Development of ways to overcome infertility. If menstruation is painful, does it lead to infertility? How to overcome the rather serious barrier of genetics on the path to pregnancy

Infertility in the Bible (Old Testament, New Testament)

Studying the causes of infertility

Overcoming infertility

...give me children; and if not, I die.

Genesis Chapter 30 (1)

For centuries, humanity has tried to solve two opposing problems related to reproduction: how to avoid unwanted, unplanned pregnancy and how to get pregnant, or rather overcome infertility when it becomes an obstacle to procreation. Moreover, if everyone has probably heard about modern methods of contraception, then people who themselves encounter this problem in their life practice usually learn about methods of combating infertility. At the same time, one may get the impression that the second task - overcoming infertility - is, against this general background, of secondary importance. The main thing is to take control of the birth rate! Meanwhile, this is not so, and especially for today’s Russia.

Fertility (from the Latin fertilis - “fertile”) - the ability to reproduce offspring, is one of the main physiological functions of a person. Infertility (loss of fertility) is undoubtedly one of the most serious and difficult problems for the individual and society. Infertility is by no means a new disease. Tragedies associated with the absence of children and unrealized parental instinct permeate the entire history of mankind.

The first words with which God, according to biblical texts, addressed Adam and Eve were “...be fruitful and multiply and fill the earth...” (Genesis, Chapter 1, 28). This covenant determined the most important purpose of man - to give birth to children.

In the lines of the New Testament, better known to many of our compatriots from the anecdote from the “Golden Calf” than from the original source: “Abraham begat Isaac, Isaac begat Jacob, Jacob begat...” are hidden stories that the wives of these first parents of Jesus Christ: Sarah, Rebekah and Rachel suffered from infertility.

The very first chapters of the first book of the Bible, Genesis, tell us that the Lord promised Abraham and Sarah to produce from them many tribes and nations for their righteousness and devotion. However, the couple lived to an old age without having children. And when everything “ordinary among women” ceased with Sarah, she told Abraham that tribes and peoples should probably come from him. “And Sarah Abraham's wife took her maidservant, Hagar the Egyptian, and gave her to Abraham her husband as a wife. He went in to Hagar, and she conceived." Hagar bore Abraham a son; "And Abraham called the name of his son born of Hagar Ishmael. Abraham was eighty-six years old when Hagar bore Abraham Ishmael."

When Abraham was ninety-nine years old, and Sarah was 90 years old, God appeared to Abraham and promised: “...it is Sarah your wife who will bear you a son... And from her nations and kings of nations will come.” Hearing this, “Sarah laughed inwardly, saying: Shall I, when I am old, have this consolation? and my lord is old.” However, it happened as God said - a year later she gave birth to Abraham’s son Isaac.

What does this Old Testament story teach? Never lose faith and wait patiently!

However, the story did not end there, but only began. Ishmael began to tease and insult Sarah - they say, the old woman gave birth! Sarah complained to Abraham: “What is this? How do you allow the son of a slave to laugh at your wife?” Abraham had to drive Hagar and Ishmael out of the house, as a result of which they almost died in the desert. In fact, this was the first documented family conflict, the root cause of which was infertility!

The Bible also tells us that the barren wives of Abraham’s son and grandson sought salvation from this misfortune from God. They, like Sarah, decided to give their husbands maidservants to overcome the problem. One of these stories was described by Thomas Mann in the novel Joseph and His Brothers.

“...Little Rachel hung on Jacob’s neck and cried:

Give me children, otherwise I will die!

He answered:

“What is this, my darling?” Your impatience makes your husband a little impatient, and I never thought that such a feeling would ever rise up against you in my heart. Really, it’s unreasonable to bother me with tears and requests. After all, I am not a god who does not give you the fruits of your body.”

... Of course, he was irritated, because it was stupid of Rachel to beg him for what he himself so ardently desired for himself, without, however, reproaching her for his deceived hopes. And yet, in her grief, the poor thing justified a lot, for as long as she remained barren, she had a bad time...”

It must be said that in fact, Jacob already had children from Rachel’s sister Leah, whom their father Laban deceived as a wife to Jacob instead of Rachel, and from Rachel’s maid Bilhah, and from Leah’s maid Zilpah. One of our modern scientists, discussing the problem of infertility in biblical times, wrote: “Polygamous marriage and the opportunity to resort to the services of slaves, who, as a rule, were amazingly fertile, quite simply solved the problem of infertile marriage - all children born from the head of the family were considered common.” . Indeed, this is how the problem of procreation was often solved in some countries in the old days. However, in all centuries, people, in addition to the instinct of procreation, have also experienced one of the most powerful feelings - the feeling of love. They loved, and therefore they wanted, and today they passionately want, at all costs, to have a child from their loved one. T. Mann so brilliantly described the joy that Jacob experienced when he saw the child born to his beloved woman:

“... It was Bilha, pale and laughing, who ran out into the courtyard, where Jacob had rushed unconsciously and, choking, reported to the master that a child had been born to us, that a boy had been given to us, and that Rachel was alive; and he, trembling all over, wandered to the mother in labor, fell at her feet and began to cry. Covered with sweat and as if transformed by death, she sang a breathless song of exhaustion... She did not have the strength to turn her head towards him and even smile at him, but she stroked his crown as he knelt beside her, and then squinted her eyes at the cradle so that he looked at the child's life and laid his hand on his son. The bathed child has already stopped screaming. It was asleep, wrapped in swaddling clothes. He had smooth black hair on a head that had torn his mother apart when he came out, long eyelashes and tiny hands with clearly sculpted nails. It was not beautiful at the time; and how can one talk about beauty when it comes to such a small child. And yet Jacob saw something that he had not seen in the children of Leah and did not notice in the children of the maids, he saw at first glance something that, the longer he looked, the more his heart was filled with reverent delight. There was something in this newborn that could not be defined, some radiance of clarity, comeliness, proportionality, favorability and sympathy, which Jacob, as it seemed to him, although he did not understand, but discerned. He put his hand on the boy and said: “My son.” But as soon as he touched the baby, he opened his eyes, which were then blue and reflected the sun of his birth in the top of the sky, and with tiny, clearly sculpted hands he grabbed Jacob's finger. He held him in the most tender embrace, continuing to sleep, and Rachel, the mother, also slept deeply. And Jacob, so tenderly detained, stood bent over and must have looked at his bright son for a whole hour, until he cried for food; then he picked it up and handed it to his mother.”

