Absolute and relative infertility: what is the difference? Treatment and diagnosis of female infertility.

03.03.2009

Infertility cannot be viewed as a purely medical problem. It concerns all fundamental areas of family life: psychological, emotional, social. The number of childless couples in need of help is constantly growing. The causes of infertility are varied. They can be divided into objective and subjective. Objective factors include environmental pollution, a stressful lifestyle, poor nutrition, lack of rest and physical activity, while subjective factors include families often deciding to postpone the birth of a child until later, women taking contraceptives for several years, and terminating pregnancy.

Modern science has made huge strides forward over the past decades. Thanks to the latest discoveries, thousands of families have overcome the problem of childlessness and found the joy of motherhood and fatherhood.

Relative and absolute infertility

Infertility is considered both relative and absolute. Relative infertility includes reversible problems associated with the conception and birth of a child, while absolute infertility is an irreversible condition that does not give a chance of having children.

The term “relative infertility” is used in cases where a married couple has had regular sexual intercourse for two years without using contraception, but pregnancy does not occur. Relative infertility is potentially reversible with greater or lesser success, it all depends on the causes, and it is treatable. Absolute infertility is a completely different matter. If the reason lies in the physiology of one of the partners - for example, the woman does not have a uterus or the man does not develop sperm, then only then do they speak of absolute infertility. Doctors make a diagnosis of “absolute infertility” only in exceptional cases, because the rapid development of science makes it possible to solve this problem (in vitro fertilization, surrogacy, etc.).

Theoretically, every woman is able to give birth to a child during the period from the first to the last menstruation. But conceiving a child is most likely if ovulation occurs regularly. This time begins a few years after puberty and ends a few years before menopause.

Who is the reason?

The problem of infertility affects both partners. It is known that in 45% of cases the cause is a man, 45% - a woman and the remaining 10% - both or the cause cannot be determined.

The process of giving birth to a child is very complex and consists of many periods, at each of which failures can occur. At the first stage, an egg develops in the woman’s ovary, and sperm develops in the man’s testicles. The egg is released from the ovary during ovulation, and sperm are released at the time of ejaculation. The egg and sperm must enter the fallopian tube at the same time for fertilization to occur. Next, the fertilized egg begins to divide and an embryo develops. Then it penetrates the lining of the uterus. The development process of the embryo must proceed successfully - until the very moment of birth. The slightest violation in at least one of its phases can make pregnancy and childbirth impossible.

Female infertility

The causes of female infertility can be different, for example, metabolic disorders (diabetes, obesity, hypothyroidism - decreased thyroid function). The normal activity of the pituitary gland is very important - it is an organ that controls the hormonal balance of the body. The pituitary gland is responsible for the functionality of the thyroid gland and adrenal cortex, hypofunction and hyperfunction of which can lead to disorders of the reproductive system.

Infertility can be caused by diseases of the female genital organs: vagina (congenital defects, inflammation, antibodies to sperm in vaginal discharge), cervix (congenital defects, tumors) or polyps. There are known malformations of the body of the uterus - for example, a bicornuate uterus, adhesions in its cavity, tumors, endometrial diseases or an incorrect reaction to hormonal influences - all this prevents the embryo from gaining a foothold in the mucous membrane and developing correctly. Past inflammatory processes often lead to insufficient patency of the fallopian tubes and disruption of their contractile activity. A woman's ovaries, which are responsible for the formation of eggs, may be underdeveloped, in which case the eggs do not develop correctly. With chronic inflammatory processes, the maturation and release of germ cells is delayed, and as a result of tumors and cysts, ovarian tissue is degenerated.

Psychological and emotional factors have a significant influence. Prolonged stress and nervous tension disrupt a woman’s hormonal balance and often cause infertility.

Male infertility

Male infertility has two main causes. The first is that normal sexual intercourse is not performed, the second is the inability to fertilize. The latter can be caused by disturbances in spermatogenesis by the testicles, diseases of the spermatic cords, malfunctions of the immune system, for example, the body produces antibodies against its own sperm). In order for fertilization to occur, sperm must meet certain parameters in terms of the quality of genetic material, structure, quantity, viability and mobility. Much also depends on the composition of the seminal fluid, the patency of the seminiferous tubules and vas deferens.

Special studies

To determine the causes of infertility, a man and a woman need to consult a specialist who will determine the cause of this problem. A woman will have to undergo a gynecological examination, an assessment of the monthly cycle, bacteriological cytology and tests, ultrasound diagnostics, laparoscopy and hysteroscopy, and sometimes hysterosalpingography. The man's genitals are examined, hormone levels are determined, seminal fluid and sperm, chromosomes are tested, and in some cases it is necessary to do a testicular biopsy. If the partners do not show any abnormalities, they will be offered immunological tests to find out whether the husband’s sperm are able to penetrate the wife’s cervical mucus and whether they are destroyed by specific antibodies. All studies take a lot of time, but they allow you to accurately determine the cause of infertility and prescribe the necessary treatment.

Treatment

Treatment for infertility depends on the cause. Psychotherapy helps those who have an emotional problem. In case of thyroid dysfunction, hormonal treatment is required. Surgical intervention is prescribed for anatomical pathologies: tumors, adhesions, tubal obstruction. If the cause of infertility is the lack of ovulation in a woman or insufficient sperm count in a man, hormonal stimulation is offered. Inflammatory processes of the cervix or vagina require treatment with antibiotics. The last method, and sometimes the last chance for many couples, is assisted reproductive technologies: insemination (the prepared seed of the husband is introduced into the uterus) and artificial insemination (in vitro or in vitro fertilization). The main essence of “in vitro” fertilization is that an egg is taken from a woman, and sperm from a man, they are united in the laboratory, and at the stage of a zygote (fertilized cell) or embryo they are introduced into the endometrium. The success rate of this treatment method is estimated at 25%.

The main thing is not to deviate from the intended goal and believe in a positive result of treatment and pregnancy! Therefore, believe that everything will work out. And wish for a child!

Infertility in women is the inability to conceive a child. Absolute female infertility is caused by irreversible changes in the pelvic organs. This form of the disease is relatively rare. All other forms of infertility can be effectively treated.

THE COST OF AN APPOINTMENT WITH A GYNECOLOGIST IN OUR CLINIC IS 1000 rubles. Consultation on the results of tests and ultrasound - 500 rubles.

Ten out of a hundred couples show signs of infertility. Moreover, contrary to popular misconception, in almost half of the cases the reason lies in the health of men, and in other cases the reason lies in the health of women. Therefore, in order to understand what is an obstacle to conceiving a child, you need to examine both partners.

Types and causes of female infertility

Infertility is assumed when a woman does not become pregnant for 1–2 years with regular intimate life without the use of contraception. It is recommended to be examined after six months of problems with conception.

Infertility can be:

• Primary when a woman has never become pregnant throughout her life;
• Secondary which occurred after a successful or unsuccessful pregnancy in the past.

Possible causes of female infertility include many factors, but the most common causes are the following:

• increasing the level of the hormone prolactin;
• tumors and neoplasms in the pituitary gland;
• hormonal imbalance;
• structural defects of the pelvic organs;
• obstruction of the fallopian tubes;
• endometriosis;
• diseases of the pelvic organs;
• mental disorders;
• incompatibility of partners.

Depending on the reason for which conception does not occur, the following main forms of infertility in women are classified:

• Hormonal form - due to hormonal imbalance, a woman does not experienceovulation, the reasons can be both physiological and psychological;
• Uterine form - in the presence of various uterine defects;
• Immune form - presence of antisperm antibodies;
• Tubal-peritoneal form - obstruction of the fallopian tubes;
• Infertility caused by endometriosis .

As you can see, there are many reasons for this terrible diagnosis. They can be broadly divided into absolute and relative.

Absolute causes of female infertility

Absolute infertility is characterized by a woman’s inability to conceive and, moreover, bear a child due to irreversible changes in her body. Absolute infertility is, indeed, a death sentence, and with it there is not the slightest chance of a new life being born under the heart. Fortunately, there are few reasons for absolute infertility and all of them, one way or another, are associated with the absence or underdevelopment of the reproductive organs.

• Absence of uterus . This pathology can be congenital or acquired. Congenital absence of the uterus - Rokitansky-Küstner syndrome - is diagnosed in adolescence when a girl’s menstruation does not begin. In addition, the uterus can be surgically removed if it has a malignant tumor, neoplasm, severe endometriosis, or mechanical damage.
• Absence of ovaries . It can also be congenital and acquired. Congenital absence of the ovaries - Shereshevsky-Turner syndrome - is characterized by chromosomal abnormalities. Artificial removal of the ovaries is carried out in cases of severe inflammatory processes and the development of tumors in them.
• Bicornuate uterus with internal septum . With this anomaly, conception is possible, but pregnancy is impossible. The internal septum prevents the embryo from developing and it happens to a woman.
• Small size of the uterus . Baby uterus syndrome, or as this anomaly is also called, infantilism or hypoplasia, is characterized by the insufficient size of this organ to bear a baby.

