Diagnosis and treatment of infertility in women
Infertility means not getting pregnant after a year of sexual
intercourse without using prevention methods. About 20 percent of
couples suffer from infertility. Infertility can be due to a male or
female problem or a combination of problems for both people. Also, in
some couples, the cause of infertility is not recognizable. In this
article, you will learn more about the causes, symptoms and treatment of
infertility in women
Reasons for Women Infertility
Women with a certain number of eggs are born. The number and quality of
eggs decreases with age. After the age of 30, the chance to have a baby
decreases by 3 to 5 percent every year, and after 40 years, fertility
continues to decline more strongly. In addition to age, infertility in
women may be due to:
Damage to the uterine tubes:
Uterine or fallopian
tubes carry oocytes from the ovary to the uterus and any problems in
these tubes can prevent the egg and sperm from reaching. Pelvic
infections, endometriosis and surgery can lead to tissue formation or
scarring in the uterine tubes, which can be closed or damaged.
Hormonal changes:
Disturbances of reproductive
hormones in women can lead to ovulation problems. These hormones play a
role in oocyte release and ovulation and thickening of the inner lining
of the uterus or endometrium to prepare the uterus for the implantation
of the fertile egg. In the event of a hormonal disorder in women, the
process of ovulation, fertilization and implantation may be difficult.
Hormonal disorders usually lead to a change in the women's habitual
habit.
Cervical Problems:
Cervical problems can prevent the
sperm from reaching the egg. The abnormality of the uterine discharge or
the history of cervical surgery may cause this problem. Although this
is a common problem in infertile women, it can be treated with
intrauterine insemination (IUI).
Uterine problems:
abnormal uterine anatomy, such as when there is polyp or fibroids in the uterus.
Infertility with unknown cause: The cause of infertility is not
detectable in a large percentage of couples with current methods.
Identify the cause of infertility
To diagnose infertility, a sperm analysis may first be required to
evaluate the quality and quantity of sperm in men. If there is no
problem in male sperm, then it will be done to examine the infertility
problems of the woman. To investigate the problem of infertility in
women, blood tests are usually first required to monitor the level of
various hormones. Also, for further examination, the endometrium or
uterine wall may be screened to check for any problems in the uterus.
Vaginal sonography or colorectal imaging of the uterus or
hysterosalpingography may also be used to check the health of the
uterine tubes and to accurately diagnose uterine problems.
Hysterosalpingography involves performing ultrasound or x-rays of the
reproductive organs. By injecting a color or salt solution with air into
the uterus and entering into the uterine tubes, open or blocked uterine
tubes are identified during ultrasound or imaging. If the problem is
not detected by the above methods, the doctor may use laparoscopic
surgery to check the uterus, ovaries and tubes more accurately. In this
practice, the physician examines the circumference of the uterus,
ovaries, and uterine tubes by creating a small incision near the
umbilical cord and inserting a narrow tube fitted with a crotch into the
abdomen, and the presence of abnormal tissue such as endometriosis may
be reported. Meanwhile, the physician can examine the openness or
obstruction of the uterine tubes with greater care.
Ways to Treat Women Infertility
Infertility treatment is done in different ways due to the cause of
this problem in women. In cases where some chronic patients, such as
diabetes or thyroid, have an infertility problem, the physician first
tries to treat the disease, while simultaneously improving fertility.
Below are some common ways to treat infertility:
Drug treatment:
This treatment is usually for people
who have ovarian or ovarian problems or drugs that do not have an
infertility problem. In this method, the doctor stimulates the ovulation
process by prescribing drugs such as clomiphenicitate, letrozole or
gonadotropin. Usually, after prescribing the drug, the doctor asks men
and women to re-apply naturally to become pregnant. These drugs increase
the number of released oocytes by stimulating the ovary, which
increases the chances of female fertility. In the process of drug
therapy, the physician may prescribe the number of follicles and
released eggs by vaginal ultrasonography to investigate the effect of
drug therapy.
IUI Sperm Intrauterine Injection:
In cases where the doctor considers the cause of infertility to be a
problem in the uterus or the arrival of sperm in the uterine tube, it
may be performed by intrauterine insemination. In this method, on the
day of ovulation, the doctor discharges the sperm from the male and the
sperm to the sperm through the narrow, uterine catheter to the uterus.
Your doctor may use medication to stimulate ovulation before increasing
your chances of getting pregnant.
Extra fertilization or IVF:
In cases where the cause
of infertility is unclear, the doctor usually uses the IVF method to
become pregnant. In this method, the eggs are transferred to the womb
after being fertilized by sperm in the laboratory. The doctor initially
releases a large number of eggs by administering a period of ovulation
stimulant such as gonadotrophin. After maturation of the oocyte, the
doctor removes the eggs from the vaginal pancreas with ultrasound. After
collecting sperm from the man and washing them, sperms are added to the
egg for fertilization in the laboratory. A few days later, after
fertilization and cell division, one or more fertilized eggs are
transferred to a mother's womb using an instrument. The doctor may, at
the request of the couple, freeze the embryos for future referenceا
ICSI microinjection:
This method is used if the number of healthy male sperm is low. The
microinjection method is quite similar to IVF, except that healthy sperm
are injected precisely into the egg. In this case, the chance of
fertilization of the egg is greatly increased. In this method, like IVF,
after oocyte fertilization, they are transmitted to the mother's womb.
Nowadays, in the IVF method in Iran, microinjection is used to fertilize
the fertility rate and the chance for fertility.
After laparoscopy and genital problems, the doctor may need to consider
the IVF method for pregnancy. In practice, laparoscopy, the surgeon can
open the tissue of the wound or the ovarian cysts, endometriosis or
block the uterus through the insertion of several tubes into the
abdominal tube.
Hysteroscopy:
In this method of treating uterine problems such as polyps and fibroids
or removing the problems of the uterine tubes, the doctor examines the
problems by inserting the hysteroscope through the vagina into the
uterus and, if necessary, removes extra tissues or wounds. Or open the
blocked uterus.
GIFT and ZIFT methods:
In these two methods, like the
IVF method, the egg is extracted from the ovary, transferred to the
uterus in an experimental medium with sperm and returned to the uterus.
In the ZIFT method, fertilized eggs or zygotes are transferred to the
uterine tubes within 24 hours after fertilization, and in the GIFT
method, the sperm and egg are mixed together and placed directly into
the uterus. The chances of fertility are similar to that of IVF, and the
doctor usually uses IVF for treatment. However, in cases where the
woman is not pregnant with IVF, the doctor may recommend this method
because the two fertilization methods are very close to their normal
state. However, these two methods are not common in the treatment of
infertility.
Donating an ovum:
Women over 40 years old who have ovarian failure, and whose ovaries do
not work properly or have insufficient oocytes, but whose uterus is
normal, can be transmitted through the donation of an oocyte. In this
method, after taking fertility drugs and stimulating ovulation in the
donor, several oocytes are extracted from the ovary, then the oocytes
are combined with the recipient's sperm and the fertilization is carried
out in the laboratory, then the fertilized eggs are transferred to the
recipient's mother's womb.
Alternative uterus:
Women who have uterine problems
and can not get pregnant but have ovaries and healthy eggs can use an
alternative womb. In this method, the egg and sperm are combined with
the husband and wife outside the lab and the fertilized egg is
transferred to the uterus of the donor's surrogate uterus and the fetus
develops in another woman's womb.
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