We have failed to build socialism with a human face, that is, a society in which the interests of the individual would be no less significant than public interests, and even more important than them. Under socialism, in which our compatriots of the middle and older generations grew up, everything was the other way around. A popular song at the time sang: “If only my native country would live, and there would be no other worries...”. The man, his ancestral roots were not important. Moreover, the state machine often tried to erase this memory. Unfortunately, we managed to do something in this regard. Many in Russia now do not know anyone in their family beyond their grandfather, or at best, their great-grandfather. And even now, these days, medical officials often say: “What kind of funding for infertility treatment are you talking about? We have more important problems in our country! Tuberculosis, AIDS, our Russian women have the most abortions of anyone in the world (indeed, 4 million abortions a year!). There are a lot of homeless children. Let those who want to have children adopt them.” Yes, that's all true. However, people want, first of all, to have their own children and are ready to make any sacrifices and trials for the sake of a child.

There are plenty of examples of this in the same biblical stories. The Virgin Mary's parents, Joachim and Anna, did not have children for many years. They led righteous lives, prayed earnestly, brought double gifts and asked God to give them children. However, everything was in vain. Having grown old and having lost his last hope, Joachim went into the desert, saying that he would remain here until God responded to his request. In the desert without water or food, he spent 40 days and nights in prayer and was already not far from death when an Angel finally appeared to him. He told Joachim that the Lord had heard his prayer, and he and Anna would have offspring, about which the whole world would know.

After all of the above, it is obvious that in the past people associated infertility only with the will of God, which applied specifically to the woman. The reason for infertility lay precisely in her inability to become pregnant. Listen to these Old Testament formulations: the Lord “closed her womb”, “God opened her womb”... They are talking about women’s problems. It must be admitted that this misconception about the guilt of only the woman in an infertile marriage continues to exist in modern society. In fact, the illnesses of husbands and wives are approximately equally responsible for childlessness. However, here’s what’s interesting: in approximately 10% of cases of infertile marriage, it is not possible to find any reasons for infertility among the spouses at all! In the official classification of the World Health Organization (WHO), this type of infertility is called unexplained. Perhaps in these cases it is quite acceptable to talk about the providence of the Almighty? Or maybe science doesn’t know everything yet, there’s still a lot to be discovered? Exploring the world, humanity sought to discover the secret of the origin of new life and by the beginning of the 21st century it had been very successful in this area.

To be fair, it should be said that back in the 1st century BC, Julius Caesar’s ally Lucretius, in the poem “On the Nature of Things,” was the first to associate infertility not only with a woman, but also with a man. The accuracy of the empirical results is striking:

...And it is not by the will of the gods that the sowing is fruitful

Taken away so that he would never hear from kind children

The name of the father and forever remained barren in love.

Many people think so and, while grieving, pour out abundant

They fill the altars with blood and the sanctuaries with gifts,

So that they can bear from the abundant seed of the woman.

In vain, however, they bother the gods and oracles.

For they are sterile because they are too thick

Their seed is excessively fluid and liquid.

Liquid (since it cannot adhere to the proper place)

It immediately flows back and leaves without conceiving a fruit;

The seed is thicker, erupting from them more closely,

What it should be, or not able to fly fast enough,

Or it cannot penetrate evenly where it is needed,

Or, having penetrated, it is difficult to mix with the female seed.

For love, apparently, depends a lot on harmony.

It may make you pregnant sooner and make it easier for the pregnant woman.

Many wives, until then, were barren in many

In marriages, they finally found husbands from whom

They were able to conceive and enjoy offspring from them.

It is also not uncommon for those who have fertile wives

Still, they didn’t give birth to children; they found suitable spouses

And they could finally provide for their old age with children.

(Quoted from: Lucretius. On the nature of things. - M., 1958)

Many bright minds of humanity have tried to understand and explain the cause of infertility. Thus, Aristotle, as a result of his observations, came to the conclusion that excessive consumption of wine leads to infertility in men. The great physician, poet and philosopher of the ancient East, Ibn Sina (Avicenna), was the first to connect infertility not only with the pathology of the seed, but also with diseases of the genital organs of men and women.

In 1677, Anthony Leeuwenhoek, using a microscope he designed, first examined human sperm, in which he discovered “animalcules” - that’s what he called spermatozoa (from the Latin animalculum - “animal”). Leeuwenhoek mistakenly believed that the sperm is already an embryo that uses the contents of the egg as a nutrient medium for its development.

The first practical application of the acquired new knowledge took place in 1790, when, in order to overcome infertility associated with her husband’s illness, the doctor and researcher Hunter first used a syringe and injected the husband’s sperm into his wife’s vagina. This is how the first artificial insemination operation (insemination) was performed. The result was a pregnancy that resulted in the birth of a healthy child.

However, another 150 years passed before, in 1827, Karl Baer in St. Petersburg discovered an egg in a mammal (dog) and established that in order to start a new life, not only the penetration of the sperm into the egg is necessary, but also the fusion of the contents of the male and female reproductive cells .

In the middle of the 17th century, the first microscopes appeared, thanks to which a real revolution in science took place. In 1672, the Dutch scientist R. de Graaf published a message “On female organs serving the cause of reproduction,” in which he first described the structure of the ovary. Graaf was the first to discover a vesicle in the ovary, which was later named after him - Graaf's vesicle (mature follicle). Graaf thought that this bubble was the “female seed” - the egg. In fact, as it turned out later, the egg is located inside the Graafian vesicle and is surrounded by thousands of other cells that provide its nutrition.

In 1890, Walter Heap isolated fertilized eggs from the fallopian tubes of a female rabbit and transferred them to another rabbit. This was the first time embryos were transferred from one female mammal to another. Veterinarians were the first to take advantage of the results of this experiment. Nowadays, this is how elite breeds of livestock are bred. To solve human problems, this achievement was used at the end of the 20th century in the surrogacy program.