All pathologies that cause absolute female infertility are easily identified by ultrasound examination.

Relative causes of female infertility

These causes of infertility are called relative because with adequate and timely treatment they can be eliminated. In some cases, to restore a woman's ability to conceive and bear fruit may require many years of treatment and restorative procedures.

The reason for a woman’s inability to conceive and bear a child can be anything; the first step to eliminating this problem will be to correctly determine the true etiology (cause). Knowing the cause, you can cure female infertility in less than a year.

Primary diagnosis of infertility

To diagnose infertility, you need to conduct a series of studies. Often prescribed:

• Postcoital test– the study determines whether sperm activity occurs after they enter the woman’s body.
• - for this, on certain days of the cycle, the woman donates blood to determine the level of various hormones, and also monitors the rectal temperature for one or two cycles in order to build temperature curves for subsequent study.
• – allows you to identify pathologies of the organs of the reproductive system and the presence of neoplasms of this localization.
• Carrying out hormonal tests– provide a more accurate picture of a woman’s hormonal health.
• - carried out to determine signs of endometriosis.
• Hysteroscopy or laparoscopy- carried out to exclude or confirm uterine infertility. During the procedure, the doctor carefully examines the condition of the uterus, because these are one of the most accurate diagnostic methods.

Tests are also carried out for the presence of sexually transmitted infections and x-rays of various organs, the condition of which may affect reproductive function.

Endocrine (hormonal) infertility

Every third woman with infertility is diagnosed with hormonal disorders, which may be the reason for the lack of pregnancy. Endocrine diseases require hormonal treatment.

What is endocrine infertility

Endocrine infertility is a complex of pathologies that have one cause - hormonal imbalance. The functionality of the reproductive system directly depends on the hormonal balance, therefore the treatment of endocrine infertility is based on detailed diagnosis and precise selection of hormonal agents.

A woman's hormonal levels are affected by:

• (dysfunction of the ovaries, adrenal glands, hypothalamic-pituitary system, thyroid gland, diabetes mellitus and severe obesity, weight deficiency).
• Hereditary causes.
• Ovarian cysts and uterine tumors.
• Inflammatory gynecological diseases.
• Surgical abortions, especially during the first pregnancy.
• Physical and nervous stress when combining work, study and family life.
• Features of professional activity and environmental factors.

Top causes of hormonal infertility

Impaired egg maturation and lack of ovulation are caused by:

• Excessive production of the hormone prolactin - a common endocrine disorder resulting from pathology of the pituitary gland. Excess prolactin in a woman’s body causes a natural contraceptive effect similar to what is normally observed in pregnant and breastfeeding women.
• Endometriosis – with this disease, the work of a woman’s reproductive organs is disrupted due to adhesions and neoplasms.
• Polycystic ovary syndrome occurs when there is a complex disruption of the ovaries, pancreas and thyroid glands, which leads to the cessation of egg maturation.

Inability to conceive due to diabetes mellitus, obesity, pituitary gland dysfunction, hypothyroidism, kidney, adrenal and liver diseases is also common. All these diseases lead to insufficiency of the luteal phase of the monthly cycle due to a deficiency of progesterone and estrogen in the body and, as a consequence, to impaired egg maturation.

Types of endocrine infertility

Depending on the type of infertility, a method for restoring ovulation is selected:

• Chronic anovulation,arising due to polycystic ovary syndrome, dysfunction of the pituitary gland and adrenal glands, premature ovarian failure.
• Luteal phase deficiencyassociated with progesterone deficiency, which leads to poor mobility of the fallopian tubes and pathological changes in the endometrium, interfering with embryo implantation.
• Hyperprolactinemiacaused by a tumor of the pituitary gland or problems with the functioning of the thyroid gland.
• Early luteinization of follicles without ovulation.
• Hypothalamic-pituitary disordersassociated with brain tumors, genetic disorders, systemic diseases, injuries, poisoning.

Diagnostics

Forms of endocrine infertility are identified through a comprehensive examination.

• The regularity of the cycle is assessedwith ovulation tests.
• . Ultrasound to track the development of follicles. On certain days of the cycle, ultrasound monitoring is performed to measure endometrial thickness and assess follicular growth. If necessary, an endometrial biopsy is performed. .
• . For patients with suspected endocrine infertility on the 3-5th day of m.c. Before 11.00, venous blood is taken on an empty stomach for laboratory analysis. If necessary, functional and hormonal tests are carried out.
• X-ray of the skull and MRI of the brain. They are carried out if a brain pathology is suspected.

Treatment methods

Treatment regimens for patients with endocrine infertility are developed individually and may include several areas:

• Conservative methods with the selection of maintenance doses of hormonal drugs for 3-4 months, then agents that promote ovulation are added. A diet is prescribed to normalize weight.
• In case of polycystic ovary syndrome in young women (if the spouse's sperm count is normal), an operation is performed, after which ovulation is restored.
• For hormonal infertility, gynecological massage and physiotherapy are useful - electrophoresis with copper and zinc preparations on the pelvic area, quantum hemotherapy, ozone therapy, reflexology. The methods are effective only in complex treatment.
• If the problem is related to stress, psychotherapy is carried out with the selection of sedatives and normalization of the rest regime.

Prevention

The development of endocrine infertility can be prevented by treating hormonal disorders, normalizing weight, and correcting psycho-emotional and physical stress. It is important to regularly see a gynecologist-endocrinologist for any menstrual irregularities.

Uterine infertility: pathological changes in the uterus

About a third of cases of female infertility are associated with pathological changes in the uterus, leading to miscarriage of fertilization of the egg.

What is uterine infertility

Uterine infertility is a condition in which a woman with a normal ovulatory cycle and hormonal levels cannot become pregnant due to uterine pathologies that prevent the embryo from attaching to the endometrial layers. Pathologies include mechanical and anatomical obstacles that make conception, the formation of a fertilized egg or the development of the fetus impossible, due to repeated miscarriages during pregnancy.

Thanks to the capabilities of modern diagnostics and low-traumatic medicine, overcoming uterine infertility is possible in most cases.

Causes of uterine infertility

Infertility of this type occurs against the background of various pathologies in the uterine cavity:

• , multiple or single large nodes are especially dangerous, preventing the implantation of the embryo or causing miscarriage and premature birth.
• Endometrial hypoplasia or, conversely, endometrial hyperplasia.
• (lumpy formations on a thin connective tissue stalk).
• Intrauterine synechiae(fusion) with complete or partial fusion of the uterine cavity with constrictions and partitions made of connective tissue fibers.
• Foreign bodies in the uterine cavity(remains of an intrauterine device or suture material after gynecological operations) can mechanically impede the advancement of the egg or lead to the development of endometritis (chronic inflammation with an asymptomatic course).
• Pathological development of the uteruswith the formation of intrauterine septa, a saddle-shaped, one-horned or two-horned uterus can provoke persistent infertility.
• Pathologies of the cervix(changes in the properties of cervical mucus - acidity, viscosity, stenosis - narrowing of the cervical canal) interfere with fertilization.

Diagnostics

Comprehensive diagnostics helps to quickly and clearly identify pathological changes in the uterus that cause infertility and develop a treatment regimen. The set of diagnostic procedures includes laboratory and hardware tests:

• Patient interview. An important part of the examination, which makes it possible to suggest a diagnosis even before the examination begins. Thanks to this step, the number of analyzes can be reduced. The gynecologist studies data about the patient’s inflammatory and gynecological diseases, characteristics of previous pregnancies, and the presence of symptoms of diseases of the reproductive system.
• Assessment of menstrual cycle abnormalities. For women expecting infertility, it is important to constantly keep a calendar of their monthly cycle. Deviations in the parameters of menstruation (intensity, regularity and duration of bleeding) are characteristic of endometrial pathologies and the development of myomatous nodes.
• . The doctor determines the anatomical position of the uterus and its parameters, assesses the condition of the appendages and ovaries.
• . Bacteriological analysis of biomaterial from the genital tract and , detecting infections and identifying the pathogen. Microscopic examination of a cervical smear to assess possible cervical pathologies contributing to the development of infertility.
• with determination of the position of the uterus, the presence of fibroids and adhesions, polyps and other pathologies. If necessary, it is performed with contrast (a coloring liquid is injected into the uterus).
• for subsequent tissue histology. Detects uterine hyperplasia and cervical pathologies.
• Hysterosalpingography. X-ray of female organs using contrast fluid. It is done if it is necessary to assess the patency of the uterus and its deformation, to study the location of large polyps and adhesions. It is prescribed as a last resort, as the procedure is unpleasant and painful.

