Infertility (İnfertilite)
Definition: Infertility refers to the inability to conceive despite regular sexual intercourse for a year. If you are a woman over 35 years old, the inability to conceive after six months of trying is considered infertility. Additionally, the ability to conceive but the inability to have a live baby also constitutes infertility.
Primary and Secondary Infertility: A woman who has never been pregnant is diagnosed with primary infertility, while a woman who has had at least one pregnancy is diagnosed with secondary infertility.
Male Infertility: Infertility is not just a female issue. Men can also be infertile. About one-third of infertility cases are attributed to female infertility, one-third to male issues, and the remaining third may result from a combination of both or have no known cause.
When to See a Doctor?
If you experience any of the following situations, I recommend seeing a gynecologist specializing in infertility:
- If you are under 35 and have been trying to conceive for at least one year.
- If you are 35 or older and have been trying to conceive for six months or longer.
- If you are over 40.
- If you have irregular menstrual cycles.
- If you experience pelvic pain.
- If you have a known infertility diagnosis.
- If you have been diagnosed with endometriosis or pelvic inflammatory disease.
- If you have had multiple miscarriages.
- If you have undergone cancer treatment.
For your partner:
- If they have low sperm count or other sperm-related issues.
- If they have a history of testicular, prostate, or sexual issues.
- If they have undergone cancer treatment.
- If they have small testicles or swelling in the scrotum.
- If there are others in your family with infertility issues.
I recommend consulting with a gynecologist. Your partner may sometimes be referred to a urologist specializing in infertility.
Common Causes of Infertility in Women:
- Ovulation problems (e.g., polycystic ovary syndrome (PCOS))
- Blockages in the fallopian tubes
- Pelvic inflammatory disease (PID)
- Uterine problems
- Tubal ligation
- Endometriosis
- Advanced maternal age
- Autoimmune causes
Ovulation issues can arise from:
- Hormonal imbalances
- Tumors or cysts
- Eating disorders (such as anorexia or bulimia)
- Alcohol or drug use
- Thyroid problems
- Obesity
- Stress
- Excessive exercise
- Very short menstrual cycles
Causes of damage to the fallopian tubes or uterus include:
- Pelvic inflammatory disease
- Previous infections
- Polyps in the uterus
- Endometriosis or fibroids
- Previous surgeries and adhesions
- Chronic medical conditions
- Previous ectopic (tubal) pregnancy
- DES syndrome (the drug DES, given to women to prevent miscarriage or preterm birth, can cause fertility issues in their children)
Abnormal cervical mucus can also cause infertility in women, as it may prevent sperm from reaching the egg or hinder its entry.
Infertility Treatment:
When planning treatment, various tests and evaluations are conducted to establish a diagnosis:
- A sperm analysis (spermiogram) for the male
- Hormone testing for the female
- Counting eggs and performing an ultrasound on days two and three of the menstrual cycle
- Measuring progesterone hormone on day 21 of the cycle
- HSG (hysterosalpingography) or sonohysterography (SIS)
In about 25% of cases, no cause can be found, leading to a diagnosis of unexplained infertility.
