the age of 35, this period is 6 months in order not to lose any more time. Infertility tests should be performed without waiting for women who have irregular menstrual periods or have a history of surgery due to gynecological diseases and are planning a pregnancy.

The most frequently asked question to couples from the moment they get married is “Aren’t you thinking about having a baby?” Although it is not considered in the early stages of marriage, the passing time and close circle somehow create a desire in couples to have a baby. While some couples can have a child right away, some unfortunately can try for months or even years to get pregnant. During this prolonged process; the good news expected as a result of pregnancy tests repeated every month never comes and the fear of not being able to become a parent comes into play. Different suggestions come from the circle and all these increase the stress load. As a result of these experiences, couples go to the doctor under stress and seek solutions to their problems. In cases where no condition preventing pregnancy is detected as a result of examinations and tests performed on women or men, the importance of stress becomes apparent. Stress can lead to infertility and infertility can lead to stress. In other words; although there is no definitive scientific evidence, it is accepted that stress and infertility are in a cause-and-effect relationship.

IVF treatment can be decided upon as a result of examinations and tests performed on these couples who cannot conceive. In order to increase the effectiveness of ovulation monitoring, insemination, and IVF treatments applied by IVF specialists; it is very important for couples to stay away from stress. Just as it is known that alcohol, cigarettes, unbalanced and irregular nutrition prevent pregnancy; it is also accepted that stress factors prevent a baby. Stress increases and the chance of success of the treatment decreases in couples who are constantly reminded that they do not have a baby. The support provided by their close circle is very valuable during this treatment process, which can be extremely exhausting both physically and psychologically and can bring couples to the point of separation. It may not be possible to completely stay away from stress during this process, but it is possible to manage stress and cope with it. Getting psychological support from outside is also beneficial in this regard. Treatment processes that do not increase stress, where families show understanding, couples do not blame each other, and where there is no room for anger and hopelessness, result in faster and more successful results.

What are the Surgeries That Can Be Performed for Infertility?

Laparoscopy: It is a surgical technique performed with special instruments and a camera system prepared for laparoscopy surgery after 0.5 - 1 cm incisions are made in the lower abdomen and navel. It is important in terms of patient comfort. There is no incision scar or it remains in the form of a minimal scratch. Patients are discharged earlier after surgery compared to open surgeries. Many surgeries can be performed with a closed method; Myoma surgery, endometriosis surgery (chocolate cysts), opening of adhesions, removal of damaged tubes, etc.

Laparotomy: Open surgery can be performed on patients who cannot undergo closed surgery or if the surgeon does not have experience in closed surgery. It is logical to prefer open technique surgery in the presence of large or multiple myomas, in patients who have had multiple abdominal surgeries, and in patients who are at risk for laparoscopy in terms of anesthesia.

Hysteroscopy: A hysteroscope is a tube-shaped device with a camera on its end. It can be performed under general anesthesia, local anesthesia or sedation. A small telescopic camera system is sent through the vagina, passing through the cervix and into the uterus. The fluid coming from the instruments fills the uterus with fluid and the camera image can be taken. Polyps, myomas, septa and adhesions inside the uterus can be cleaned this way.

Robotic Surgery: It can be a logical option for reopening blocked tubes.

Does Myoma Prevent Pregnancy? When Should We Recommend Myoma Surgery to Patients with Infertility Complaints?

Myomas are benign muscle tumors, or masses, found in the uterus. However, they present symptoms in different ways depending on their location in the uterus or their size. Almost one in every 10 women undergoes myoma surgery, which we call myomectomy, due to these complaints (recurrent miscarriages, infertility, irregular menstrual bleeding, abdominal bloating, abdominal pain, frequent urination, inability to defecate, etc.).

If myomas are in the inner layer of the uterus, where the embryo formed from the fertilized egg will attach and grow, or if there is a myoma that presses on the inner layer of the uterus, it is recommended to remove these myomas with surgery, as it may result in miscarriage. If myomas are close to the tubes and block the tubes, it is recommended to remove them with surgery, as it may prevent sperm passage and pregnancy.

Myoma surgery can be performed using an open surgery technique (laparotomy), a closed surgery technique (laparoscopy) or a hysteroscopic resection.