Treatment methods

The choice of treatment method is related to the pathology causing uterine infertility:

• Small fibroids that prevent conception are treated conservatively with hormones, while large tumors and multiple fibroids are removed surgically. After surgical treatment, you will need to wait for the formation of a full-fledged scar on the uterus, then you can plan a pregnancy.
• In case of infertility due to endometrial hyperplasia, followed by hormone therapy.
• Adhesions, septa and adhesions in the uterine cavity that interfere with the advancement of the egg are surgically removed. Next, hormonal therapy is carried out to prevent the formation of repeated synechiae.
• Endometritis caused by foreign elements in the uterus is treated with antibiotics after removing parts of intrauterine devices or suture material found in the cavity.
• Certain anatomical features of the uterus are treated with surgical methods. In this case, it is necessary to choose low-traumatic techniques.

Preventive measures

Many causes of uterine infertility can be prevented with the help of preventive measures - it is enough to avoid abortions, promptly treat inflammation and protect against sexually transmitted infections.

Even in the absence of symptoms, you need to undergo a gynecological examination every six months to identify hidden pathologies or infections and consult on the selection of contraceptives. The appearance of any unpleasant sensations in the genital area or menstrual irregularities is the reason for an urgent visit to the gynecologist.

Tubal infertility, tubo-peritoneal infertility

Half of women with infertility are diagnosed with a tubo-peritoneal form of pathology, which is considered the most difficult from the standpoint of restoring the functionality of the reproductive organs.

The combination of peritoneal and tubal infertility is associated with the action of several negative factors at once, so the real opportunity for a woman with such a diagnosis to become pregnant depends on the choice of medical institution and the competence of the doctors working with the patient.

What is tubal infertility

Tubal infertility - infertility caused by problems with the patency of the fallopian tubes. Adhesions and inflammations that cause narrowing of the channels through which the egg moves are formed as a result of acute and chronic inflammation in the uterus, fallopian tubes or ovaries. Obstruction of the fallopian tubes leads to the inability to conceive, since the eggs will not be able to pass into the blocked fallopian tube. And a pathological change in the inner layer of the uterus caused by inflammation will prevent normal implantation of the embryo into its wall.

Causes of tubo-peritoneal infertility

Combined infertility occurs against the background of obstruction of the fallopian tubes and adhesions in the pelvic area. Causes:

• , especially chlamydial infection, lead to partial or complete obstruction of the fallopian tubes, their swelling and deformation of natural folds, destruction of the fimbriae and epithelial layer.
• Abortions and gynecological surgeries, unskilled disrupt the microflora, injure the mucous membrane, causing endometritis, salpingitis and other diseases, and provoke multiple adhesions.
• Laparoscopic operations, especially emergency ones, if it is necessary to remove uterine fibroids, ovarian cysts or ectopic pregnancy, can trigger the development of adhesions with the formation of fibrous formations, which subsequently transform into connective tissue adhesions.
• Launched with deep tissue damage, the formation of cysts on the ovaries and involvement of the fallopian tubes leads to a chronic adhesive process with tubal obstruction.
• Hormonal imbalanceagainst the background of excess production of male and stress hormones. The process leads to a decrease in the tone of the fallopian tubes and a slowdown in the movement of a mature egg through them.
• Postoperative complications with purulent processes, previous peritonitis, inflammation of the intestines, bladder.

A history of ectopic pregnancy, in which one or both tubes were removed, is also a cause of tubal infertility. If one tube is preserved, pregnancy can occur naturally. If both tubes are removed, conception is possible only with the help of IVF.

Symptoms and complications

Patients with tubal obstruction and adhesions in the pelvis are bothered by cramping or constant pain in the abdomen and menstrual irregularities. Without timely diagnosis and treatment, adhesions lead to complications:

• • Ectopic pregnancy b.
  • Persistent infertility.
  • Impossibility of pregnancy due to complicated endometriosis.

Diagnosis of tubo-peritoneal infertility

Correct treatment is possible only based on diagnostic results that determine all the causes of infertility, the degree of activity of pathological processes and reproductive dysfunction.

The examination includes:

• Examination by a gynecologist. Study of symptoms, nature of pain, cycle parameters and other important signs of gynecological pathologies. Generalization of information on past diseases and operations.
• Mmicroscopic analysis of urogenital smearsfor sexually transmitted infections. Culture of a gynecological smear in order to select antibiotics active for the identified pathogen.
• Hysterosalpingography (X-ray with contrast) to identify the nature and location of adhesions, the condition of the fallopian tubes and ovaries.
• Endoscopic examination(laparoscopy) identification and dissection of adhesions.

Treatment methods

Treatment of tubo-peritoneal infertility involves:

• Carrying out fimbryoplasty and fimbryolysis.Surgical formation of fallopian tube funnels to ensure their patency.
• Laparoscopic dissection of adhesionsusing surgical manipulators, pressurized water jets, current or laser radiation.
• Salpingostomy.Creation of artificial openings in the fallopian tubes, restoring their patency when completely closed.
• Postoperative physiotherapy.Electrophoresis with copper, zinc preparations, pulsed ultrasound and other methods that accelerate tissue restoration, improve blood flow and metabolic processes in the pelvis.

If it is impossible to restore tubal patency, assisted reproductive technologies are used.

Prevention

Prevention of the occurrence and aggravation of tubo-peritoneal infertility includes mandatory treatment of gynecological inflammations, including STIs (STDs). Careful personal hygiene and regular gynecological examinations are required, as well as the use of barrier contraception and the prevention of abortion.

Immunological infertility

Immunological infertility accounts for 10% to 20% of all cases of reproductive disorders.

What is immunological infertility

Immune infertility is the inability to conceive due to the female body’s rejection of sperm or fertilized eggs.This female infertility is rare and difficult to correct. Most often, sperm die in the cervical mucus due to antibodies produced by the female body.

With autoimmune thyroiditis, the female body produces antibodies that interfere with the continuation of pregnancy and provoke miscarriage in the early stages. Autoimmune disorders of the adrenal cortex block the onset of ovulation.

Causes and types of immunological infertility

Immunological infertility manifests itself in non-occurrence of pregnancy due to damage to sperm by specific immune cells - antisperm antibodies (ASAT). They can be produced in a woman’s body or in a man’s seminal fluid. As a result, with an immunological factor, the body perceives the male reproductive cell as harmful and destroys it.

The following types of ASAT are distinguished:

• Sperm-immobilizing ASAT. Antibodies completely or partially immobilize sperm. Heavy antibody cells (IgG, IgA, IgM) attach to the head or tail of the sperm, making it difficult for it to move towards the egg.
• Sperm agglutinating ASAT. These antibodies glue sperm together and with other cells and mucus particles. The sperm loses its viability (dies).
• Spermolizing ACAT. Antibodies are aimed at the complete destruction (destruction) of germ cells.

Depending on the carrier of antisperm antibodies, male and female immunological factors of infertility are distinguished.

Male immunological factor

Sperm in the human body are produced during puberty. Nature intended that male reproductive cells should not have direct contact with the host’s blood. If germ cells enter the systemic bloodstream, the immune system perceives them as a foreign aggressive agent and triggers a defense mechanism - antisperm antibodies. This is how an autoimmune reaction develops. The probability of identifying the cause of male immunological infertility is 15%.

Sperm can enter the bloodstream for the following reasons:

• Anatomical development abnormalities: testicular torsion, varicocele, inguinal hernia, cryptorchidism.
• STIs are sexually transmitted infections.
• Chronic inflammation: prostatitis, orchitis, epididymitis.
• Injuries.

Female immunological factor

For the female body, sperm are by nature foreign, so the vaginal mucosa does not allow male cells to enter the general bloodstream, so as not to provoke an immune response. If contact between male reproductive cells and the immune system has taken place, the body produces antisperm antibodies. The probability of identifying female immune factor infertility is 30%.

Diagnostics

First of all, laboratory analyzes of biological materials are carried out: the blood of both partners, the man’s seminal fluid and the contents of the woman’s cervical canal. The material is used to perform several tests:

• Shuvarsky test– determines whether the partner’s seminal fluid is compatible with the woman’s cervical mucus. The test is taken at ovulation, 4-5 hours after sexual intercourse.
• MAR test– determines the number of sperm exposed to ACAT. The diagnosis of immunological infertility is made if more than half of the germ cells have been inactivated by antigens.
• Kurzrock-Miller test– study of the penetrating properties of seminal fluid.
• Bouveau-Palmer test– comparative analysis of the penetrating ability of sperm from several donors.

Treatment of immunological infertility

The presence of antisperm antibodies in one or both partners does not mean that pregnancy is completely impossible, but it significantly reduces the likelihood of natural conception. Partners must understand that it will not be possible to completely eliminate the formation of ACAT antibodies, since this requires fighting the body’s immune system, which is unsafe.