It's hard to believe, but the possibility of transferring an embryo from one mother to another was predicted several thousand years before this event! On the wall of one of the Indian temples (now kept in the British Museum) in 599 BC. e. a fresco was made in which a deity in the form of a deer takes the fetus from one woman and carries it to another. This is an illustration of the legend about the conception of the founder of Janism, Mahavira. Due to an oversight of the gods, Mahavira was accidentally conceived in the womb of a woman of low birth. When this was discovered, one of them - the deer-headed deity Harinegameshin - had to take the fetus from the uterus of a pregnant woman at night, as the legend says, and transplant it into the womb of another woman of noble royal blood.

Another, more recent example. In 1932, A. Huxley’s science fiction novel “Brave New World” was published. It described the method infertility treatment which later in Russia became known as in vitro fertilization (IVF), that is, fertilization outside the human body. According to the author, the resulting embryos had to go through all stages of their embryonic development in vitro.

Not surprisingly, biologists soon began work on implementing this fantastic idea. John Rock was the first to attempt to fertilize human eggs. After 4 years of work, he stated that fertilization of human oocytes in culture is impossible. In 1934, our compatriot O. V. Krasovskaya reported the successful fertilization of rabbit eggs in vitro (Latin - in glass, in a test tube). Because of the Iron Curtain, no one in the world knew about this, and all the glory of the first fertilization of a mammalian egg went to the American M. Chang, who not only fertilized the eggs of a rabbit for the first time in culture, but transferred them to a female rabbit and got offspring.

At the very beginning of the 60s, news spread throughout the world that a group of Italians led by Daniele Petrucci managed not only to fertilize a human egg in vitro, but also to ensure the development of the embryo outside the mother’s body, in laboratory conditions. In those days, all the media reported every day how things were going in the laboratory of Italian researchers. After 58 days, Petrucci announced that he had to interrupt the experiment due to the protest of the Catholic Church. However, as it turned out, it was a hoax. Even today, it is possible to maintain normal development of an embryo outside the body for no more than a week. Since then, no one has heard anything more about Petrucci.

The real scientific work at this time was carried out by the Englishman Robert Edwards. It was he who discovered many features of the maturation of human eggs and achieved, after their fertilization, the development of embryos in vitro.

The next step to overcoming infertility with IVF was a meeting in 1968 between R. Edwards and gynecologist Patrick Steptoe and the subsequent 10-year collaboration in developing methods for retrieving eggs using so-called laparoscopy. This is the name for the method of visualizing the abdominal organs using a special optical probe inserted into it through a small incision (from the Greek lapara - “belly” and scopeo - “I look”, “I observe”).

Robert Edwards and Patrick Steptoe accomplished a truly scientific feat in the name of humanity. 10 years of work, endless failures. Several hundred embryo transfers without any result. This means that even more laparoscopies were done, since not every laparoscopy resulted in the retrieval of eggs, and not always after the union of sperm with the egg, fertilization occurred. Constant criticism from colleagues. Attempts to ban research (as with cloning today). The first pregnancy turned out to be ectopic, the second was terminated.

However, neither the scientists nor their patients gave up. They stopped communicating with the press. The world learned about the third pregnancy only after it ended on July 28, 1978 with the birth of a healthy child. This is how Louise Brown was born - the world's first "test tube baby".

Pioneers infertility treatment with IVF in Russia and the former Soviet Union there were employees of the laboratory of clinical embryology of the All-Union Center for Mother and Child Protection, now the Scientific Center for Agipology of the Russian Academy of Medical Sciences in Moscow and the group of early human embryogenesis at the Research Institute of Obstetrics and Gynecology named after. D. O. Ott RAMS in St. Petersburg, then still Leningrad. The first child, a test tube girl, was born in Russia in Moscow in March 1986. Second child born with help ECO- Russia's first test tube boy was born in St. Petersburg at the end of November of the same year.

The International Center for Reproductive Medicine in St. Petersburg and the Leningrad Region is the oldest clinic for treating infertility using IVF in Russia. The hospital's doctors have extensive experience in infertility treatment caused by various factors. A free consultation will help answer your questions and guide you on program prices infertility treatment (IVF).

I couldn't give birth to my first child for 6 years. Like any woman in such a situation, I was examined and underwent medical treatment. It was like trying to catch up with my tail: hormones were jumping, the cycle was one thing or another, some complications constantly appeared - my body did not want to come into balance. An endless process. In the fifth year of visiting clinics, apathy and reluctance to do anything at all set in. I was just lying on the couch, sleeping and didn’t want to wake up.

Somehow it happened that I ended up at a business training where I learned about psychosomatics - the influence of thoughts, feelings and lifestyle on health.

We ourselves, without realizing it, create what happens to us in life. I was very inspired by this idea: after all, if I myself created my infertility, then I myself can remove it.

This was the turning point in my quest, and for the first time in many years I saw that there was light at the end of the tunnel. At various personal growth trainings, I began to look for the reason not in my health, but in my thoughts and beliefs. I discovered that my current state is a consequence of my way of thinking. I realized that if I want to have children, then I need to change.

Through personal growth trainings and books, I realized that internally I'm too afraid of having children: I'm afraid that I can't become a good mother, I'm afraid my husband won't cope himself in business without me while I'm on maternity leave. To death I'm afraid of childbirth. Gradually, I was able to bring this entire set of internal attitudes to the level of awareness and worked with them for about a year. Step by step I changed. It's easy to write about it, but it's not easy to go through it. My attitude towards my husband changed: I stopped controlling him and learned to trust. Our relationship has found new depth and intimacy. I became satisfied, I began to enjoy life, and I made up for the many years of lack of joy.

At some point, there came a feeling that the internal spring of control had unclenched and a true readiness to have children appeared. I just physically felt it - this is it! You can prepare for conception! I gave myself six months to prepare my body.

