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Infertility can be defined as the situation in which pregnancy never occurs or pregnancy no longer occurs even if pregnancy has occurred before. According to the World Health Organization (WHO) criteria, infertility is defined as the failure to become pregnant despite having regular and unprotected sexual intercourse for a year. This reproductive problem, which is seen equally in men and women, can be seen in both couples without any health problems. However, advancing age is among the most common causes of infertility. Therefore, couples who want to have children after the age of 35 are recommended to consult a physician if they cannot conceive a baby despite having sexual intercourse for 6 months. Sexually informed couples who plan to have children can increase their chances of achieving pregnancy both naturally and through assisted reproductive treatment techniques. Therefore, infertility should be evaluated separately for male and female genders.

What is Female Infertility?

In order for a woman to become pregnant, her brain, endocrine and reproductive systems must work healthy and in harmony with each other. First of all, the hypothalamus and pituitary glands, which are endocrine glands in the brain, must function properly. In order for pregnancy to occur, the hypothalamus, located at the base of the brain, weighs only 0.5 grams. It stimulates the pituitary gland. As a result, the pituitary gland secretes the hormones LH (Luteinizing hormone) and FSH (Follicle stimulating hormone). The ovaries are stimulated thanks to the hormones that reach the ovaries through the bloodstream. Thus, some of the small sacs (follicles) containing the eggs enter the maturation process. The maturation process begins on the 6th day after the first menstrual bleeding and continues until the 14th day. Of the 3 to 30 eggs that mature, the most mature and healthy one will hatch at the end of this period. It is released into the fallopian tubes, a channel between the uterus and ovaries. This period, also known as the ovulation period, coincides with the middle of the menstrual cycle, which occurs every 28 days on average. After the egg is released into the fallopian tubes, the follicle from which the egg comes out secretes estrogen in case of possible pregnancy, and the endometrium, known as the uterine wall, thickens. The egg, which must be fertilized in the fallopian tubes, can remain alive in the female body for approximately 24 hours. Sperm, the male reproductive cell, can remain alive in the female body for up to 4 or 5 days. Therefore, fertilization can occur through sexual intercourse in the few days before ovulation or on the day of ovulation. The single cell formed after fertilization rapidly divides and multiplies. During this period, the living creature called zygote descends from the fallopian tubes, attaches to the uterus and forms the embryo after the 3rd week. Thus, pregnancy is achieved.

What are the Causes of Female Infertility?

Some of the causes of infertility due to women can be listed as follows:

  • Thyroid hormone disorders

  • hyperprolactinemia

  • Ovulation irregularities

  • Endometriosis (chocolate cyst)

  • Polycystic ovary syndrome (PCOS)

  • Having adhesions in the uterus (Asherman syndrome)

  • Pathologies in the uterus such as endometrial ossification

  • Fallopian tubes are closed

  • Low egg reserve, (Amh)

  • Traumas to reproductive organs

  • advanced age

  • early menopause

What is Male Infertility?

Sperm production is very important in the male reproductive system. Sperm production and maturation takes approximately 74 days. The semen expelled from the body during ejaculation is produced by different glands in the testicles. There must be more than 15 million sperm cells in every milliliter of semen. It must be suitable for reproduction in terms of criteria such as sperm count, shape and motility. Semen contains lubricating organic substances that increase the sperm's mobility and fertilization ability. The sperm in the semen released into the vagina during ejaculation, with the help of the secretions in the vagina, move their tails and reach the uterus, and from there to the fallopian tubes, where fertilization takes place. If an egg, which is a female reproductive cell, is found in the fallopian tubes, the egg is fertilized. If there is no egg, the sperm stays alive here for about 4-5 days. If the egg reaches the fallopian tubes during this period, fertilization occurs.

What are the Causes of Male Infertility?

Some of the causes of male infertility can be listed as follows:

  • Congenitally blocked sperm ducts

  • Presence of varicocele

  • Problems with sperm morphology (deformities)

  • Low sperm count

  • Low sperm quality

  • No sperm in the semen

  • exposure to chemicals

  • Being in extremely hot environments for a long time

  • working sitting down

  • Alcohol and cigarette consumption

What are the factors that trigger infertility?

Many health problems in men or women can lead to infertility. In addition, there are many factors that can lead to infertility. Some of the factors that trigger infertility are:

  • Obesity

  • vaginismus

  • Closed cervix (cervical stenosis)

  • drug use

  • Receiving chemotherapy and/or radiotherapy

How to Diagnose Infertility?

Diagnosing infertility requires a full systemic examination. During this process, the doctor questions and examines the person in detail. It is recommended that couples consult a physician together for the diagnosis of infertility. This way, the couple's history can be taken accurately. Diagnosis of infertility requires different tests for men and women. For men, a physical examination is first performed. The penis and testicles are examined. The presence of varicocele is investigated. It is checked for breast enlargement (Gynecomastia). Body hair is examined for hormonal reasons. After the examination, the person is asked to abstain for 3 to 5 days. After this period, the person is subjected to a spermiogram, or as it is commonly known, a sperm test. Thus, the reproductive ability of the sperm cells in the semen is examined. According to the analysis results, the person is diagnosed with infertility. For women, a gynecological examination is first performed. Menstrual regularity is questioned. The person's ovaries and uterus are examined with ultrasonography. Additional laboratory and radiological imaging examinations are performed. In the light of the data obtained, a problem with the female reproductive system is detected and a diagnosis of infertility is made.

What are the Infertility Treatment Methods?

Infertility can occur for many different reasons. Infertility treatment is performed after the focus causing infertility is identified. In some cases, in vitro fertilization treatment, one of the assisted reproductive treatment methods, is recommended for the couple. In this treatment method, fertilization is achieved by bringing together the male reproductive cell, the sperm, and the female reproductive cell, the egg, in a laboratory environment. The resulting embryo is deposited into the expectant mother's uterus to ensure pregnancy. Some of the frequently used methods in infertility treatment are as follows:

  • In vitro fertilization treatment

  • Egg rejuvenation (PRP)

  • IUI (IUI)

  • microinjection

  • egg freezing

  • embryo shaving

  • Assisted hatching

  • Mitochondria transfer

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