There are a number of measures that reduce the quantitative content of immune bodies in the blood. One of the methods is long-term use of barrier contraception followed by its cancellation. Some antihistamines also suppress the formation of immune cells.

Cervical infertility in women is a result of abortion

It occurs due to various pathologies of the cervix, or more precisely due to cervical mucus. Cervical mucus is necessary for transporting sperm inside the female body to the fallopian tube, in the villi of which there is a mature egg awaiting fertilization. If there is not enough mucus or it is too thick, then sperm will not be able to penetrate through it. This pathology can occur due to frequent abortions or deformation of the cervix.

Menstrual irregularities

Must be regular and precise like clockwork. Since the cause of infertility is the irregularity and lack of ovulation, outwardly this can be expressed in the irregularity and absence of menstruation. The reason for this may be a strict diet, stress, unfavorable living conditions, etc. When these factors are eliminated, menstrual function resumes on its own.

Idiopathic female infertility or infertility of unknown origin

Unexplained (idiopathic) infertility is quite rare, and, as a rule, has causes that specialists simply could not determine during previous tests and tests.

What is idiopathic infertility

Idiopathic infertility is the absence of pregnancy for an unknown reason. The diagnosis is made after completely excluding all possible pathologies. Many practicing doctors are skeptical about this diagnosis, believing that there is still a reason, and its identification is only a matter of time. Others are sure that it’s all about the subconscious and negative thoughts. Sometimes, indeed, pregnancy in a woman with such a diagnosis occurs when she stops expecting it.

We can talk about idiopathic infertility only if a woman has a regular menstrual cycle with high-quality ovulation, and her partner’s sperm count is normal. To make a diagnosis, you should exclude:

• Genetic factors and childhood diseases that complicate conception.
• Hormonal imbalances.
• The presence of inflammatory processes or adhesions.
• Pathologies of the reproductive organs in men and women.
• Problems with spermogenesis and the activity of male germ cells.
• Immunological factor of infertility.
• Incompatibility of partners.

Treatment of idiopathic infertility

If both partners are completely healthy, the couple should pay attention to the frequency of sexual intercourse. The belief that frequent sex significantly increases the chances of conceiving a child is not without common sense. But too much sexual intercourse does not allow full-fledged viable sperm to mature, which significantly reduces the likelihood of pregnancy. As for rare sexual intercourse, partners may miss ovulation, which occurs at different times in different menstrual cycles. The best sex life schedule is “every three days.” This increases the chances of a woman ovulating and maturing a normal number of sperm in a man.

The main and most difficult problem of all couples who are faced with infertility, especially its idiopathic form, is the psycho-emotional factor. Psychologists say that sometimes a woman on a subconscious level does not accept pregnancy, while being absolutely sure that she wants to become a mother. Obsession with the painful topic of pregnancy also prevents conception, as it provokes depression and apathy after each new unsuccessful attempt.

Treatment of female infertility

After the doctor has examined the woman, he decides what treatment to prescribe for her. First of all, the primary cause of infertility should be eliminated.

If the patient has a hormonal form of infertility, she is prescribed appropriate therapy. Then the course of the disease is monitored. Most women (more than seventy percent) become pregnant after undergoing the test.

• In cases of uterine infertility, complex operations are performed to restore the normal state of the uterus. The probability of cure in such patients is 15-20%.
• In the case when a woman has a tubo-peritoneal form of infertility, an operation is most often performed, during which the normal patency of the tubes is restored. More than a third of patients become pregnant after undergoing treatment.
• In case of endometriosis, the source of the disease is surgically removed, after which a course of treatment with medications is carried out. More than 30% of women conceive after treatment.
• Immunological infertility is usually the most difficult to treat. In most cases, the couple is offered artificial insemination.

The effectiveness of infertility treatment decreases with age. At the same time, effective diagnosis and treatment of all forms of infertility is carried out, regardless of the age and health status of the patient.

Many couples face the problem of infertility quite often, but only 10-20% of them actually experience infertility.

What is female infertility?

Many young families live for a long time for themselves, without thinking about the children, and when this comes up “closely”, problems begin.

Others plan offspring when it happens on any day of the month, without even knowing about fertile days, and when they encounter the problem of conception, they run to a specialist, independently diagnosing themselves with infertility! But in fact, the reason is banal - ignorance of your body and physiology! Let's look at all the issues related to infertility.

The concept of infertility in women means the absence of pregnancy in a woman of reproductive age during a year of regular sexual activity on fertile days of the cycle (ovulation) without the use of contraceptive methods.

What leads to female infertility?

The causes of infertility in women are very diverse. Moreover, the problem can be not only for the woman, but also for the partner; according to statistics, approximately the same number of men and women suffer from infertility, on average 40% and 45%, respectively.

There are primary and secondary infertility. Primary, when a woman has never had a pregnancy in her life, and secondary infertility – there have been pregnancies, but at the moment all attempts are unsuccessful.

Most likely reasons secondary infertility Abortions and spontaneous miscarriages, especially those with complications, as well as ectopic pregnancies are considered.

The concept of absolute infertility implies the inability to become pregnant naturally when a woman does not have reproductive organs - the uterus, fallopian tubes, ovaries. So, the main causes of female infertility:

Psychological factors

Stress at work, conflicts in the family, dissatisfaction in the sexual sphere, a painful and obsessive desire to have a child, all this leads to hormonal disorders and ultimately lack of ovulation. Due to the fact that stress, affecting the nervous system, causes excitation processes in the brain, where the pituitary gland and hypothalamus are located, which are responsible for the production of female sex hormones, the woman’s body responds with a violation of ovarian-menstrual function and the absence of pregnancy.

For example, this is why many young girls, during stress during the exam period, experience disturbances in the cycle (delays or vice versa).

Endocrine infertility

In 35–40% of cases, the cause is hormonal disorders in the woman’s body, leading to anovulation (lack of ovulation), a decrease in progesterone, the hormone of the second phase of the menstrual cycle (luteal phase insufficiency).

Anovulation develops as a result of an increase in the level of the hormone prolactin, male hormones (testosterone, DHEAS), a decrease or increase in estrogen, metabolic disorders (metabolic syndrome, increase or decrease in body weight), diseases of the thyroid gland or adrenal glands.

When progesterone decreases in the second phase, a sufficient amount of endometrium does not grow, necessary for the implantation and development of a fertilized egg, so pregnancy cannot develop and does not occur. Insufficiency of the luteal phase is observed with a decrease in the function of the corpus luteum of the ovaries that produce it, as well as with disruption of the menstrual cycle, inflammation of the ovaries, and the same reasons that lead to anovulation.

Tubal infertility

(tubal-peritoneal) Develops in 20-30% of cases of all forms of female infertility. The reason for its development is anatomical changes in the fallopian tubes, disruption of their function and patency due to inflammatory diseases or surgical interventions on them, as well as endometriosis.

The adhesive process in the area of ​​the uterine appendages leads to peritoneal infertility, when due to adhesions the egg from the ovary cannot reach the tube and then the uterine cavity.

It is worth noting that in such women, if pregnancy occurs, there is a high probability of developing an ectopic pregnancy. Since fertilization occurs in the fallopian tubes and then the fertilized egg is sent down for implantation into the wall of the uterus, and if there are adhesions in the tube, it is delayed and begins to grow and develop outside the uterine cavity, but within the fallopian tube.

And even in very rare cases, the development of an embryo in the ovarian or abdominal cavity, which is very dangerous for the woman’s life and poses a threat to the fetus.

Immunological infertility

Develops less frequently (in 2% of cases). The reason for its development is the immunological incompatibility of a man and a woman, as a result of which the woman produces antisperm antibodies that destroy the man’s sperm.

Infertility due to diseases

Infertility due to gynecological diseases occurs when it is impossible for a fertilized egg to implant into the wall of the uterus due to the presence of adhesions or septa (synechias) in it due to inflammation or curettage in the past. As well as congenital anomalies of the development of reproductive female organs.

The causes also include myomatous nodes that deform the uterine cavity, polyps and endometrial hyperplasia, endometriosis. These reasons occur in 15-25% of cases.

Diagnosis of infertility

It is mandatory to examine both spouses to exclude male factor infertility. And also if all joint tests have been completed in full and their results are good, but the cause of an infertile marriage is unclear, a joint consultation with a geneticist and a study of the chromosome set of each partner is recommended to exclude chromosomal mutations and anomalies in the genotype.