However, the body had its own plans and a month later I found out that pregnant... ()

After the birth of my child, I went to study to become a reproductive psychologist. Now I have two children and am extremely grateful for my infertility. Infertility is the best opportunity to prepare for motherhood. And the participants in my courses confirm this with their examples.

Childbirth is a process of transformation

I remember that from childhood I was afraid to give birth. I even agreed with my friend that we we won't give birth together, but let’s just take a child from an orphanage. Where does this girl have this fear? It turns out that generic programs act on us, whether we know it or not. And my birth program was a long, difficult and traumatic birth. Because that’s how my mother gave birth to me, and her mother gave birth to her. And a child who has gone through a difficult birth remains perinatal stress for the rest of his life. In girls, this can lead to infertility due to fear of labor pains. But fortunately, there are ways to remake generic programs and create your own program that our children will inherit.

I prepared for childbirth throughout my pregnancy.. Not just like that, I couldn’t do it any other way. I was eaten away from the inside by an animalistic fear that I wouldn’t be able to give birth, that it was beyond my strength. I worked with patterns of infantilism, immaturity, desire to shift important and difficult things to someone else. I was afraid of pain, and even more, I was afraid of my weakness, that I would panic and give up in childbirth. I learned to trust my body, I learned to live with my body, not my head, I did a lot of practices for relaxation, immersion in myself, and contact with the baby.

I came to know childbirth as a delightful, beautiful, deep, strong, wise and gentle process. Conscious childbirth alone replaces years of training. Such childbirth expands consciousness, changes self-esteem, allows you to touch the Divine with your hand, and literally create a new life together with God.

Parenting

I can see from my children that my inner work continues to bear fruit—my husband and I manage to raise happy children. This can be seen in them: they are open to the world and new things, they are raised in love and acceptance, they trust their parents - and this is the basis of trust for life. The experience of infertility forever changed my life and turned it into a completely new area - conscious motherhood, in which I have been improving every day for more than 8 years.

From an infertile woman to a perinatal psychologist

My first child seemed to bring with him an unmanifest knowledge that children are waiting for their parents to finally do their inner work and invite children into their lives.

The birth of my first baby inspired me to pursue my mission of passing on knowledge and inspiration to all women who have difficulty having children.

By first education I am a physicist. This education formed my analytical mindset, which later came in handy in structuring and preparing a program to overcome infertility. After the birth of my eldest son, I went to study as a perinatal psychologist in Institute of Perinatal Psychology in Moscow, and by the time the youngest was born she was already psychologist specializing in preparation for the birth of children.

I passed it myself as a client a huge amount of training and more than 500 hours of individual and personal therapy. The knowledge gained and my personal experience allowed me to create step-by-step online program preparation for motherhood and overcoming infertility, which has shown its effectiveness. This program lasts 1 year and allows women shorten your path to children by years, and sometimes decades.

What prevents women from becoming mothers

Over 3 years of working with women, I saw that the main problem lies in:

• What a woman does not know that infertility is a psychological conflict expressed in physiology. Women do not know that all women’s illnesses and diagnoses also have psychological roots and can be corrected.
• The woman knows all this, but doesn't know where to go, what to do.
• A woman is afraid of change, and therefore takes a wait-and-see attitude and doing nothing.

Children are waiting for their mothers

I feel that many children are waiting for their mothers. Are you ready to meet halfway and make an infinitely valuable gift for yourself and your children?

Start with a diagnostic course. is an opportunity to discover their causes of infertility.

Specialization: gynecology

AN AGE-AGED REDUCTION IN REPRODUCTIVE FUNCTION IS INEVITABLE. THE RATE OF THIS REDUCTION IS DETERMINED BY A COMBINATION OF GENETIC FACTORS AND ENVIRONMENTAL INFLUENCES. THIS FEATURE OF THE FEMALE BODY PROVIDES THE POSSIBILITY OF CONCEPT AT AN AGE WHEN A YOUNG HEALTHY WOMAN CAN FULLY CARE FOR HER CHILDREN. THE FINAL DECAY OF THE REPRODUCTIVE FUNCTION IS PRECEDED BY THE LATE REPRODUCTIVE PERIOD, IN WHICH THE ABILITY TO CONCEPT IS ALREADY EXTREMELY LOW.

In the late reproductive period, a woman still has menstruation, but her ability to conceive is sharply reduced. Hormonal function of the ovaries ceases at the age of menopause, which is usually closer to 50 years. In practice, after 40 years of age, it is quite difficult to get pregnant with your own oocytes, even with IVF.

WHEN DOES THE LATE REPRODUCTIVE PERIOD START?

Currently, it has shifted to 35–38 years. This increase in age is explained by modern social realities, in which women postpone having children until after 30 years of age due to the need to study, acquire a profession, a career and create a material base for future children. But few women know that involutive processes, which reduce the likelihood of spontaneous pregnancy, begin after 30 years of age and after 35 years of age significantly accelerate.

WHEN DOES THE REPRODUCTIVE AGE END?

According to WHO definition, reproductive age is defined as up to 49 years. This means that by the age of 49, most women lose the ability to become pregnant spontaneously. But in fact, most women lose this ability much earlier. And these are population averages that do not take into account premature ovarian failure syndrome and surgical interventions on the ovaries. Knowing this, doctors need to promptly orient patients to assisted reproductive technologies, and not waste time on restoring natural fertility.
There is an idea that a woman is capable of conceiving as long as she has menstruation and follicles are identified. But in the vast majority of cases this is not the case. What are the main pathogenetic mechanisms of decreased fertility in older women? There are only two of them: a decrease in the number of eggs and a decrease in the quality of eggs, and the second reason interferes with conception much more than the first, and doctors often take into account only the number of eggs, focusing on the number of follicles on ultrasound. It is known that with age, fewer follicles are initiated to grow in each cycle. Thus, according to M. Faddy and R. Gosden, at the age of 20–25 years, 50 primordial follicles grow daily, at 34–35 years old – 17 follicles, and at 44–45 years old – no more than three, and the rate of follicular atresia after 36 years it doubles, which, of course, leads to depletion of the follicular reserve. But it would seem that one egg is enough for pregnancy, then why does it not occur even if there are three or more eggs? Precisely because pregnancy requires one genetically and morphologically complete egg, capable of fertilization. But it is these eggs that become catastrophically few after 35 years, and fewer and fewer every year. Therefore, in order to get a full-fledged egg after 40 years, you have to process a large amount of material. Sometimes we manage to get such an egg on the first IVF attempt, and then we get pregnant the first time. But often it is necessary to repeat attempts precisely because of the poor quality of the resulting embryos.

