Find out how to determine infertility in women. This diagnosis is made to a woman if, within 1 year or more, with the regularity of sexual relations without the use of contraception, pregnancy does not occur. Absolute infertility is diagnosed if a woman has irreversible anatomical disorders that make conception impossible (lack of fallopian tubes, uterus, ovaries). With relative infertility, treatment is carried out and reproductive function is restored.
Also, primary infertility is distinguished, which is characterized by the absence of pregnancies in the woman's history and secondary - the impossibility of re-conception. Infertility occurs in 10-15% of couples. Of these, in about 40% of cases, male infertility is observed, inthe remaining 60% are female.
Causes of female infertility
To understand how to determine infertility in women, let's look at the causes of the pathology. The main provoking factor can be a violation of physical he alth. A woman's social, family and mental problems can also lead to infertility. To select a treatment tactic, it is necessary to determine the exact causes that caused it.
The most common causes of infertility in married women include:
- increased secretion of prolactin;
- tumor neoplasms of the pituitary gland;
- various forms of menstrual disorders (oligomenorrhea, amenorrhea, etc.) provoked by hormonal imbalance;
- congenital anatomical defects of the genital organs;
- endometriosis;
- bilateral obstruction of the fallopian tubes;
- adhesions in the pelvic area;
- acquired malformations of the genital organs;
- common autoimmune pathologies;
- tuberculous lesions of the reproductive organs;
- psychosexual disorders;
- negative postcoital test;
- unclear reasons.
Degrees of infertility
In medicine, there are three degrees of infertility in women. Primary (1st degree) is characterized by the fact that the woman has never had a pregnancy. What does 2nd degree infertility mean? The woman in this case had previous pregnancies, and repeated attempts at conception were unsuccessful. We can say about infertility of the 3rd degree that this is a kind of absolute second, but doctorsthe diagnosis is usually not used. It is understood that a woman permanently loses the ability to procreate.
Varieties
Classify also forms of infertility in women:
- endocrine (hormonal);
- tubal-peritoneal;
- uterine;
- infertility due to the development of endometriosis;
- immune;
- infertility of unknown etiology.
Describe each.
Endocrine infertility
Endocrine form of female infertility is caused by violations of the hormonal regulation of the cycle, which ensures ovulation. This form is characterized by anovulation due to insufficient maturation of the egg or its absence from the follicle. This is often due to injuries or pathologies of the hypothalamic-pituitary region, excessive secretion of prolactin, polycystic ovaries, progesterone deficiency, inflammatory and tumor formations of the ovaries.
Tubal infertility
This form develops in cases where there are anatomical obstacles along the path of the egg through the fallopian tubes to the uterus, i.e. both tubes are impassable or absent. With peritoneal infertility, an obstruction occurs not in the tubes themselves, but between them and the ovaries. The tubal-peritoneal type usually occurs as a result of adhesive processes or after atrophy of the cilia located inside the tube and ensuring the movement of the egg. May lead to adhesions in the fallopian tubesreproductive system surgery.
Uterine infertility
This form of pathology is caused by anatomical (acquired or congenital) anomalies of the uterus. Congenital defects are its underdevelopment, doubling, saddle shape or the presence of an intrauterine septum. Acquired defects of the uterus are its cicatricial deformity, intrauterine synechia or tumors. Acquired anomalies develop as a result of surgical interventions, such as after an abortion.
Infertility due to endometriosis: how does it manifest itself and why does it occur?
Often, infertility provokes endometriosis in women (the symptoms and treatment are determined by the doctor). This pathology is diagnosed in about 30% of the fair sex. Main signs: heavy menstruation, pain syndrome, discomfort during intercourse.
The mechanism of the impact of this disease on infertility has not yet been fully elucidated, but it can be reliably said that endometriosis areas in the ovaries and tubes prevent the normal course of ovulation and the movement of the egg through the tubes. The symptoms and treatment of endometriosis in women are interrelated. How to treat this form of infertility, we will tell below.
Immune infertility
The development of the immune form of this pathology is associated with the presence of antisperm antibodies in the body - a specific immunity that is produced against the embryo or spermatozoa. In about half of the cases, such infertility is provoked not by a single factor, but by a complex of several reasons. In a numbercases, they remain unidentified even after careful diagnosis.