For a man, the examination protocol includes:

• Spermogram. Its normal indicators are the total number of sperm in the ejaculate - more than 20 million per ml, of which at least 25% should remain actively mobile one hour after the test and at least 50% of the normal structure, without gluing. The total volume of ejaculate is more than 2 ml. Leukocyte content should not exceed 1 million per ml.
• Tests for sexually transmitted infections
• Hormonal study

Examination for infertility in women:

Infertility treatment

Treatment of female infertility is multifaceted and requires an individual approach, depending on the cause of its occurrence.

Thus, endocrine infertility is treated by stabilizing a woman’s hormonal levels using hormonal drugs that normalize menstrual function. At the same time, it is important to correct a woman’s body weight. In case of anovulation, ovulation stimulation is used with special hormonal drugs.

If pregnancy has not occurred within a year of hormonal treatment, hysteroscopy and therapeutic and diagnostic laparoscopy are suggested.

In the tubal-pretoneal form, treatment of infertility in women begins with the method of restoring the patency of the fallopian tubes using laparoscopy, in which adhesions are separated and concomitant pathology, if any, is simultaneously eliminated (endometriosis, myomatous nodes, ovarian cysts).

This treatment method is not applicable if there are acute inflammatory processes in the pelvis, the woman is over 35 years old and has been infertile for more than 10 years. In case of existing absolute obstruction that cannot be corrected, the IVF method is used.

If a woman has immunological infertility, assisted reproductive technologies are used - IVF and ICSI. If there is a concomitant infection, it is treated, after which, before ovulation, estrogens are prescribed for the onset of spontaneous pregnancy, having initially warned the married couple about the use of condoms 6 months before attempting spontaneous fertilization, in order to reduce the antigenic influence of the woman’s body on the husband’s sperm.

In case of infertility of unknown origin, after a preliminary full course of examination and unsuccessful attempts at pregnancy, in vitro fertilization is ultimately offered.

In case of male factor infertility, the partner is examined and treated, and if this is unsuccessful, artificial insemination of the woman with a donor is used or ICSI technology is used (laboratory injection of the husband's sperm into the woman's egg).

When a couple loses all hope for their pregnancy due to anatomical pathologies of the reproductive organs (absence of the uterus) in a woman, surrogacy or adoption comes to the rescue!

In conclusion, I would like to say that a couple’s step-by-step comprehensive approach to examination, strict adherence to all doctors’ recommendations and faith in the result contribute to victory in the fight against infertility! After all, there is always a way out - even adopting a baby and raising him will make you a happy family, even if you are diagnosed with an infertile marriage! The most important thing is that you will become parents! Good luck to you and your future family!

In the modern rhythm of life, sometimes women do not pay due attention to their health. At first, everyone tries not to notice the problems, and when doctors diagnose “Infertility”, they begin to complain about their fate. Modern medicine has come a long way. It helps to cope with all terrible diseases. It is worth studying in order what infertility is and how it manifests itself.

Detailed description of the diagnosis

Infertility is the inability of a couple to conceive a child naturally through regular and unprotected sexual intercourse. Doctors make this diagnosis if a woman is unable to conceive for one year or more. In the medical community there is such a thing as absolute infertility. It is expressed not only in the inability to get pregnant, but also in the presence of irreversible anatomical changes. But first things first.
There are statistics that are impressive. For example, in the United States, every fifth couple suffers from infertility. In Russia, 10-15% of families are diagnosed. In 40% of couples, male infertility is to blame. It occurs for a number of reasons, for example:

• infectious diseases;
• seminiferous tubules are impassable;
• hormonal imbalance;
• low potency;
• psychological disorders associated with lack of potency.

Types of infertility

Experts divide infertility into two groups. One of them is called absolute. It is placed when there are irreversible anatomical changes in the female body and it is simply impossible to conceive a child naturally:

• absence of ovaries and fallopian tubes;
• no uterus;
• Poorly developed genitals.

If we single out absolute infertility as a separate phenomenon, then we can distinguish a number of main types of infertility:

• masculine;
• feminine;
• combined;
• incompatibility between men and women;
• endometriosis;
• infertility is unclear or idiopathic.

There are separate subtypes of female infertility, namely:

• tubal infertility;
• tubo-peritoneal;
• endocrine.

Experts highlight infertility cycle. It can be temporary or permanent. The first includes minor changes in the body associated with a change in time zone or sudden climate change.
It is worth considering each of the presented types in detail.

Combined infertility

The problem of infertility in this case is associated with health problems in both the male and female body. In such cases, experts suggest treatment together with your partner.

Female and male incompatibility

The husband and wife are absolutely healthy, but conception does not occur. The answer lies in the incompatibility of the spouses, which is called biological or immunological. The causes of infertility lie in the production of antibodies. They are formed in the male and female body. It happens like this:

1. Antibodies in the male body accumulate in sperm.
2. Female antibodies are concentrated in the mucous membrane of the cervical canal.
   In turn, they completely block
   the work of male antibodies.

Incompatibility can manifest itself in Rh conflict. Before planning a child, you can undergo diagnostics and determine whether there is incompatibility in the couple. The following methods exist for this:

1. Postcoital test. It should be taken in the middle of the menstrual cycle, when a woman is ovulating. To do this, examine the posterior vaginal vault and the cervical canal.
2. Test for sperm permeability during ovulation. To do this, they are placed in the woman's cervical canal.
3. Determination of sperm activity in the cervical canal.

Based on all the findings, specialists make a diagnosis. To ensure the reliability of the tests, it is recommended that you stop using hormonal drugs in the month in which you will undergo the examination.

Endometriosis

This is a common gynecological disease. May appear as:

• dizziness;
• heavy discharge during the menstrual cycle;
• severe pain in the lower abdomen during intercourse.

If such symptoms are observed, this does not mean that there is endometriosis. It can sometimes be difficult to establish on ultrasound. Patients may experience outbursts of aggression, tearfulness, and an unbalanced state of mind. The doctor will make an accurate diagnosis only after a complete clinical and ultrasound examination. Infertility in women associated with endometriosis is not due to the disease itself, but to associated disorders and failures. These include:

• ovulation disorder;
• formation of adhesions on the ovaries and fallopian tubes;
• disruption of the uterine mucosa and its inferiority.

Endometriosis can lead to relative infertility. Treatment can overcome the disease. It includes:

• hormone therapy;
• radon baths;
• radiation therapy;
• surgery.

Treatment for endometriosis can take anywhere from several weeks to six months. It all depends on the degree of the disease.

Idiopathic infertility

In most cases, it is diagnosed in women whose age has passed over 40 years. Idiopathic infertility disease is confirmed only by a complete study, which shows the following:

• regular ovulation;
• normal hormonal levels;
• uterus without pathologies;
• no adhesions on the ovaries;
• absence of antibodies;
• postcoital test is positive.

The following indicators must be confirmed in a man:

• good spermogram;
• antibody test negative.

Spouses should not have infectious diseases that are sexually transmitted. And, of course, there must be regular sexual intercourse during ovulation for at least a year.
If a married couple has not had children for about a year, then they are diagnosed with this type of infertility. There are reasons why doctors make this diagnosis:

• disturbances in the functioning of the endocrine and reproductive systems have not been established;
• constant menstruation and ovulation;
• good patency of the fallopian tubes;
• good cervix;
• no genetic diseases.

In these cases, experts strongly recommend paying attention not to your physical condition, but to your psychological one. There is no treatment for the disease. To get pregnant, you can resort to the following methods:

1. Insemination. The doctor will use a catheter to inject sperm into the uterine cavity. This method is considered close to natural conception.
2. Stimulation of ovulation. With the help of medications, the doctor promotes the maturation of several follicles. Then everything is simple. You can try to get pregnant naturally or resort to insemination.
3. Artificial insemination. The embryo is grown in a special laboratory under certain conditions. It is then transferred to the uterus. There are big disadvantages: the burden of drugs on the body, premature birth and miscarriages. And the cost of the procedure is not suitable for every family.
4. The use of vitamins and microelements.

Tubal infertility

This is the most common type of disease among women. Uterine infertility occurs due to obstruction of the fallopian tubes. There are several reasons why the disease develops:

• endometriosis;
• abortion;
• sexually transmitted infections;
• myoma;
• adhesions in the pelvis.

Diagnosis of infertility can be done using one of the following methods:

1. X-ray of the fallopian tubes. To do this, a contrast agent is injected.
2. Ultrasonography. A special substance is injected and the examination begins.

Tubal-peritoneal infertility

This disease is classified into two main subtypes:

• disruption of the fallopian tubes – hypertonicity, tone, incoordination;
• damage to the fallopian tubes - adhesions, sterilization, complete obstruction.

Women experience symptoms such as:

• intestinal dysfunction;
• pain in the lower abdomen;
• dysmenorrhea or dyspareunia.

The disease can be diagnosed in several ways:

1. Ultrasound examination of the pelvic organs.
2. X-ray of the uterine cavity.
3. Laparoscopy.

In addition to all the presented types of disease, psychological infertility can also occur. No procedures or medications will help here. Need help from a qualified psychologist. The couple needs to go to his consultation together.

