If after two years of active attempts by a couple, conception does not occur, it talks about probable infertility. In this case, it is recommended, without further delay, to seek medical attention, undergo an examination and find out the cause. Don't delay, because the sooner the diagnosis is made and treatment started, the greater the chance of success. Success in the treatment of infertility is the birth of a healthy baby.
The problem of infertility is relevant worldwide. According to statistics, about 20% of all couples are infertile. One of the solutions to this global problem is ART - assisted reproductive technologies. This is the name of those methods of infertility treatment in which some or all of the stages of fertilization are performed by reproductive specialists outside the mother's body.
Infertility types
Infertility can be female and male, as well as mixed and combined. According to the WHO, there are 22 female infertility factors and 18 male infertility factors. Mixed infertility is called infertility caused by several factors in one person at once, and combined is one that has causes from both the woman and the man.
Depending on the cause, infertility is called tubal, uterine, endocrine, immune, and infertility of unexplained genesis is also standed out - when, despite a thorough examination of the couple, the cause cannot be found.
The most common causes of female infertility: Fallopian tubes obstruction, lack of ovulation due to endocrine disorders, endometriosis, inflammatory diseases.
The most common causes of male infertility: insufficient number of spermatozoa or their poor motility, abnormal spermatozoa, ejaculation disorders (vas deferens obstruction), endocrine pathology.
There are also primary infertility - pregnancy has never occurred, and secondary, which developed after at least one pregnancy.
Infertility can also be absolute - when conception is impossible, for example, in the absence of a uterus, and relative - when conception is possible after the cause has been eliminated.
Infertility Treatment Methods
Some types of infertility caused by inflammation or hormonal disorders can be treated with medication. Infertility caused by obstruction of the reproductive tract, in some cases, can be eliminated with the help of surgery. If neither medical nor surgical treatment brings the desired result, ART (assisted reproductive technologies) is used to treat infertility.
ART is a method of fertilization, some of the stages of which occur outside the body of a woman. These include:
● intrauterine insemination (IUI);
● in vitro or artificial insemination (IVF);
● ICSI (intracytoplasmic sperm injection);
● TESA (Testicular Sperm Aspiration, aspiration of spermatozoa from testicular tissue), PESA (Percutaneous Epididymal Sperm Aspiration, aspiration of sperm from the epididymis) and TESE (Testicular Sperm Extraction, removal of sperm from testicular tissue);
● use of donor material (sperm, oocytes or embryos);
● surrogacy.
Intrauterine insemination
The method consists in introducing prepared sperm into the uterine cavity using a catheter. It is used when sperm cannot pass through the cervical canal due to problems with the canal itself (cervical factor infertility) or sperm problems (insufficient spermatozoa activity).
In Vitro Fertilization
IVF is also called test tube conception. To do this, the oocytes extracted from the ovaries are placed in a laboratory dish, where the prepared sperm is added. After some time, the formation of blastocysts
(precursors of embryos) is assessed and cultured for five days. After that, the most successful embryos are selected and transferred to the uterus.
Intracytoplasmic Sperm Injection
ICSI is a type of IVF. The difference is that the process of egg fertilization is done manually under a microscope: a specially selected sperm is placed in a microneedle, then the prepared egg is pierced with this needle and the sperm is injected inside. All other stages correspond to the usual artificial insemination.
TESA, TESE, PESA
These are surgical methods for obtaining spermatozoa, TESA and PESA - using puncture, and TESE - using microsurgery. The methods are used in violation of the production and maturation of spermatozoa, that is, when there are not enough or no spermatozoa in the ejaculate that can fertilize an egg.
Donor oocytes, sperm and embryos
Artificial insemination techniques using donor material offer hope for healthy children to people who do not have their own reproductive cells, as well as to those who are at high risk of transmitting genetic diseases.
Surrogate Motherhood
This is ART that allows couples to get offspring for which all previous ART either did not fit or were unsuccessful.
Infertility is surmountable problem anyway. It is not always possible to solve it on the first try, besides, the age factor plays a role: after reaching a certain age (40 years for women), the chances of success begin to decline. Therefore, reproductologists advise not to postpone this problem until later. The earlier infertility treatment is started, the chances of success is higher.
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