Female fertility test
There are many different methods for determining infertility in women. However, these are not tests that can determine the presence of pregnancy at home. A similar type of infertility test can be performed on men to determine sperm motility and quality. For women, laboratory and instrumental tests are recommended.
So, how to determine infertility in women? The easiest and most affordable way to indirectly confirm the pathology is an ovulation test, which can also be done at home. This technique is similar to express methods for confirming pregnancy. In this case, a special strip is placed in the urine. Before the release of the egg from the follicle, there is an increase in LH, to which such a test reacts. If pregnancy is not possible, tests are usually negative.
Such a test for infertility in women is used only if an endocrine type of disease is suspected. In other cases, ovulation may occur, but pregnancy does not occur for other reasons, for example, if the egg does not pass through the fallopian tube due to its obstruction.
Clinical guidelines for female infertility
The decision on infertility therapy is made by the doctor after evaluating the results of all diagnostic examinations and establishing accuratethe reasons that caused it. Treatment usually begins with the elimination of the original cause. The techniques used in this are aimed at:
- to restore the patient's reproductive functions by surgical or conservative methods;
- use of assistive technology when natural conception is not possible.
In the endocrine form of the pathology, the hormonal disorder is corrected and the ovaries are stimulated. Non-drug types of correction include weight normalization (in case of obesity) through diet therapy and increased physical activity, physiotherapy.
Endocrine Infertility Therapy
The main type of drug therapy for the diagnosis of infertility in women of the endocrine type is hormonal treatment. The process of maturation of the follicle is controlled by ultrasound monitoring and monitoring the content of hormones in the blood. With an adequate selection of hormonal medications, 70-80% of patients with this form of infertility become pregnant.
Elimination of the tubal-peritoneal form of pathology
In the tubo-peritoneal form of the disease, the goal of treatment is to restore the normal patency of the fallopian tubes using laparoscopy. The efficiency of this method is approximately 30-40%. With prolonged adhesive obstruction or with the ineffectiveness of a previous operation, artificial insemination is recommended.
Treatment of the uterine form of the disease
In cases of development of the uterine form of female infertility and the presence of its anatomical defectsperform reconstructive plastic surgery. Pregnancy occurs in approximately 15-20% of cases. If it is not possible to promptly correct the uterine form of infertility and to bear the child independently, the services of a surrogate mother are resorted to.
How to treat infertility due to endometriosis?
Infertility due to endometriosis is treated through laparoscopic endocoagulation, during which pathological foci are removed. The result of surgical treatment is fixed by a course of medication. The chance of pregnancy after this is about 30-40%.
Immune infertility: how to fight?
In immunological infertility, in most cases, artificial insemination is carried out through artificial insemination. This technique allows you to overcome the immune barrier of the cervix and in 40% of cases contributes to the onset of conception.
Treatment of unexplained infertility in women
Therapy of unidentified forms of this pathology is a very difficult problem. In these cases, most often resort to the use of assisted reproductive technologies. In addition, indications for IVF are:
- absence of fallopian tubes or tubal obstruction;
- condition after conservative therapy and laparoscopy for the elimination of endometriosis;
- absolute infertility of the sexual partner;
- ovarian exhaustion;
- unsuccessful treatment of endocrine forms of infertility;
- relatedpathologies in which pregnancy is impossible;
- some cases of uterine infertility.
In vitro fertilization methods
The main methods of artificial insemination are:
- Intrauterine insemination with partner or donor sperm.
- Intracellular injection of a spermatozoon into an egg.
- Surrogacy.
- In vitro fertilization.
- Using a donor embryo or a donor egg.
The age of the spouses affects the effectiveness of infertility therapy, especially for women (after 37 years, the probability of successful conception is sharply reduced). Therefore, treatment of this pathology should be started as early as possible, which significantly increases the chances of having he althy offspring and allows you to get by with minimal drug costs. It should be remembered that surgical methods of treatment are used only in extreme cases and many forms of the disease can be treated with conservative methods.
We looked at how to determine infertility in women.