Main degrees of infertility

Many experts advise not to panic ahead of time and seek help from doctors only after a year of constant attempts to get pregnant. Because most often it happens that conception does not occur for other reasons, for example:

• bad environment;
• constant stress at work and at home;
• poor nutrition;
• diets and much more.

If a married couple has not been able to have children for more than a year, then it is worth visiting the clinic. The first thing doctors will begin to identify is the degree of infertility. Today there are two of them:

• primary;
• secondary.

First degree

This disease applies not only to women, but also to men. It is generally accepted that first degree infertility occurs only in those patients who have never been pregnant. If we draw a parallel with a spouse, then the first degree of infertility occurs only in men from whom none of the partners became pregnant.

Second degree

This type of infertility is diagnosed in women who have been pregnant at least once. This does not take into account their outcome, which could have ended:

• childbirth;
• miscarriage;
• abortion;
• ectopic pregnancy.

Secondary infertility in men is diagnosed in a similar way. If at least one other woman became pregnant from him, then he has the second degree of the disease.

It is worth remembering that with the first and second degrees, spouses can be absolutely healthy. Accordingly, the matter may be for completely different reasons, for example, incompatibility. And in this case, IVF helps many couples.
Also, a few women may experience third degree infertility. It is simply the inability to get pregnant, not in any available way. The solution for such couples, in whom I diagnose such a serious illness, is surrogacy.

Causes of female and male infertility

It is difficult to answer the question: “ Why did I experience infertility?" There are a number of reasons for this, which experts determine during the examination.

Causes of the disease of the first degree

Female and male bodies are different. Hence, the causes of infertility will vary. If your wife has been diagnosed with the first degree of the disease, it means that the following has been discovered:

• ovulation is rare and inconsistent;
• ovaries are absent or improperly developed;
• gynecological diseases that in every possible way oppose natural conception;
• pathology was discovered in the fallopian tubes;
• the uterus is poorly developed or the cervical canal is obstructed;
• pathology of the immune system;
• serious deviations in the structure of chromosomes; in these cases, eggs that are fertilized are simply not viable.

Additionally, for each woman this list can be expanded depending on the state of the body and overall health.
If your spouse has been diagnosed with first degree infertility, it means that the following reasons have been identified:

• pathology of the genital organs, which can be congenital or acquired;
• genital injuries;
• hormonal imbalance;
• genetic diseases;
• poor functioning of the immune system.

Also, first degree male infertility may be due to the following reasons:

• obstruction of the vas deferens;
• sperm are not produced.

If a couple has undergone a complete examination, which reveals no problems, there may be another reason. Namely, in immunological infertility. To help doctors confirm their diagnosis, they perform a MAP test. It is aimed at detecting antibodies in blood and semen. We cannot ignore the fact that the first degree of infertility can be hidden:

• in drug and alcohol abuse;
• taking medications;
• poor environment;
• infectious diseases;
• chronic diseases of the genitourinary system.

Causes of the disease of the second degree

If a woman is diagnosed with the second degree of the disease, then most often this is due to a serious hormonal imbalance. Among other things, there are several causes of second degree female infertility:

• myoma;
• cyst;
• poor nutrition and exhausting diets;
• complicated previous births;
• frequent ectopic pregnancies.

The reasons may not be hidden in diseases. One of these types is abortion. It is complicated by the fact that complications could arise during the procedure and the doctor could not provide qualified assistance. Even a medical abortion cannot guarantee that everything will be successful.
After an abortion, experts recommend undergoing good rehabilitation, otherwise endometriosis may begin, which will not immediately manifest itself, but in the future will have a detrimental effect on the condition of the internal organs.
Abortion is not the only thing that affects health. The second degree of infertility is diagnosed for women who have constant stress and early menopause.
As for the causes of second degree male infertility,
then everything here is almost identical to the first:

• genitourinary tract infection;
• varicose veins on the testicle;
• liver disease, asthma, tuberculosis, traumatic brain injury, diabetes;
• radiation and chemotherapy;
• disrupted hormonal levels;
• obstruction of the vas deferens.

If a man took steroids, tranquilizers and other similar drugs, then the risk of acquiring the second degree is high. Signs of infertility have many faces and are determined individually in each case.

Symptoms of male and female infertility

As you can see, there are a huge number of reasons for infertility. This includes not only serious illnesses, but also constant stress, poor lifestyle, and even improperly tight underwear. It is worth talking separately about how the symptoms of infertility manifest themselves in the female and male bodies separately.

Signs of female disease

Experts automatically diagnose a woman as infertile if, after 1-2 years of trying to conceive, no conception has occurred. But as it turns out, this is not the only symptom:

1. Amenorrhea. Lack of menstruation. A healthy and strong woman has only three stages when there are no periods: before puberty, pregnancy, menopause. Everything else is not considered normal and should be treated. In some cases, irregular periods occur due to the use of birth control pills, patches and injections.
2. Irregular menstruation. This leads to the fact that ovulation does not occur. The egg is not able to mature normally and cannot be fertilized.
3. Early health problems. This includes chronic inflammation of the pelvic organs, diseases of the nervous system, and the pituitary gland of the ovaries.
4. Pathology of the structure of internal organs. These are mostly congenital effects. And it’s not just about getting pregnant, sometimes it’s impossible to have sexual intercourse for purely mechanical reasons.
5. Age. This is, of course, a subjective assessment of infertility, but still in some cases it is taken into account. Thus, every girl who has not reached puberty can be considered infertile. Among doctors, it is generally accepted that it is difficult for a woman to conceive a child after 35 years of age. But still, it is worth taking into account the characteristics of each organism separately.

Signs of male infertility

The spouse’s body can also malfunction. The main symptom is the wife’s lack of pregnancy after trying for a year. But this is not the only symptom that manifests itself:

1. It is worth thinking more seriously if no partner has ever become pregnant from unprotected contact.
2. The genitals are not developed.
3. Lack of sperm or small quantity. As a rule, this indicates obstruction of the vas deferens or hormonal imbalance. This is where you first need to pay attention to your wardrobe. Tight trousers and insulated underwear are strictly contraindicated. With such clothes, you can doom your husband to heat castration, but everything can be fixed.
4. Serious diseases suffered by the body.

In some cases, men are diagnosed with several stages of infertility at once, but all of them can be eliminated and cured at an early stage.
The above symptoms are not a reason to self-diagnose or self-medicate. At the slightest suspicion, it is better to consult a doctor. The infertility clinic will conduct a full examination, and only then, based on the tests, will give a full conclusion and prescribe treatment.

Disease factors

Infertility– this is a many-sided disease and the cause of its occurrence is most often difficult or completely impossible to establish. Studies have shown that infertility factors are grouped according to several criteria:

• anatomical localization;
• pathophysiological processes;
• genetic abnormalities;
• psychosomatic state of a woman;
• the impact of male infertility.

In order to somehow understand all the complex concepts, it’s worth talking about everything separately.

Cervical factor

For fertilization to be successful, about 10 million sperm must enter. In order for them to get inside freely, the following is necessary:

• sperm activity;
• chemical properties of cervical mucus.

If a woman experiences pathologies, these are the results of the following:

• hormonal disbalance;
• inflammation in the cervix;
• disruption of microflora on the walls of the uterus.

Pipe factor

The tubes are needed to transport the mature egg into the uterine cavity. The movement occurs as a result of:

• peristaltic movements of the cilia, which are located on the tubes;
• the flickering of these cilia, which create the movement of the pipe fluid.

If the cilia are damaged, there is a risk that the pregnancy will be ectopic. The greatest negative phenomenon occurs due to complete or partial obstruction of the pipes. This phenomenon can be varied:

• obstruction in the area of ​​the far and near parts of the fallopian tube;
• along its entire length.

This infertility factor may appear due to the formation of adhesions or various tumors. Accompanied by severe pain in the abdominal area.

Cervical factor

In the center of the uterus there is a pharynx that connects it to the vagina. It contains cervical mucus, which must be accessible for sperm to penetrate. If this does not happen, then this is cervical infertility. To diagnose it, a woman is sent for colposcopy. It is possible to clarify the situation by taking tests. These include:

• study of mucus for biochemical and rheological properties;
• postcoital test;
• test to determine the periovulatory test.

In order for the results to show the true situation, you need to trust experienced laboratory doctors who must determine the favorable time for research.

Tubal-peritoneal factor

If infertility occurs as a result of this factor, then most likely it happened for the following reasons:

• inflammation of the pelvic organs;
• serious complications after abortion.

Additionally, the disease manifests itself in the following form:

• pipe obstruction;
• a large number of adhesions have accumulated in the pelvis;
• violation of the monthly cycle;
• the pain syndrome enters the chronic stage.