WHAT HAPPENS TO EGGS WITH AGE?

The results of cytogenetic analysis of oocytes obtained from patients of various age groups show a systematic increase in their degenerative forms in women over 35 years of age. According to Boyarsky K.Yu. and Gaidukov S.N., deformation and lysis of structural elements, fragmentation and vacuolization of the nucleus and other visual signs of cellular degeneration are found in oocytes. In the genome of embryos obtained from oocytes of women in the older age group, the frequency of chromosomal abnormalities increases significantly. Most often, aneuploidies occur due to chromosome nondisjunction or chromosome delay during anaphase movement. Aneuploidy can be manifested by monosomy or trisomy on any pair of chromosomes. The most common trisomies are Down syndrome (21 pairs), Edwards syndrome (18 pairs) and Patau syndrome (13 pairs), and monosomies are Shereshevsky-Turner syndrome (X chromosome). But their frequency is very arbitrary, since these pathologies are more often diagnosed in full-term fetuses precisely because it is possible to carry the pregnancy to term and give birth to a child with these pathologies. Trisomies in other pairs lead to complete non-viability of embryos and, accordingly, to termination of pregnancy at an earlier stage and therefore remain undiagnosed and unaccounted for. It is thanks to them that the frequency of miscarriage in women of the older age group is much higher than in younger women. Data that takes into account the prevalence of chromosomal abnormalities not only in newborns, but also in abortions, allows us to conclude that in women over 42 years of age, up to a third of all conceptions have abnormalities in the genetics of the embryos. More serious violations in the genetics of the egg lead to the fact that it is not fertilized and pregnancy simply does not occur.

INDICATIONS FOR THE USE OF DONOR OOCYTES ARE DIVIDED INTO ABSOLUTE AND RELATIVE

Absolute readings

1. Gonadal dysgenesis.
2. Premature ovarian failure syndrome or resistant ovarian syndrome.
3. Post-castration amenorrhea due to oophorectomy, chemotherapy or radiation therapy.
4. Natural menopause.

Relative readings

1. A sharp decrease in ovarian reserve, in which in previous attempts at ovarian stimulation no oocytes were obtained or the oocytes obtained were of poor quality.
2. Risk of transmitting genetic diseases to children

HOW TO OVERCOME A QUITE SERIOUS GENETICS BARRIER ON THE PATH TO PREGNANCY?

There are two ways here. The first is to repeat IVF procedures until a viable embryo is obtained. This method is quite complicated both from a financial point of view and from the point of view of the hormonal load on a woman’s body. One way to solve these problems may be the use of IVF in a natural cycle. This type of IVF is used if a woman cannot grow more than one oocyte during stimulation. It does not use stimulating drugs; only one follicle, which has grown independently in the woman, is punctured. This allows you to reduce the hormonal load on a woman’s body during numerous stimulations, as well as reduce the cost of each IVF attempt. But a significant disadvantage of this method is the high frequency of premature ovulation of the follicle, when for several months it is not possible to puncture the follicle due to its ovulation before puncture. In practice, getting pregnant even with monthly IVF procedures in women of the older age group is quite difficult, and often impossible. To date, there are no ways to improve the quality of a woman’s oocytes and make her ovaries work better, so there is a need to take eggs from women who have good quality and sufficient quantity.
In this regard, the second way seems more profitable - the use of donor oocytes. Of course, the decision to use donor material should be made exclusively by the married couple. The doctor is obliged to explain that this child will not be genetically related to the woman, but will be genetically related only to the man. It is necessary to switch to using donor material only if all other methods of obtaining pregnancy in a given couple have been exhausted. The obvious reason for the higher effectiveness of IVF programs using donor oocytes is that they use eggs from young women that are of better quality, in which chromosomal aberrations are much less common. This proves that for pregnancy to occur, the quality of the oocytes is more important than the somatic and gynecological status of the patients (not taking into account, of course, gross somatic or gynecological pathology that prevents the onset and gestation of pregnancy).
Currently, up to 20% of patients undergoing IVF turn to donor oocytes. This increase in the frequency of use of donor material has recently been facilitated by significant improvements in embryo cryopreservation methods, which make it possible to ensure 95% survival of embryos after thawing. Currently used embryo vitrification allows embryos to be frozen, stored and thawed without losing their quality and viability. Therefore, most donor programs use frozen embryos. This is more convenient, does not require synchronization of the cycles of the biological mother and the oocyte donor, and allows the recipient’s endometrium to be most adequately prepared for embryo transfer.

The examination of the oocyte donor is carried out in almost the same scope as during standard preparation for the IVF program; in addition, a psychiatrist’s opinion and genetic examination are required. The oocyte donor can be a somatically, mentally and gynecologically healthy woman 19–35 years old.
According to existing legislation, the use of donor oocytes is possible only with the full informed consent of both spouses and the oocyte donor. It is necessary to prepare the relevant regulatory documents. Financial issues are regulated either by patients themselves (for example, in the case of involving relatives or friends of the couple as donors of eggs), or by specialized legal agencies. Medical personnel should refrain from the financial side of the issue.
In conclusion, I would like to say that getting pregnant in women of older reproductive age is quite complex, labor-intensive and lengthy work. Considering the duration and low effectiveness of these efforts, the patient often despairs of getting pregnant and refuses further treatment. At these moments, it is possible and even desirable to use the help of psychologists, which allows the woman to go through all the stages of the necessary treatment in the least painful way.

It is believed that in a healthy young married couple, pregnancy occurs on average within 1 year of regular sexual activity without the use of contraception. If pregnancy has not occurred within a year, the spouses are diagnosed with infertility. Naturally, in this case it is necessary to find out the cause of this problem.

