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Infertility is an increasingly common problem. Almost every fifth couple need the help of doctors to have a child. Fortunately, medicine can help them more and more effectively. The most modern methods of infertility diagnosis and treatment are also available in Poland. See what tests diagnose male and female infertility.

Infertilityis a drama of many couples. They used to be left alone with this problem, today they can count on the help of medicine, which has great achievements in this field. Aboutinfertilitydoctors say when pregnancy does not occur after a year of regular intercourse without the use of contraception. In this situation, it is approx. 20 percent. par.

Do you have to see a doctor then? If both partners are very young, you can still wait for it - in the next year, a few more percent of couples will conceive. However, if both, and especially a woman, are in their twenties, it is better not to wait and see a doctor specializing in fertility treatment. In certain situations, it is worth starting diagnostics even before the end of the year.

Causes of infertility

It's not true that a woman is usually responsible for infertility. Equally often - and more and more often - the cause of trouble is the male factor. He is directly responsible for the lack of pregnancy in approx. 20% of women. par, and coexists with other reasons in another 30-40 percent.

Causes of male infertility - deteriorating sperm quality

The quality of semen has been deteriorating for years. In 2010, the World He alth Organization considered it normal to have a concentration of at least 14 million sperm in 1 ml of semen, while 50 years ago the norm was 40-60 million sperm in 1 ml of semen.

Worse and worse semen is the result of, among others, environmental pollution, stressful and unhygienic lifestyle (stimulants), overheating of the testicles.

Other causes of infertility in men

Other causes of male infertility include:

  • bilateral cryptorchidism,
  • going through acute infectious diseases with testes reaction,
  • surgical procedures on the testicles and seminal cords,
  • erectile dysfunction and ejaculation,
  • hormonal or genetic disorders.

Causes of infertility in women

UIn women, ovulation disorders are a frequent cause of pregnancy failure. They may be the result of polycystic ovary syndrome, diseases of the thyroid gland, insufficiency of the hypothalamic-pituitary system, hyperprolactinemia or excessive body weight.

Another common cause of infertility is obstruction of the fallopian tubes, caused, for example, by adhesions formed after operations in the abdominal cavity, endometriosis, and inflammation. Sometimes the reason for the lack of pregnancy cannot be determined at all - it is then called idiopathic infertility.

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Stages of infertility treatment

Inability to get pregnant is always a problem for both partners, so both should visit a doctor and undergo tests at the same time. The first important element of diagnostics is the medical history. The data obtained from it make it possible to determine the chances of spontaneous pregnancy or to focus on treatment immediately.

The principle that doctors and patients should follow is to perform only the necessary examinations.

Male fertility research

The basic diagnostic test in determining a man's fertility is semen analysis (performed twice). It should be linked to an interview. If the history shows that there are any abnormalities or the results of semen analysis are incorrect, the man should be physically examined, taking into account the structure of the genitals.

More detailed tests (advanced methods of semen evaluation, hormonal and genetic tests, ultrasound) should be considered in couples with idiopathic infertility, and also in cases of ineffective treatment of the partner. In certain situations, a test for anti-sperm antibodies in semen (ASA) is performed.

Women's fertility tests

In a woman, diagnosis also begins with an interview and gynecological examination. The doctor asks about the age, date of the first menstruation, cycle length, symptoms accompanying ovulation and menstruation, family diseases, history of inflammation, diseases and operations.

Assessment of ovulation is very important, based on medical history, ultrasound of the ovaries and testing of progesterone levels 7 days before the expected menstruation.

In menstruating irregularly, the cause of the disorders should be determined by assessing the ultrasound examination of the ovaries and performing additional progesterone concentration tests 7 days beforethe expected menstruation. In irregularly menstruating women, the cause of the disorders should be determined by ultrasound evaluation of the ovaries and additional hormonal tests.

In women with amenorrhea, the concentration of prolactin, LH and FSH is checked; in the case of hyperprolactinaemia, magnetic resonance imaging is performed. In women with regular menstruation in late reproductive age, after ovarian surgery or advanced endometriosis, FSH levels are tested on cycle day 3 to assess ovarian reserve.

To assess the anatomical condition of the reproductive organs: ultrasound, hysterosalpingography (HSG), laparoscopy and hysteroscopy. HSG can tell if the fallopian tubes are obstructed or there are adhesions. It also informs about the shape of the uterine cavity and changes within it (septum, fibroids).

Laparoscopy is effective, but it is expensive and involves the risk of complications, so it is only performed when ultrasound or HSG results are abnormal.

Infertility treatment methods

Of the many treatments proposed in the past, only a few have proven to be really effective.

These methods are:

  • surgical treatment of selected lesions,
  • ovulation induction,
  • intrauterine insemination,
  • in vitro fertilization.

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Pregnancy