Immunological factor

In a normal case, the female body does not react in any way to extraneous interference from foreign bodies that are found in sperm. The manifestation of such a phenomenon as sperm rejection has not been fully studied by scientists. It's more like an allergic reaction.
Doctors try to cure such infertility by adjusting the immune system.
The female body is an unpredictable thing, so sometimes there are cases when the body rejects its own mature egg. In this case, conception is possible only after examination and treatment by an immunologist.

Endocrine factor

A common type of disease that occurs due to hormonal imbalance. As a result, the woman has irregular periods. The main violations occur for the following reasons:

• traumatic brain injury;
• damage to the ovaries and adrenal glands;
• poor thyroid function;
• the amount of estrogen in a woman’s body is too low;
• hormonal disorder;
• underdevelopment of the birth canal.

If a woman has a disturbance in her monthly cycle, then it is worth undergoing an examination to determine the functioning of the endocrine system. This is especially necessary for patients who are obese or malnourished. But in most cases, such hormonal infertility is treated quickly.

Psychological factor

Stress is the scourge of the 21st century. With its help, hormonal levels are instantly destroyed. In the form of infertility, they manifest themselves in each case individually. The main sources of stress are:

• a huge and daily flow of negative information;
• frequent emotional shocks;
• lack of confidence in your spouse or yourself;
• physiological reactions of the body.

Oddly enough, these signs lead to infertility. Here you need to either correct the oppressive situation, or go with your spouse to an experienced psychologist. He will help establish the reasons and adjust further actions.

Genetic factor

The absence of a long-awaited pregnancy may be caused by some genetic abnormalities. Namely:

• excess male hormones;
• proliferation of the walls of the uterus;
• premature menopause;
• primary amenorrhea.

Genetic infertility has been little studied by scientists. But if you want to consult and rule out all possible diseases, then you should consult a geneticist.

Diagnosis of male and female infertility

If after 12 months the spouses have not achieved the long-awaited pregnancy, then a diagnosis is made of an infertile marriage.
To begin treatment, specialists must make a correct diagnosis. On the way to the birth of the baby, both parents must undergo a comprehensive examination. Many doctors advise referring your husband to the clinic first. There are a number of reasons for this:

• in half of the cases it is male infertility that affects conception;
• it is easy to diagnose and treat.

In addition, the cost of the examination is much lower, which is affordable for many families. There is a certain list where all the tests for infertility are collected:

• consultation with a urologist;
• blood test for sex hormones;
• spermogram;
• Ultrasound of the prostate gland;
• analysis for infectious diseases.

If the diagnosis does not reveal any deviations from the norm, then it is worthwhile to examine the woman. The list of tests is much longer than for men, but there are also plenty of difficulties with the body. Here is a detailed list:

• initial appointment with a gynecologist;
• blood test for female sex hormones;
• taking a smear from the cervical canal;
• blood test for HIV infection;
• thyroid examination;
• blood test to check the functioning of hormones in the thyroid gland;
• ultrasound examination of all pelvic organs;
• analysis for the presence of infections;
• colposcopy, ultrasound of the uterus and tubes;
• test for compatibility of sperm and cervical mucus;
• determination of karyotypes of both spouses.

For a gynecologist to make a diagnosis of infertility, it is worth telling all the details and little things. You should not hide the number of all pregnancies, abortions and miscarriages. The specialist needs to know the following points:

• physiological and psychological changes that have occurred;
• sudden weight loss or gain;
• what contraceptives did you use;
• How long can you not get pregnant?
• Are you bothered by pain during sexual intercourse and all other details that at first glance seem like ordinary little things.

Once the doctor has diagnosed infertility, he will begin a serious fight against the problem.

Treatment of female infertility

When the doctor has fully assessed your health and has all the tests, he begins infertility treatment. To begin with, the primary causes are eliminated. Namely:

• restoration of a woman’s reproductive system using a conservative or surgical method;
• the use of technological functions if conception on your own is completely impossible.
  It is worth talking about the methods more specifically.

Hormone therapy

This method is used in the treatment of hormonal infertility. To normalize the patient’s hormonal levels, doctors prescribe special medications. In some cases, therapy helps to cope when ovarian infertility is detected. This method stimulates the production of eggs.

Anti-inflammatory treatment

These procedures are aimed at combating infectious diseases that are sexually transmitted. They are the ones who prevent the conception of a child. Treatment is completely completed with the help of medications.

Laparoscopy

If adhesions and cysts are identified and it is necessary to restore the patency of the fallopian tubes, then this procedure is used. Laparoscopy for infertility is a therapeutic diagnostic operation. Using a microcamera, the true reason why pregnancy does not occur is determined. The cause is immediately eliminated.
Most often, this method is used for infertility of unknown origin. The operation is harmless and has no side effects.

Insemination into the intrauterine cavity

If doctors determine the incompatibility of spouses, then this method is used. This is done simply: on the selected day, processed sperm is injected into the woman’s uterus. And you can wait for the results.

In Vitro Fertilization (IVF)

The procedure takes place entirely in laboratory conditions. To do this, the egg is fertilized in a special environment. The grown embryo is placed in the uterus and awaits its development. This method is considered the most effective, which helps with all types of infertility.
If a married couple cannot have children for a long time, then do not despair. Even the most unusual methods are used.

Traditional recipes for infertility

There are some tinctures and decoctions that will help saturate the body with nutrients and beneficial substances. In this procedure, the main thing is to believe in what you are taking, and then infertility treatment with folk remedies will be successful.

Recipe 1
A useful tincture is prepared from the following ingredients:

• 1 liter of freshly squeezed viburnum juice;
• 2 kg sugar;
• glass of water;
• juice of one lemon.

Mix everything. Take the drug three times a day. To do this, stir a tablespoon of medicine in a glass of boiled water.

Recipe 2

• 1 teaspoon of ground calamus roots;
• a glass of boiling water.

Pour water over the calamus and infuse. It is recommended to use once a day before meals. Preferably half an hour in advance.

Recipe 3
Our grandmothers also used sea buckthorn juice. It is enough to drink a glass once a day. It is recommended to continue the course of treatment for one month.
But do not forget that it is better to consult a gynecologist in medical institutions.

Side effects during treatment

There are no contraindications to infertility treatment. All side effects that occur are temporary and then go away easily on their own. Mostly, such actions occur when taking medications that are prescribed for IVF or ICSI. The most common phenomena:

• mood swings;
• nausea;
• dizziness;
• increased sweating;
• anxiety;
• migraine.

It is worth remembering that treatment leads to some undesirable consequences.

Complications during treatment

If a couple wants to conceive a child, they undergo treatment. If a woman undergoes IVF, her chances of becoming pregnant increase. As a gift for their patience and efforts, the couple can receive several implanted embryos. This is considered a multiple pregnancy. Here doctors note the following complications:

• difficult childbirth;
• high blood pressure;
• premature birth;
• miscarriages.

Reproduction doctors warn that the development of intrauterine pregnancy during IVF is much higher than in other cases. This can be determined by the following symptoms:

• sharp pain in the lower abdomen;
• vaginal bleeding;
• brown and red discharge.

To carry out IVF and ICSI procedures, you need to extract the egg. During the procedure, there is a risk of infection, which can only be treated with antibiotics.

As you can see, infertility is not a final death sentence. It is not only possible, but must be treated. An unborn child in the past means infertility in the future.

Infertility itself is a separate and large-scale topic, because it can occur with various symptoms and be the result of a variety of factors and causes. There is male infertility and female infertility, that is, non-occurrence of pregnancy can be caused by both actual problems of reproductive function in men and problems of reproductive function in women.

Infertility, as you can understand, is the inability of a mature organism to produce offspring. If pregnancy, subject to normal sexual life and without the use of any contraception, does not occur within the next two years, then a diagnosis of “infertility” is made. And although this is, in principle, not a disease, but a condition caused by certain factors, to get rid of infertility it is often necessary to make a lot of effort, or even even be faced with the need to use alternative, not entirely traditional forms of conception. Also, infertility is a diagnosis for the general picture of the anamnesis (medical history) in the case where there have been repeated miscarriages, that is, we are talking about a pathology such as miscarriage.

Female infertility: causes

Female infertility, which we will focus on in this article, can be caused by a variety of factors. Upon closer examination, the reader will be able to understand that a woman’s reproductive system is actually very fragile in relation to any impact, as, indeed, the female body itself, therefore the parting words to “take care of yourself,” if you think about it, has a very, very deep meaning. So, let's look at what the main causes of female infertility may be.

