What is Infertility? What Causes It? Diagnosis and Treatment Process
Are you unable to conceive?
While pregnancy is a natural process for many couples who wish to have children, for some couples, pregnancy may take longer than expected. This situation does not always mean there is a serious health problem. However, if pregnancy does not occur despite unprotected and regular sexual intercourse for a certain period, evaluation is important.
Infertility is a health condition that affects many couples today but can be significantly managed with correct diagnosis and appropriate treatment.
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What is Infertility?
Infertility is defined as:
● For women under 35: 12 months,
● For women aged 35 and over: 6 months
of regular, unprotected sexual intercourse without conception.
In some cases, evaluation may be necessary without waiting for this period. For example, early consultation is recommended if there is menstrual irregularity, a history of previous tubal infection, endometriosis, chemotherapy, or suspicion of a male factor.
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How Common is Infertility?
Approximately one in every 6–7 couples in society may need an infertility evaluation at some point in their lives.
Therefore, it is important to know that you are not alone. Today, many causes can be successfully diagnosed and treated.
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What are the Causes of Infertility?
Infertility is not solely a female issue.
It is evaluated approximately as:
● Female-related causes
● Male-related causes
● Causes related to both partners
● Unexplained infertility
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Female-Related Causes
The most common causes are:
Ovulation disorders
● Polycystic Ovary Syndrome (PCOS)
● Thyroid diseases
● Hyperprolactinemia
● Premature ovarian failure
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Blocked fallopian tubes
Damage or blockage in the fallopian tubes can prevent sperm and egg from meeting.
Causes:
● Past infections
● Abdominal surgeries
● Endometriosis
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Endometriosis
This is the presence of tissue similar to the uterine lining outside the uterus.
This condition can negatively affect:
● Ovarian reserve,
● Tubal function,
● Conception
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Intrauterine problems
● Polyps
● Fibroids
● Intrauterine adhesions
● Congenital uterine anomalies
can make pregnancy difficult.
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Age Factor
In women, egg count and quality decrease with age.
Especially after age 35, the chance of pregnancy gradually begins to decline.
After age 40, the decrease becomes more pronounced.
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Male-Related Causes
Male factor infertility is also quite common.
The most common causes are:
● Low sperm count
● Motility disorders
● Morphology disorders
● Varicocele
● Hormonal disorders
● Genetic diseases
Therefore, infertility evaluation should be planned for both partners.
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Unexplained Infertility
In some couples, despite all evaluations being normal, pregnancy may not occur.
This condition is called “unexplained infertility.”
With an appropriate treatment plan, pregnancy can be achieved in many couples.
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How is Infertility Evaluated?
A detailed history is taken during the initial consultation.
The evaluation may include the following steps:
● Detailed gynecological examination
● Ultrasonography
● Ovarian reserve assessment (AMH, AFC)
● Hormone tests
● Hysterosalpingography (HSG) if necessary
● Sperm analysis
● Other necessary laboratory tests
The evaluation is individually planned for each couple.
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What is Ovarian Reserve?
Ovarian reserve is one of the important indicators showing the remaining egg capacity of the ovaries.
In the evaluation:
● AMH
● Antral follicle count (AFC)
● Age
● FSH and other hormones
are evaluated together.
Ovarian reserve alone does not indicate the chance of pregnancy; it should be interpreted in conjunction with clinical evaluation.
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Infertility Treatment Methods
Treatment is planned by determining the cause.
Main options:
Ovulation induction: Can be applied to women with ovulation problems.
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Intrauterine Insemination (IUI)
Can be considered for suitable couples.
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In Vitro Fertilization (IVF)
May be the most suitable option in some cases.
For example:
● Advanced age
● Severe male factor
● Blocked fallopian tubes
● Certain cases of endometriosis
● Repeated failed treatments
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Surgical Treatments
In patients deemed necessary:
● Hysteroscopy
● Laparoscopy
● Polyp or fibroid surgery
can be planned.
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Does Lifestyle Affect the Chance of Pregnancy?
Yes.
For couples planning pregnancy:
● Quitting smoking
● Achieving a healthy weight range
● Regular exercise
● Balanced nutrition
● Limiting alcohol
● Controlling chronic diseases
can positively affect reproductive health.
You can contact us for appointments and information.