Fertility is the ability to conceive and give birth to a live baby.
Answer Infertility is the inability to conceive and give birth to a live baby. Infertile couple is a couple when the spouses of childbearing age with regular sexual intercourse without contraception for a year and longer have no pregnancy.
Primary infertility, when a woman having sexual intercourse has never been pregnant. Secondary infertility is absence of pregnancy after the woman had at least one pregnancy, no matter how it ended (birth, spontaneous abortion, abortion). Also there are male and female infertility.
Unlike usual diseases, infertility refers not to one person, but to a couple. So it’s more accurate to say not about infertility, but about infertile couple. The frequency of infertile couples is about 15-–20%. The most common causes of infertility in women are: the fallopian tube-peritoneal factor, which includes anatomical and functional changes in genital organs after previous inflammatory diseases of the fallopian tubes, ovaries, uterus, uterine cervix, sheath, adhesions in the abdominal cavity, the uterine cavity.
- Hormonal factor:
- abnormal functions of ovaries and pituitary
- adrenal function abnormality
- thyroid function abnormality
- uterine tumor (myoma)
- ovarian tumors
- existence of hereditary diseases
- genetic predisposition to blood coagulation system abnormalities
- congenital abnormalities of the reproductive organs genesis
The most common causes of infertility in men are:
- reduction in spermogram values
- urinery tract infections
- endocrine factor
- immunological factor
- sexual and/or ejaculation disfunctions
- congenital abnormalies
Examination for female infertility includes the following directions:
- assessment of the nature of the functional changes in ovaries and uterus
- assessment of the state of the uterine cavity and fallopian tubes patency
- tests for urinary tract infection
- detection of immunological conflict between husband and wife, examination of the immune system values
- detection of karyotype, genetic factors
- examination of the blood coagulability values
Ultrasonic monitoring of folliculogenesis, as well as hormonal monitoring are the most informative ovarian hormonal function examinations.
Basal (or rectal) temperature is measured in the rectum in the morning before getting out of bed. Based on the results obtained, the graph of the basal temperature is plotted. In the middle of the menstrual cycle, the basal temperature, under the influence of progesterone (a yellow body hormone), increases by 0.4 degree Celtigrade (37 degrees and above). Within 12–-14 days it stays at that level. For 1-2 days before the start of the menstruation, it is reduced to 36.6 degrees Centigrade.
Unfortunately, not always. More than 15% of women find out that when the basal temperature increases they have no ovulation, and vice versa, -– ovulation can occur at a constant basal temperature below 37 degrees Centigrade. Therefore, this method actually is not used in modern conditions.
It is not. During an intercourse the male’s seminal fluid enters the female's genital tract. And the fecundating ability (fertility) is detected by the quality of sperm cells.
Primarily, examination of sperm (spermogram) is carried out. In cases of variations from the normal values, consultation by the andrologist is conducted to find out the causes and refer to the appropriate treatment.
Under the influence of alcohol, nicotine, unhealthy diet (spicy and fatty foods), overfatigue and stress the semen quality deteriorates significantly. Therefore, for best results of the spermogram, the impact of the above factors should be excluded or minimized.
The obligatory requirement before semen collection is the sexual abstinence, as well as avoidance of hot baths and saunas for 3 days.
The intrauterine artificial insemination is the injection of sperm using a special catheter into the uterine cavity.
The artificial insemination is prescribed in case of some forms of the male and the female endocrine and immunological infertility. The obligatory requirement for this procedure is normal fallopian tube patency. On a day favourable to get pregnant (in a natural cycle or with the hormonal stimulation of ovulation), the female is injected with a catheter in the uterine cavity preliminary prepared husband’s or donor’s sperm.
Treatment for male infertility may be conservative (hormonal, anti-inflammatory) or surgical. If the patient fails to overcome infertility by using these methods, the methods of ART (assisted reproductive technology) are applied: IVF, ICSI, TESA, MESA.
IVF (in vitro fertilization, fertilization outside the body) is a method of treatment for infertility, in which fertilization of the female oocytes by the male sperm cells occurs outside her body. After fertilization, the obtained embryos are transferred into the cavity of the female uterus, and she carries the pregnancy.
No. The processes of fertilization, which take place in a female's body in the fallopian tubes, when making IVF, are carried out in special boxes and incubators. IVF program was originally created for women with removed or blocked fallopian tubes.
ICSI is an option of the female's ovum fertilization during IVF, injection by using special micromanipulators of one sperm cell directly into the cytoplasm of the oocyte. Using this micromanipulation, fertilization occurs.
If as a result of any desease the sperm cell looses the ability to get inside the egg, because of its dense outer shell becomes an invisible obstacle for it, there is a need to apply the ICSI method.
IVF is a method of treatment, within which fertilization of the ovum can be performed using the ICSI method. ICSI does not exist without IVF.
IMSI is selection of the sperm cells from the ejaculate at very high magnification for conduction of ICSI.
Both programs are used in cases of azoospermia — the absence of sperm cells in the ejaculate. TESA and MESA are the options of the ICSI program. The difference lies in the “source” of the sperm cells: in TESA, sperm cells required for injection into the egg, are retrieved when puncturing the testis, and MESA — with the use of the epididymis.
Sperm donation is used in cases of absolute male infertility or for single women.
Patients, using description, are able to choose a donor with the desired male appearance data and blood group.
The semen bank is a store of frozen sperm portions. Most often it refers to the donor sperm bank. However, men whose activities are connected with risk to life and health, as well as for other reasons willing to preserve samples of their semen, can also make use of services of the sperm bank.
In some females infertility is connected with that in their ovary follicles growth and maturation of oocytes do not occur. In this case, oocytes are obtained from a female donor and fertilized with the sperm of the patient’s husband or the donor’s sperm. The obtained embryos are transferred into the patient's uterus, and she carries the pregnancy.
AMH (Anti-Mullerian Hormone) is one of the markers of the reproductive system of a female's body that is directly connected with the ovarian reserve and the ability of the ovary to produce eggs. The lower is AMH, the less oocytes the ovary produces.
Yes. With age, the level of AMH is reduced, especially after 40 years.
Unfortunately, in current conditions it’s not possible to substantially influence on the level of AMH. At very low rates of this marker, programs using the donor's oocytes can be offered as well.
The “surrogate maternity” program gives the chance to become moms for females with removed uterus or which have serious deseases in which carrying of the pregnancy is contraindicated. In these cases, when conducting IVF, the egg and sperm of the infertile couple are used. The obtained embryos are transferred into the uterine cavity of the “surrogate mother”. She is during nine months carrying this pregnancy.