• Inflammatory processes and pathologies directly related to the genital organs . In particular, this refers to the relevance of pathological inflammatory processes with damage to the fallopian tubes and/or ovaries. It is a known fact that inflammatory processes develop not only due to normal hypothermia, but also due to exposure to certain forms of sexually transmitted infections. What is noteworthy is that about 75% of the fairer sex periodically experience the “delights” of such inflammations, and often no less significant part of them let everything take its course, believing that the treatment of inflammation of the organs of the female reproductive system can be excluded as such, that is, we are talking about “everything will work itself out” principle. However, this is not just an erroneous assumption, but also a very risky one, because an advanced form of inflammation or chronicity of the process (its transition to a chronic form with alternating exacerbations/remissions) is the first, if not the main factor in subsequent infertility.
• Artificial termination of pregnancy (abortion), miscarriage (i.e. spontaneous termination, miscarriage), injury to the uterus and various types of intervention (diagnostic curettage, installation of a contraceptive device, etc.). The listed reasons for infertility on this point are, in general, known to many, especially when it comes to abortion, but this kind of knowledge does not always become a factor excluding abortion. Naturally, such an “injection” is not suitable for situations in which abortion is a forced and necessary measure (presence of medical indications, certain life situations, etc.). In any case, it is important to consider that any abortion can cause irreversible consequences for the body, being the basis for the development of miscarriage syndrome and infertility in general.
• Hormonal disorders . If there are certain disruptions in the menstrual cycle (they can be very different, including amenorrhea, that is, the absence of menstruation for six months or more), we can say that conception can be comparable to certain difficulties in achieving the desired result. If the hormonal background has changed, which can happen due to a number of different circumstances, ranging from heredity to environmental features in the area in which the woman lives, then the functions performed by the ovaries are subject to disruption. In addition, the maturation of eggs is also subject to disruption, which is why infertility often develops. It should be added that the relevance of hormonal imbalances also causes the early development of menopause in a woman.
• Cysts, tumors affecting the ovaries and uterus. This reason is also not uncommon today in considering the influencing factors that cause female infertility. This particularly includes ovarian cysts, polycystic disease, uterine fibroids, etc.
• Metabolic disorders. On average, this cause accounts for about 12% of cases of infertility. As confirmation of this trend, we can add that it is a known fact that pregnancy is somewhat more difficult for overweight women.
• Relevance of congenital defects of the genital organs. The reasons for this type of pathology can be very different; in addition, this type of defect can be either congenital or acquired. Among them are underdevelopment of the fallopian tubes, absence of ovaries, “childish” uterus, etc.
• Obstruction of the fallopian tubes. This pathology, on average, becomes the cause of female infertility in 20% of cases. Such obstruction can be partial or complete; it develops against the background of previous inflammatory processes in the environment in question, after surgical interventions in the pelvic organs, due to abortion, etc.

All of these are the basic causes of infertility, and the most common causes when considering this type of reproductive disorder. In a more succinct form, the causes are often identified as three: problems with ovulation, endometriosis and obstruction of the fallopian tubes.

Separately, age can be identified among the factors of infertility - the ability to conceive in women after 35 years is almost halved, while the most optimal age is considered to be from 20 to 30 years. You can also add stress, combined with constant overwork, lack of sleep and an overly active (or, conversely, passive) rhythm of life, which, as can be understood from considering other diseases, can lead not only to infertility, but also to a whole “bouquet” of other diseases . And finally, among the most common causes of infertility are the reasons that have not found an appropriate medical justification for the impossibility of pregnancy. In this case, we may even be talking about some purely psychological “blockages”, due to which pregnancy does not occur even if both potential parents are in normal health.

A special role is played among the factors of infertility by the “sexual revolution”, due to which the prevalence of infectious diseases has especially increased; the delay of the first pregnancy by young women has become no less significant. What is noteworthy is that male infertility becomes an actual reason for a woman’s failure to become pregnant in about a third of cases, the other third accounts for female infertility, and the remaining part accounts for families in which, for one reason or another, both partners were infertile at the same time. The causes of male infertility mainly come down to pathological changes in sperm, decreased sperm activity, and insufficient volume of sperm released.

Types of infertility

Infertility, depending on the specific reason that provoked the inability to conceive a child and to bear children, can be hormonal (there is a disturbance in the process of maturation of the egg and its release due to hormonal imbalances), as well as tubal (impaired patency of the tubes) and uterine (relevant hereditary or acquired developmental disorder of the uterus). A special place is occupied by the already noted infertility, the causes of which cannot be explained from a medical point of view, where, most likely, we are talking about some psychological “blocks” and “attitudes” that exclude conception.

So, even an excessive desire to get pregnant, not to mention the reluctance to have children, can become an obstacle in this regard, although, of course, deviations are allowed on these points - there are plenty of examples of the appearance of “unwanted” children in life, therefore, in any case, even the inexplicable Infertility is all strictly individual.

Absolute infertility and relative infertility are also distinguished. The points discussed above fall under relative infertility, and in these cases it is curable, that is, pregnancy still occurs. As for such a form as absolute infertility, it, unfortunately, indicates the impossibility of pregnancy due to the relevance of certain physiological characteristics of the female body and the reproductive system in particular (for example, the absence of ovaries, uterus, etc.).

In addition, infertility can be primary or secondary. Primary infertility is the inability to become pregnant given the previous absence of attempts to become pregnant, that is, pregnancy as such has never occurred at all. If pregnancy has already occurred, regardless of the results of its outcome (full gestation and birth of a child, miscarriage, artificial termination of pregnancy, etc.), and within the specific period under consideration it is not possible to become pregnant, then this is secondary infertility.

Infertility: treatment

To cure infertility, it is extremely important to determine what exactly is causing it. Equally important is a mutual examination of the couple, that is, examination of both women and men. Based on the results obtained, the doctor subsequently either prescribes additional diagnostics or, if the cause of infertility was identified during the main examination, determines which treatment will be most appropriate in this case. The following options can be offered:

• Planned sexual intercourse. If the results of examinations and tests are satisfactory, and no physiological abnormalities are identified that limit the possibility of fertilization, the couple is offered the simplest option, called “planned conception.” As a reason why pregnancy does not occur even under such conditions, there is reason to consider this option, which is the incorrect calculation of ovulation, and it is this calculation that is the basis of this method. As an assistant, you can use a special test sold in a pharmacy, an analogue of a pregnancy test - an ovulation test, it is used according to the same principle. Again, we may be talking about the presence of some psychological barriers, which requires contacting a psychotherapist. There is nothing wrong with this, on the contrary, this specialist will be able to detect some “pitfalls” that cause the problem of non-occurrence of pregnancy at the psychological level.
• Treatment using hormonal drugs. This treatment method is used in cases of hormonal infertility. Due to such drugs, the patient’s hormonal background is adjusted in a certain way, the normalization of ovarian functions is ensured, and the processes of egg production are stimulated. This method increases the likelihood of achieving the result, pregnancy itself, several times after completion of the course of treatment. What is noteworthy is that such a method as treatment with hormones is more than popular today, the reason for this is the frequency of diagnosis of thyroid diseases and periodic disruptions in the cycle. However, as you probably know, there are some negative aspects to this method of treatment, such as weight gain, changes in vaginal environmental conditions (for example, excessive dryness), hot flashes, etc. A separate nuance may be the impact on the emotional state of a woman , therefore, the influence of hormones can even cause depression due to the characteristics of the large-scale load exerted on the body as a whole.
• Artificial insemination. This method is applicable if certain hormonal changes are relevant in the body of a woman planning to become a mother. Artificial insemination is preceded by a preliminary examination, then proceed to hormonal stimulation of the ovaries. The ultrasound method makes it possible to monitor the maturation process of follicles, after which, when determining the most favorable moment for conception, the spouse’s sperm is injected into the uterus. This procedure is completely painless, the probability of successful fertilization when using it is about 30%.
• ECO. You can learn about everything related to IVF from, which is fully devoted to this topic. Here we note that this method is one of the most effective. The essence of “growing a child in a test tube” is simple: under anesthesia, eggs are removed from a woman (manipulation within 5 minutes), after which the egg is artificially fertilized using the sperm of her husband or donor. Then, after 72 hours, the embryos are “planted” into the uterus, which is completely painless. After 1-2 weeks, an ultrasound is performed, which allows you to determine whether the woman is pregnant. IVF is one of the most effective methods among the possible solutions implemented in case of obstruction of the fallopian tubes in a woman. Pregnancy does not always occur from the first time of IVF. However, in addition to a number of other specific features of IVF, it is worth adding that many clinics return money if there is no fertilization result three times, which in a certain way can compensate for the costs of an unsuccessful struggle for motherhood.
• Donation. Here we can consider both traditional surrogacy, in which for a certain amount a donor carries an embryo in a couple with infertility, and the use of donor eggs in the event that a woman does not produce her own eggs or has a certain disease that affects their production and excludes the possibility get pregnant naturally. In the latter case, a woman can carry a child on her own.