Who goes for IVF infertility treatment view age fertility detail male and female specification

Infertility is considered a situation when a couple leads a regular sexual life without protection for a year, and pregnancy does not occur.

Such a period is taken for analysis, because not every sexual act, even in a couple without any problems, leads to conception.
Natural fertility, or in another way the ability to conceive— is about 20% per month.

How is it evaluated? If 10 young healthy couples live a regular sexual life for a month, as a rule, pregnancy occurs only in 2. This is 20%.

The regularity of sexual activity throughout the year is important. The egg matures once a month. To get pregnant, at this moment there must be sexual intercourse: during her maturation and even a week before. Spermatozoa can be in a woman’s genital tract and wait for an egg for a whole week.

When does a couple need to undergo treatment?

If the situation is higher about your couple, then you need an examination.

Start with an initial examination. It should answer three questions:

  1. Does a man have spermatozoa, how many of them and what is the quality of sperm?
  2. Is the egg maturing and is there ovulation in a woman?
  3. What is the condition of the fallopian tubes and are they passable?

Spermogram

To assess the quality of sperm, a man needs to make a spermogram. The normal concentration of spermatozoa in 1 milliliter is more than 15 million. The total number is more than 39 million, the progressive motility of spermatozoa is more than 32%.

Normal sperm structure should be 4% or more. If a man sees such a small percentage in the finished analysis, there is no need to worry — this is not a pathology, but the norm.

Causes of decreased sperm production:

  • hormonal dysfunction at the level of the hypothalamus and pituitary gland;
  • genetic pathologies;
  • disorders of function or pathology in the testicles;
  • sexually transmitted infections;
  • violation of the functions of the thyroid gland or adrenal glands;
  • the influence of environmental factors — oxidative stress (preservatives in food, alcohol abuse, smoking, drugs, overheating or hypothermia, sleep disorders, etc.).

To solve the problem, the doctor can prescribe medication therapy based on the examination data. Less often surgical interventions are needed.

Ovulation

There are different ways to check if a woman’s egg is maturing:

  • urinary ovulation tests;
  • assessment of progesterone level – it usually rises in the second phase of the cycle, when the egg matures;
  • functional diagnostic tests of cervical vaginal mucus;
  • ultrasound examination.

Ultrasound is the most affordable and easiest way. Moreover, it is important to trace the dynamics. The first ultrasound is prescribed immediately after menstruation, then closer to ovulation on the 10-12 day of the cycle. During this period, the follicle should mature. The third study is carried out a few days after the second to make sure that the follicle has burst. If this does not happen, pregnancy will not occur.

Ovulation may not occur if a woman:

  • overweight or underweight;
  • excessive or insufficient production of certain hormones (for example, increased prolactin suppresses ovulation);
  • polycystic ovary syndrome (PCOS);
  • violation of the function of the hypothalamus, pituitary gland or ovaries;
  • stress.

Treatment is aimed at eliminating the causes of ovulation disorders. In some cases, medications are prescribed.

Patency of the fallopian tubes

The fallopian tube is a living organ in which spermatozoa meet with an egg, where fertilization takes place. Later, it is the fallopian tube that will “push” the embryo into the uterus, where it should attach and develop. If the patency or function of the tube is impaired, then pregnancy may not occur.

To check the patency of the fallopian tubes, use:

  • X-ray. Previously, this was a classic way of diagnosis. But recently it has been abandoned due to the negative effect of X-ray radiation on the ovarian area;
  • ultrasound examination with special contrast. Now they are switching to this method of research;
  • laparoscopy. This method is used if a woman has previously had an inflammatory process, miscarriage, ectopic pregnancy, infections, abdominal surgery. The advantage of the method is that if there are adhesions on the fallopian tube, they can be dissected during laparoscopy.

Causes of fallopian tube obstruction:

  • previous infections;
  • endometriosis;
  • surgical interventions on abdominal organs that led to adhesions;
  • incorrect structure of the fallopian tube.

In this case, anti-inflammatory treatment, physiotherapy may be prescribed. But the main method of treatment is surgical — laparoscopy.

What else to check to identify all possible problems?

To detect all the problems that may be the causes of infertility, conduct:

  • hormonal profile study (hormones of the ovaries, adrenal glands, thyroid gland, pituitary gland);
  • examination for sexually transmitted infections;
  • examination for pathology of reproductive organs (uterine fibroids, polyps, endometriosis, fusion in the uterine cavity – synechiae);
  • Ultrasound of the mammary glands, thyroid gland, abdominal cavity and kidneys.

Close attention is paid to the cervix. For example, its erosion can prevent sperm from entering the uterine cavity.

When these problems are eliminated, as a rule, the problem of infertility is eliminated.

What should a couple do if infertility treatment did not help?

There are two approaches to infertility treatment that complement each other:

  • restoration of natural fertility. During the year, an examination is carried out, from one to two more years are needed for treatment. Doctors help to solve problems both conservatively and operationally — pregnancy occurs naturally;
  • the use of assisted reproductive technologies.

These are in vitro fertilization (IVF) and intrauterine insemination (IUI). They are prescribed if it was not possible to restore natural fertility. Or when the doctor understands that such treatment will give the couple more chances.

Intrauterine insemination is a procedure in which the most mobile processed (washed) and concentrated spermatozoa are injected into the uterine cavity through a special catheter.

The chance of getting pregnant in this case is the same as with natural conception – no more than 20%. The procedure is close to the natural process of fertilization. It is safe and harmless. Insemination can be done several times.

IVF is resorted to when no other methods have helped a woman get pregnant. For example, when there is an unavoidable obstruction of the fallopian tubes, when the tubes are removed, when a man has a small number of spermatozoa and it is not possible to increase this indicator in any way.

The medical indication for IVF is infertility that cannot be treated by other methods or the probability of overcoming which with the help of assisted reproductive technologies is higher than with the use of other methods of treatment.

The patient’s ovaries are stimulated to get several healthy eggs. They are extracted from the woman’s body under anesthesia, then combined with a sperm in the laboratory. Special incubators have created conditions for egg fertilization and early embryo development. On day 3-5, the embryo is painlessly moved from the incubator to the uterus with a special catheter.

After the procedure, the woman receives drugs to preserve pregnancy. After 2 weeks, you can do a blood test to find out if pregnancy has occurred, after two more — ultrasound. If the ultrasound showed that the embryo in the uterus is alive, then pregnancy has really occurred.

The frequency of pregnancy with IVF in young women under 35 years of age is 40-45%.

On average, 60-70% of women under the age of 38 manage to get pregnant in 3-4 attempts.

Age is important in IVF. A set of eggs in women is laid from birth and with age they age, their quality deteriorates. The chance of getting pregnant is decreasing.

At 38 years of age, the probability of pregnancy as a result of IVF is 35%, at 40 years of age — 20%, at 43 years of age – 5% or less.

Who goes for IVF infertility treatment view age fertility detail male and female specification

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