Is your dream of having a baby being thwarted? Let's talk about infertility

You and your partner are probably looking forward to adding a new little guest to your family with great hopes. But when that dream doesn't come true after months, maybe even a year of trying, it's hard to put into words the sadness, anxiety, and loneliness you feel? This becomes even more burdensome with the questions coming from those around you. But don't think that you are facing this alone. Today we are talking about this issue that many people are holding back in their hearts, that is, infertility. Let's talk about it openly and clearly.

Simply put, what is infertility?

Infertility is the inability to get pregnant due to a condition in your reproductive system. It can affect anyone. Often, it is not caused by one thing, but by several things.

Think about it, pregnancy is a very amazing, multi-step process. It's like a chain, if one link breaks, the whole chain breaks.

• First, your brain needs to produce hormones that control the function of your ovaries.
• Secondly, those hormones must cause an egg to mature in one of your ovaries.
• Next, the mature egg must be released from the ovary. We call this ovulation .
• Then, the egg needs to be captured through the Fallopian tube.
• Meanwhile, a male sperm must enter the uterus through the vagina, travel down the fallopian tube, and reach the egg.
• There, the sperm must unite with the egg and fertilize it, forming an embryo .
• Finally, the fertilized egg must travel down the fallopian tube and implant in the wall of the uterus.

If any of these steps are not done correctly, pregnancy will not occur.

Typically, doctors diagnose infertility by:

• If you are under 35 years old and have not become pregnant after one year (12 months) of regular sexual intercourse without any birth control.
• If you are 35 years old or older and have tried for 6 months without getting pregnant.

What are the main types of infertility?

Infertility can be divided into three main types. To understand this clearly, see the table below.

What causes infertility?

Often there is no single, simple answer to this. Sometimes it can be a woman's problem, sometimes it can be a man's problem. Other times, it can be a combination of both. Here's what research has shown:

• In 33% of cases, the cause is related to the woman .
• In 33% of cases, the cause is related to the man .
• The remaining 33% of cases are affected by causes related to both or by unknown causes .

Common risk factors

Some lifestyle habits and health conditions can affect fertility.

• Age: Fertility declines rapidly, especially in women in their late 30s or 40s. For men, the effect increases after age 50.
• Smoking and drug/alcohol use: These directly harm the condition of sperm and eggs.
• Overweight or underweight: Abnormal body weight affects hormonal balance.
• Eating disorders: Conditions such as `(Anorexia nervosa)` and `(Bulimia)`.
• Excessive exercise: Excessive exercise can also affect hormones.
• Exposure to environmental toxins: Things like pesticides, chemicals, etc.
• Stress: Long-term stress has also been found to affect fertility.
• Sexually transmitted infections (STIs): Untreated infections can damage the reproductive system.
• Cancer treatments: Radiation therapy or chemotherapy.

Reasons specific to women

The main cause of female infertility is problems with ovulation . This means that an egg does not mature or release properly. In addition, these things can affect:

• Endometriosis: Tissue that should grow inside the uterus grows outside the uterus (in places such as the ovaries and fallopian tubes).
• Polycystic ovary syndrome (PCOS): A hormonal imbalance that causes small cysts to form in the ovaries and irregular ovulation.
• Blocked fallopian tubes: Blocked fallopian tubes, due to infection (e.g., Pelvic Inflammatory Disease - PID) or surgery, prevent the egg and sperm from meeting.
• Uterine problems: Uterine fibroids or polyps or congenital problems with the shape of the uterus.
• Other medical conditions: Conditions such as thyroid disease, diabetes, kidney disease, and autoimmune conditions.
• Poor egg quality: Egg quality decreases with age.

Reasons specific to men

The main cause of male infertility is sperm problems . These include:

• Low sperm count.
• Poor sperm motility.
• Abnormal sperm morphology.

In addition to this, the following reasons may also be involved:

• Testicular problems: Varicocele, injuries to the testicles, or undescended testicles.
• Exposure to high temperatures: Wearing very tight underwear, taking frequent hot showers, working with a laptop on your lap, etc.
• Hormonal problems: Low testosterone.
• Genetic diseases: Genetic conditions such as `(Klinefelter syndrome)`.
• Ejaculatory duct obstruction.
• Erectile dysfunction or ejaculation problems.
• Abuse of substances such as anabolic steroids .

How is infertility diagnosed? What are the medical tests?

When you and your partner see a doctor, he or she will first ask you about your health history, sexual life, and lifestyle. Then, they will order a series of tests to find the cause. Both of you will need to have these tests.

What are the treatments available?

After identifying the cause, your doctor will recommend the treatment that is best for both of you, taking into account your age, the cause of your infertility, and how long you have been trying.

Treatment for women

• Medication: Fertility drugs are given to stimulate ovulation and induce the release of one or more healthy eggs.
• Surgery: Surgery is performed to open the fallopian tubes if they are blocked, to remove uterine fibroids, or to treat endometriosis.
• Lifestyle changes: Maintaining a healthy weight, eating a balanced diet, and avoiding smoking.

Treatment for men

• Medication: Giving medications to correct hormone levels or treat sexual dysfunction.
• Surgery: Surgery is performed to remove blockages in the spermatic cord or to correct varicose veins in the testicles (Varicocele).
• Lifestyle changes: stop smoking and drinking alcohol, avoid tight underwear, eat a healthy diet.

Assisted Reproductive Technology (ART)

In some cases, if the above treatments do not yield successful results or if the problem is more complex, doctors resort to assisted reproductive technologies. Some of the main methods are:

• Intrauterine Insemination (IUI): In this, the man's sperm is specially prepared and inserted directly into the woman's uterus through a very fine tube at the same time as ovulation. This makes it easier for the sperm to reach the egg.
• In Vitro Fertilization (IVF): This is often referred to as "in vitro fertilization." In this method, the woman's eggs are removed from her body, fertilized with the man's sperm in a laboratory, and one or more healthy embryos are then implanted back into the uterus.
• Intracytoplasmic Sperm Injection (ICSI): This is a special procedure performed during the IVF process. In cases where sperm motility is very poor or the number of sperm is very low, a single healthy sperm is selected and injected directly into the egg.

When should you see a doctor?

This is a very important question. Asking for help at the right time can increase the likelihood of success.

• If you are under 35 years old: If you have been trying regularly for a year without any birth control and have not gotten pregnant, see a doctor.
• If you are between 35 and 39 years old: Seek medical advice after 6 months of trying.
• If you are 40 years old or older: It is important to seek medical advice as soon as possible, even if you have been trying for less than 6 months, as fertility declines rapidly with age.
• If you or your partner have a known health problem: for example, irregular menstruation, endometriosis, previous pelvic infections, see a doctor immediately for advice.

Infertility is a very difficult journey, both physically and mentally. It is very important that you and your partner work together in this journey with support and understanding. Don't hesitate to seek psychological counseling if necessary.

Infertility, Infertility, Inability to get pregnant, IVF, IUI, Women's health, Men's health