Infertility is truly a worldwide problem because... found in all countries of the world without exception. In Russia, almost 17% of married couples have difficulty getting pregnant; and this level is critical for maintaining population size.

Reproductive specialists have long proven that the likelihood of pregnancy directly depends on the age of the spouses: the older a person becomes, the less chance of success. That is why doctors recommend the earliest possible start of examination and treatment, because The sooner a married couple goes to a specialized clinic, the sooner a long-awaited baby appears in the family.

For pregnancy to occur, a combination of several factors is necessary. A man must have a sufficient number of motile sperm of good morphology in his ejaculate, i.e. correct structure. In a woman, the reproductive system is more complex: ovulation must occur (the maturation of the egg in the ovaries), there must be passable, properly functioning fallopian tubes (they must capture the egg, create conditions for fertilization and transport the embryo into the uterine cavity) and a good endometrial structure for implantation (attachment) of the embryo.

The process of pregnancy is quite complex and multi-stage; "breakdown" can occur at any stage.

The specialist’s task is to find out the reason for the lack of pregnancy in the shortest possible time and offer the most gentle method of treatment.

According to the recommendations of the World Health Organization (WHO), the duration of the examination to determine the cause of infertility should not exceed 3-4 months. In life, doctors are often faced with the fact that patients have been going for years and cannot get an answer to the most important question for them...

In advanced clinics dealing with the problem of reproductive health, all efforts are aimed at reducing the time of examination. Some infertility and IVF treatment departments operate “one-day” diagnostic centers, which allow a couple to be examined to determine the causes of infertility in 1 day. At the end of the day, the couple receives the examination results and treatment recommendations.

What modern methods of treating infertility exist?

A reproductologist has many options for infertility treatment in his arsenal, and in each specific case you need to choose the most suitable and effective one.

If the reason for the lack of pregnancy is a violation of the ovulation process in a woman, then a treatment protocol called “classical ovulation induction” comes to the rescue, when, with the help of minor hormonal effects, the functioning of the ovaries is normalized and the egg matures. Further conception occurs naturally.

If the results of the examination reveal a decrease in indicators, then the couple may be offered treatment using a method where specially treated sperm (from the husband or donor) is injected directly into the uterine cavity.

Unfortunately, such “conservative” methods do not always help: pregnancy occurs in only 15-17% of married couples.

Today, the most effective method of overcoming infertility is the IVF (in vitro fertilization) procedure. The name of the procedure comes from the Latin words extra - outside, outside and corpus - body, i.e. fertilization of a woman's reproductive cells (eggs) outside her body, followed by transfer of embryos into the uterine cavity.

The chance of pregnancy in one IVF cycle varies and ranges on average from 40 to 58%, depending on the causes of infertility and the age of the spouses.

Carrying out an IVF program is most advisable in cases of severe infertility, with a combined factor and immunological infertility, and in case of infertility of unknown origin, when traditional examination methods have not been able to establish the cause of the lack of pregnancy.

If the sperm count is low, fertilization is carried out using the ICSI method, i.e. A specially selected sperm is injected directly into the egg using micromanipulation technology. This allows you to increase the chances of fertilization even with severe male infertility.

In the absence of sperm in the ejaculate (azoospermia), it is possible to obtain sperm from the epididymis and from the testicle using puncture (TESA, MESA), after which ICSI is also performed.

In recent years, various donor programs have been used to treat infertility. In the absence of sperm from a partner or the absence of a sexual partner, donor fertilization is possible (by artificial insemination or IVF).

In cases of premature ovarian depletion (for example, after repeated surgical interventions on the ovaries) and in postmenopausal women (when the process of egg production stops due to age), donor eggs can be used to achieve pregnancy. This allows a woman to become a mother even in the most difficult cases.

If it is impossible to carry a pregnancy to term (due to developmental defects or the complete absence of the uterus; in the presence of severe concomitant diseases), you can resort to the services of a surrogate mother. When carrying out such a program, embryos obtained from the fusion of eggs and sperm of genetic parents are transferred to the uterine cavity of a surrogate mother for gestation.

Cryopreservation technology has already been well developed, i.e. freezing genetic material (embryos, sperm and eggs) for long-term storage for later use.

Not only patients suffering from infertility resort to the IVF program.

Quite often, couples who need to become pregnant with a child of a certain sex come to the IVF clinic (this need arises due to genetic diseases - for example, hemophilia, which is more often diagnosed in boys). In this case, a genetic study (preimplantation genetic diagnosis) is carried out on the embryos before they are transferred into the uterine cavity and their belonging to one or another sex is determined.

When conducting an IVF program, selection (i.e. selection) of embryos based on the Rh factor is possible. This procedure is necessary for Rh-negative patients who have had severe cases during previous pregnancies. Thanks to pre-implantation diagnostics, only Rh-negative embryos are transferred into the uterine cavity. In this case, pregnancy proceeds without conflict with the mother’s body.

Genetic diagnosis for some genetic diseases (for example, cystic fibrosis) is carried out in a similar way. Now families who are carriers of mutations have a real opportunity to have healthy children.

Discussion

It’s good that medicine has now stepped forward, and there are many methods to help women with some kind of health problems become mothers. Unfortunately, in my case, only in vitro fertilization helped... But now I am the mother of a wonderful son! Girls who are now wondering whether to do it or not, I definitely recommend it!

I was overweight, had no children, the doctor advised me to lose weight using the 30+ model. It helped, not quickly, but the weight didn’t come back, my appetite became smaller, my metabolism improved, I started eating right. Now I have two children!

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Sometimes you want to believe in a miracle and sometimes a miracle happens. I couldn’t get pregnant for a long time, my cycle was jumping, my ovaries were not working well, but a month of ovariamine course and I was lucky. I feel very sorry for the girls who go through all this; it’s good if they manage to get pregnant, but if there is no result and there is no result, this is a great sadness.

