Infertility Treatments – Female Factor
Causes of Female Infertility
1) AGE FACTOR
In normal conditions, the chance of pregnancy during a regular unprotected sexual intercourse is % 80 in the first year. In the second year, the chance is %10, in the third year the chance is % 1,2 and in the fourth year %0, 6. After 40 years of age, the chance of pregnancy decreases greatly. Even though ovulation happens, the chance of fertilization is very low.
2) Problems in the Egg Reserves
A newborn girl has almost 1-2 millions of eggs. This number reduces to 400.000 as the girl approaches the first menstrual cycle. From this moment until the menopausal age, only couple of eggs gets mature in each menstrual cycle. The egg reserve tells us how many eggs the women carry in her body. The number varies from person to person. The determination of the egg reserve is vital for women who will undergo IVF or IVF/ICSI treatment. In these treatments, the goal is to obtain as much quality eggs as possible. If the number is low, the success of the treatment will be lower.Via ultrasound guidance, and certain hormonal tests such as FSH, LH, Estradiol, Prolactin, TSH are being evaluated to determine the egg reserve. It is not possible to treat the egg reserve, to increase its number, but what’s being done is to find out the most applicable treatment method for the patient.
Factors that diminish the egg reserve:
- Ovarian surgeries
- Removal of one ovary
- Cysts in the ovary
- Inflammation and infections
- Chemotherapy or Radiotherapy
- Smoking s
- Family History
3) Problems in the Fallopian Tubes
35% of the female infertility consists of problems in the fallobian tubes. Blocked tubes, interior liquids, damage from tuberculosis, cyctic and curvy structure of the tubes reduce the chance of pregnancy tubes.
We ask for HSG ( Hystersosalpingography) ( X-RAY of the uterus and the tubes ) . When HSG is performed, a special radiopaque substance is given with pressure and a possible blockage in the tube can be opened. Therefore, pregnancy may happen and the patient should be informed about this possibility. In order to make a healthier and better decision, hysteroscopy should be performed after the HSG.
4) Uterine Problems
The lining of the womb ( endometrium) is where the embryo attaches and starts to grow. If this lining is not thick enough, if there are polyps , and myomas , then the embryo cannot attach well to the lining and cannot grow. Therefore, hysteroscopy is the perfect method to find these problems out .
5) Problems in the Cervix
There are certain liquids in the cervix such as antibodies which kill the sperm We analyze the cervical liquid from the female, the sperm from the man, and also blood samples from both the female and the male.
The best method for this is the IUI ( Intra Uterine Insemination ) which is injecting the fast-motile sperm into the uterus directly. If there is no pregnancy after 3 IUI procdures, then IVF or IVF/ICSI will be used.
6) Problems in the abdominal lining ( peritoneum)
Abdominal lining can reduce the ability of the fallopian tube to receive the egg inside. For the diagnosis, we use laparoscopy. Laparoscopy is a surgical procedure and allows the physician to see the interior of the abdomen and proceed with the treatment. For example, endometriosis can be diagnosed via laparoscopy and today % 20 of infertile women suffer from this condition
7) Polycystic Ovarian Syndrome (PCOS)
This is a fertilization problem during the fertile period of the woman. Almost % 5-10 of women suffer from this condition. There is a hormonal imbalance which prevents the ovaries to function normally. Usually, ovaries get bigger because of certain cycts full of liquids.
Here are some diagnostic findings of this condition:
- None or irregular cycles
- None or irregular ovulation
- Being overweight
- No reaction to insulin
- High cholesterol level and trigliserid level
- Oily skin
- Increase in hairiness of the face or body
- Hair loss like in men
The best treatment method in PCOS patients is to loose weight and balance of the insulin level. Afterwards, different kind of medication will be used to treat the ovulation problem. If all these fail, then IVF or IVF/ICSI will be the answer.
Endometriosis is one of the most important reasons for infertility in women. Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body. Endometriosis lesions can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall.Other common sites include the uterosacral ligaments, the cul-de-sac, the Pouch of Douglas, and in the rectal-vaginal septum. In addition, it can be found in caecarian-section scars, laparoscopy or laparotomy scars, and on the bladder, bowel, intestines, colon, appendix, and rectum. In rare cases, endometriosis has been found inside the vagina, inside the bladder, on the skin, even in the lung, spine, and brain. The most common symptom of endometriosis is pelvic pain. The pain often correlates to the menstrual cycle, but a woman with endometriosis may also experience pain that doesn’t correlate to her cycle. For many women, the pain of endometriosis is so severe and debilitating that it impacts their lives in significant ways. Endometriosis can also cause scar tissue and adhesions to develop that can distort a woman’s internal anatomy. In advanced stages, internal organs may fuse together, causing a condition known as a “frozen pelvis.” .
For the diagnosis of endometriosis, laparoscopy is being used. We look if the tissue is present in different places of the lining. The treatment method will be chosen according to the level of the endometriosis.
9) Women’s Cancer
Our patients are scanned by our doctors specialized on gynecological cancers by means of gynecologic cancers, Pap smear, vaginal ultrasound, blood tests and breast inspections. Jinemed is a women scanning center. It is one of the most appropriate centers to consult on Gynecological Oncology.
- Pap Smear
- HPV Virus
- Wart Infection
- Thin Prep
- Cone Biopsy
- Uterus Cancers
- Irregular Bleedings
- Endometrial Hyperplasia
- Endometrial Polyp
- Myomas, Sarcomas
- Ovarian Cancer, Chocolate Cyst
- Ca 125
- Ca 19-9
- Vulvar Cancers
- Vaginal Cancers
- Breast Cancers