What is infertility? How is infertility treated?
Infertility is defined as the inability to achieve pregnancy despite 1 year of regular, unprotected intercourse. When the general population is examined, it is revealed that pregnancy does not occur within 1 year in 15% of couples, and 12.5% experience problems during their first attempt to have a child. So, how is infertility treated? Urology Specialist Assoc. Prof. Dr. Hüseyin Eren explains.
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Infertility is a social issue that requires serious planning and research in its own right, and it must be evaluated by an expert.
ENVIRONMENTAL AND GENETIC FACTORS ARE EFFECTIVE
A vascular disease called varicocele (15%) ranks first as a cause of male infertility. Beyond varicocele, congenital or acquired urogenital abnormalities, radiation and chemotherapy damage, tumors, urinary tract infections, increased temperature in the testicles, hormonal disorders, genetic abnormalities, and immune system-related problems come to the fore. In 30-40% of cases, no cause that would impair semen parameters can be found, and most of these are attributed to environmental, genetic, or air pollution-related reasons.
During the diagnosis phase, information is obtained from the patient regarding medication use and medical history. After a detailed physical examination of the genital area, hormone levels in the blood are checked. A semen analysis (spermiogram) is requested from the patient after a sexual abstinence period (including masturbation) of at least 72 hours and at most 7 days. Genetic tests are not requested during the initial evaluation. Advanced genetic evaluation may be performed based on the available data.
SPERM COUNT MUST BE EXAMINED
Semen analysis is performed according to the 6th version recently published by the World Health Organization (WHO). In the evaluation, sperm count, motility, and morphology are strictly examined. If the semen analysis results are below normal values, it should be repeated. If no sperm is found in the semen analysis, this is called azoospermia, and this patient deserves further investigation. In hormonal examination, FSH, LH, and testosterone levels must be checked.
As for imaging, ultrasonography of the testicles may be performed in cases deemed appropriate by the physician.
THERE IS A WAITING PERIOD OF 6-12 MONTHS
Treatment begins first with the patient's lifestyle (weight loss, physical activity, quitting smoking and alcohol); medication or surgical intervention is added to this treatment when necessary. Since the most common known cause is varicocele, an operation plan is made for suitable patients. Varicocele surgery should ideally be performed using the microsurgery method. It should be noted that there will be a waiting period of 6 to 12 months after the operation.
If there is still a problem with achieving pregnancy despite the treatments, couples are directed to methods called assisted reproductive techniques, such as intrauterine insemination (IUI) or in vitro fertilization (IVF). It is necessary to know the fact that treatments are individual, meaning they may differ for each patient.