10/12/2015 19:53:58, Elena33

We were treated for a year, and it’s good that we went straight to a good specialist. Otherwise, when you hear enough of these stories about wasted years of going to clinics to no avail, it gives you goosebumps. People lose the most important thing - time. We recommended Karina Grigorievna Khangeldova, she is a competent specialist in the treatment of infertility. Now they are parents. This is how stories like this sometimes end. I wish everyone a similar outcome. And everyone, first of all, needs to find a good doctor.

Good day. I want to say that in many cases, infertility is not a death sentence, but a reason for action. In my practice there were very difficult cases, but a set of techniques based on herbal medicine, hirudotherapy, visceral massage, and other techniques developed by me showed very good results and this result is in the bed of my patients. And for others, mom and dad are running and screaming joyfully!
So I can say that everything can be fixed. The body just needs help and it will cope on its own.

For me personally, infertility was like an atomic bomb, given that I always went to the gynecologist and was healthy, no abortions, STDs, etc. never happened in my life, but as it turned out, infertility exists... yes, no one tried to treat me, at a certain stage I was so tired that I just decided to let the situation go for a while, but no miracle happened and only after 4 years of constant nerves I got to Strelko Reproduction. I read a lot about her and thought that I couldn’t get through to her, but I succeeded on the first try and got pregnant on the first try too) you just need to go towards the goal until you reach it)

06/10/2014 17:51:39, Diasha

Great marketing article.
Infertility should not be treated, but prevented. Literally from adolescence, girls begin to take hormones, disrupting the natural cycle for years (!) and crippling their reproductive function. It should not be surprising that this leads to miscarriages, infertility and illness. Only pharmaceutical companies and gin. This is very beneficial for clinics. First - pills, then - infertility treatment. Everything costs money, and a lot of it.

20.11.2011 21:35:53, shark111

Comment on the article "Methods of treating infertility"

The completely natural desire of any woman - to experience the happiness of motherhood - for one reason or another sometimes requires the intervention of doctors. When a diagnosis of infertility is made and conservative treatment methods are ineffective, assisted reproductive technologies (ART), in particular in vitro fertilization (IVF), are used. However, in order to increase the effectiveness of the IVF program, certain preparation of the woman is necessary, since with ART the patient receives significant, sometimes long-term...

Such treatments have a short-term effect and do not have any guarantee. This is justified in the case of infertility treatment...

Discussion

I almost moved my horse... Just one injection. And I’ve been dealing with the consequences of this buserelin for two years now. I don’t even want to remember how bad I felt then. It was prescribed to me before surgery to remove fibroids. As a result, two operations were performed without him. And now I have a lot of diseases that didn’t exist before! The heart, thyroid gland, and the whole body suffered. If I had known that this would happen, I would never have agreed. And, most importantly, it was given to my sister, but I didn’t know about it. Her consequences are even worse than mine, but she was given three injections and did not understand that it was from him. Only after I was diagnosed and the ambulance was with me EVERY day for three months, I shared with her and we discovered that she also had all the problems from it! My life is divided into before and after....

For an endometriosis cyst, the doctor also prescribed 3 injections for me - I think it’s a real setback, the side effects are terrible - after 2 injections, after 1 nothing, the hospital said that there was no need for such harsh measures. For information, buserelin seems to be good at inhibiting the development of tumors.

Infertility treatment has recently become very important. The material well-being of people increases, but the main functions of the body that are necessary for procreation suffer significantly. Experts debate what exactly is considered a reason for people to become infertile. Possible environmental pollution, rapid development of technology, genetically modified products, with all this, there are more and more infertile couples. There are many more people experiencing the suffering of infertility: some sublimate their desire into other areas...

In countries where medical tourism is traditionally a leading destination, Russians over the past three years have consistently been among the top three or five foreign citizens who come here for medical services. In 2012-2014, the bulk of Russian medical tourists came to Israel, and in 2015, Germany began to lead in the influx of patients from Russia (just over 30 thousand patients visited the country during the period). Most often, Russians go to German clinics with...

The idea of ​​using stem cells to treat female infertility has long been a source of debate among experts. Some believe that stem cells can create new functioning ovaries for infertile women, while other experts are of the opinion that the functioning of the ovaries depends on genetic factors, which makes the use of stem cells pointless to combat infertility in women. In recent research, scientists from the University of Gothenburg and the Karolinska Institutet have come to...

Is the long-awaited pregnancy?rnd=1531193792 Touching on the topic of pregnancy in adulthood, one cannot help but say about women for whom the opportunity to become pregnant only with the help of medicine has become the only chance to experience the happiness of motherhood. Among those turning to clinics for IVF (in vitro fertilization, i.e. in vitro fertilization), the last hope of women diagnosed with primary infertility, there are a lot of those who are over 30 and even over 40. The chances of giving birth to such women...

Female infertility is one of the most common and sad gynecological problems in Kazan. Currently, it is believed that if, with regular sexual activity, pregnancy does not occur within a year, it is necessary to raise the question of an infertile marriage and begin examination and treatment of the spouses. Infertility can occur in absolutely healthy couples with ideal fertility indicators. But, as a rule, it often develops after suffering from inflammatory diseases of the genitalia...

Infertility is the absence of pregnancy for 2 years or more in a woman of childbearing age who is regularly sexually active without the use of contraception. Infertility can be primary if a woman has not had a single pregnancy, and secondary if there has been a previous pregnancy. There is also a distinction between absolute infertility, in which there are irreversible pathological changes in a woman’s body that prevent conception, and relative infertility, when the causes of infertility may be...

In vitro fertilization (from Lat. extra - outside, outside and Lat. corpus - body, that is, fertilization outside the body, abbr. IVF) is an assisted reproductive technology used in cases of infertility. Synonyms: “in vitro fertilization”, “in vitro fertilization”, “artificial insemination”, in English denoted by the abbreviation IVF (in vitro fertilisation). The essence of the IVF method is as follows: an egg is removed from a woman’s body and artificially fertilized in...

Osteopathy has proven itself in the treatment of various diseases. Every year, millions of patients around the world turn to osteopaths because traditional medicine has failed to solve their problems. How can an osteopathic doctor help? Let's look at the most common cases: PAINFUL MONTHROOM. Often women notice pain in the lower abdomen or back in the first days of menstruation. Usually they use painkillers and endure it. But in fact, pain is an alarming signal indicating problems in the body and...

The complex of such an examination necessarily includes an examination for sexually transmitted infections, since this is the most common reason for non-pregnancy; ultrasound of the pelvic organs in the first and second phases of the menstrual cycle helps to assess the condition of the uterus and ovaries. Over the course of 2-3 cycles, it is necessary to measure the basal temperature and enter it into a special chart. This functional diagnostic test allows you to find out whether the egg is maturing. It is very important to evaluate how the “adjacent” endocrine glands work, which can “inhibit” the functioning of the reproductive axis and provoke cycles without ovulation (egg maturation). This includes the thyroid gland, adrenal glands, etc.

At this stage, the partner is examined in parallel: spermogram, smears for infections, bacteriological culture of sperm. After receiving the examination data, the doctor in most cases can give an opinion on whether there are any health problems with the expectant parents, and whether there is a need for further examination. If all of the above tests are in order: that is, to put it simply, the egg is maturing and there are sperm in sufficient quantity and of good quality, but pregnancy does not occur, then the problem is the impossibility of their meeting. There is a need to check the patency of the fallopian tubes. After all, it is in the tubes that the egg and sperm meet, and fertilization occurs. Previously, the X-ray method was most often used for these purposes, when a contrast solution was injected into the uterus and the patency of the tubes was assessed by whether the contrast leaked into the abdominal cavity or not. The method is not very accurate and has side effects. Ultrasonography is currently a more physiological method. Ultrasound is used to determine whether the sterile saline solution has leaked into the abdominal cavity after it is inserted into the uterus. The information content of the method is the same as when using x-rays, but there are fewer undesirable effects on the woman’s body. Adhesions are new scar tissue that forms after inflammation of the appendages and glues closely located organs together: the ovary with the tube, with the uterus, the lumen of the tube itself is clogged. The result is a conglomerate of organs that cannot always function correctly. The situation can only be corrected through surgery - to cut the adhesions and “free” the pelvic organs from each other.

announcement of the article – The sea knot of parental love

… “They ruined my whole life!” - this can be heard from adults and quite independent-looking people. Moreover, we will not be talking about children or former partners, but about our own parents. In the minds of some children who have grown up long ago, “adults” still have enormous authority and influence. This leads to mutual dependence, which prevents the older and middle generations from living their lives.

The most modern method of surgical treatment in such cases is laparoscopy. This is an endoscopic operation in which a special movie camera and manipulators are inserted into the abdominal cavity through small punctures in the anterior abdominal wall. The surgeon sees the surgical field on a television screen, and the operation itself is performed with special instruments under the control of a television camera. During laparoscopy, the patency of the fallopian tubes is most accurately determined. To do this, a colored solution is injected into the uterus and the doctor sees whether it has poured out of the tubes or not. Such operations are less traumatic; within a few hours after them the patient can be at home. The main advantage is that after the operation the risk of the formation of new adhesions is minimal, and this is very important in case of tubal factor infertility. During laparoscopy, the diagnosis is clarified as much as possible. An incidental finding during laparoscopy may be endometriosis of the pelvic peritoneum, which, while asymptomatic, can cause infertility even when there are no adhesions. In such a situation, the foci of endometriosis are cauterized. After surgery, treatment for endometriosis is prescribed, which makes it easier to get pregnant later.

As a result of the examination, it may turn out that pregnancy cannot occur naturally. This happens with some types of tubal obstruction, in the absence of both tubes, with some hormonal disorders in a woman’s body, etc., as well as with male infertility, when the number of normal sperm in the semen is sharply reduced. In such cases, the couple is offered assisted reproductive technologies - in vitro fertilization (IVF), the so-called “test tube baby”.

The essence of the method is to obtain eggs, fertilize them with sperm in a special environment, wait for 2-3 days in a special thermostat until cell division begins, that is, embryos appear, after which they are implanted into the uterus. Since the process of fertilization and implantation of the fertilized egg in the uterus is quite complex, the chance of pregnancy during the first IVF attempt is not very high (25-40%). The lack of pregnancy after the first attempt should not be disheartening; the first cycle of ovulation stimulation is often a “test”; the doctor selects an individual program for each patient. After all, it is necessary to obtain the maximum number of eggs and not get serious complications (the so-called hyperstimulation syndrome). To date, a huge number of long-awaited children have already been born, in whose families despair already reigned.

New trends in this area are the ability to preserve embryos for a long time. There is a special technique for rapid freezing (cryopreservation) and storage of embryos. The fact is that in one cycle of ovulation stimulation, a very large number of eggs are often obtained; after their fertilization, it turns out that many living embryos are obtained. In one IVF cycle, no more than 4-5 embryos are implanted, the rest are “frozen”. If the first attempt fails, the remaining embryos can be used in subsequent cycles, this avoids repeated stimulation of ovulation. Currently, there is already experience in the birth of healthy children after thawing embryos. Sperm cryopreservation is also possible. Thanks to this, IVF centers have sperm banks. A new direction in reproductive technologies is the possibility of genetic analysis of embryos before their transfer, which significantly reduces the risk of random chromosomal diseases in children.

Thus, the development of medicine in modern conditions in most cases makes it possible to help infertile couples find parental happiness.

A woman is a mysterious, complex creature of nature, who plays a key role in the continuation of the human race. It is important to understand that a woman’s health is an invaluable asset that should be treasured. In addition to regular examinations with your personal gynecologist, this includes hardening, playing sports, multivitamins, fighting excess weight, stress, colds... Everything is not only the prevention of female diseases, but also the prolongation of your youth and beauty.

from the article - Guide to dreams during pregnancy

... Dreams during pregnancy - 3rd trimester... Be sure to say a positive result out loud. If you cannot cope with anxiety on your own, consult a psychologist. Fortunately, fear is not the only feeling that permeates the dreams of expectant mothers. When a woman has a positive psychological attitude, she is calm, balanced and happily expecting a baby, this also manifests itself in her dreams. Very often, such dreams create an additional focus on a successful outcome of childbirth.