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Infertility in women: causes, signs, diagnosis and treatment methods

Pregnancy does not always occur when the couple decided that it was time to have a baby. Some couples after a year of unsuccessful attempts, doctors put on infertility and begin to find out the reasons why pregnancy does not occur.

And if a man on the subject of infertility can be examined very quickly (you just need to take a spermogram ), then a woman’s examination can take months and require money, patience and sometimes courage, since some diagnostic measures are quite painful.

Content

Causes of problems with conception

Causes of problems with conception

The absence of pregnancy for a long time is the result of dysfunctions of the endocrine, immune systems, infectious diseases, inflammatory processes or congenital abnormalities of the reproductive organs.

Hormonal factor

This is one of the most common causes of infertility in women. About the problems in the endocrine system can not be learned with a simple gynecological examination or ultrasound. The exact answer can only give the results of blood tests for hormones.

– влияет на образование доминантного фолликула в яичниках и на способность капсулы этого фолликула прорваться и выпустить созревшую яйцеклетку. Excess testosterone - affects the formation of a dominant follicle in the ovaries and the ability of the capsule of this follicle to break through and release a mature egg. Women with an excess of testosterone may suffer from follicular cyst formation.

– эстрогены влияют на рост доминантного фолликула и на толщину эндометрия в матке. Estradiol deficiency - estrogens affect the growth of the dominant follicle and the thickness of the endometrium in the uterus. When these hormones are deficient, the dominant follicle may not form, or grow, but regress just before ovulation.

And the endometrial layer usually grows very slowly, and by the time the egg leaves the follicle it reaches only 5-6 mm instead of the set 13-14 mm.

– лютеинизирующий гормон отвечает за разрыв капсулы доминантного фолликула. LH deficiency - luteinizing hormone is responsible for breaking the capsule of the dominant follicle. If the integrity of its wall is not broken, then the dominant follicle will grow into a cyst.

– может блокировать наступление овуляции и способствовать регрессу доминантного фолликула, даже если он созрел до больших размеров. Excess prolactin - can block the onset of ovulation and contribute to the regression of the dominant follicle, even if it has matured to large sizes.

These are just a few examples of hormonal infertility in women. In fact, all of the above factors may be present both individually and in combination with each other.

For example, very often increased testosterone causes a decrease in the level of estrogen in the blood.

Pipe factor

The inability to conceive a child is sometimes due to obstruction of the fallopian tubes.

In the fertilization process, this paired organ plays a leading role - it is there that sperm cells meet with the egg cell, it is from there that the fetal egg descends into the uterus for several days to implant into one of its walls.

In the presence of adhesions in the fallopian tubes , if they are diagnosed with complete or partial obstruction, there are two possible outcomes:

  1. Sperm cells will not be able to penetrate the cavity of the tube and fertilize the egg.
  2. Sperm can reach the tube and fertilize the egg, but the fetal egg cannot descend into the uterus because of adhesions. As a result, it is implanted in the wall of the fallopian tube and the pregnancy will become ectopic .

The fallopian tubes may be completely absent in the pelvic cavity due to congenital developmental abnormalities, or due to the removal of both tubes after ectopic pregnancies.

Immunological factor

Immunological factor of female infertility

Immunological factor of female infertility

This cause of infertility is expressed in the fact that a woman has antibodies to sperm. As a rule, these are immunoglobulins of the class IgG, IgA and IgM.

Moreover, the immunological factor can cause infertility in both women and men. Antibodies, depending on their class, can be attached to the head or to the tail of the sperm. This has a different effect on its ability to fertilize an egg.

For example, antibodies of the IgG class, which are mainly attached in the head of the sperm cell, deprive it of its ability to penetrate the shell of the egg cell. This means that viable sperm cannot fertilize, even if it reaches the fallopian tubes.

The immunological factor of female infertility is poorly understood, although it is often detected: of all women suffering from infertility, 15% have infertility of an immunological nature.

Endometriosis

The proliferation of the endometrium, especially if it occurs in the uterus, is fraught with the fact that the fertilized egg will not be able to gain a foothold on its wall.

The endometrial layer will be so thick that it can exfoliate from the uterus, together with a fertilized egg attached to it.

These are the main causes of problems with conception, which are especially common among women suffering from infertility.

In addition, pregnancy may not take place due to abnormalities of the reproductive organs, stress, as a result of genetic failure, uterine tumors of various origins.

Signs of infertility in women

Signs of female infertility, photo 3

You can not guess about infertility, but in most cases there are certain symptoms that directly or indirectly indicate that there will be problems with conceiving a child.

There are several signs of infertility in women:

  • Violations of the menstrual cycle. This does not always mean that there will never be a pregnancy, but such failures are a reason to undergo a thorough examination.
  • Lack of pregnancy, if within a year a couple lives an active sex life and is not protected.
  • Lack of pregnancy, if a couple tries to conceive a child for six months, focusing on the data of folliculometry, and at the same time having good semen readings.

Degrees of Female Infertility

1st degree infertility in women In medical practice, infertility is called either primary or secondary.

Sometimes they can diagnose both the primary and secondary degree of infertility in women, though not simultaneously - sequentially, at different periods of her life.

Primary infertility - is placed in the event that the pregnancy never occurred, provided that the patient was sexually active without using contraceptives.

Secondary infertility - is placed in the event that a woman was pregnant at least once in her life. It does not matter: whether this pregnancy ended in childbirth or miscarriage.

The determining factor for setting 2 degrees of infertility is the impossibility of conceiving at the moment, despite the fact that it was possible to get pregnant earlier.

Diagnosis of infertility in women

Methods of diagnosis of female infertility will depend entirely on what reason has led the reproductive organs to a state in which pregnancy has become impossible.

  1. The study of hormonal levels.
  2. Immunological study of the secretion of women for the presence of AST (antisperm antibodies).
  3. Ultrasound.
  4. GHA and SSS - to study the patency of the fallopian tubes.
  5. Laparoscopy is most often used in cases where the reasons for preventing a woman from becoming pregnant are unclear to the doctor.
  6. A picture of the Turkish saddle is an x-ray examination that helps to determine the developmental anomaly of the cranium, which can interfere with the normal functioning of the pituitary gland.

Diagnosis of infertility in women takes a lot of time, most often several months. This is because many analyzes and studies need to be carried out only on certain days and phases of the cycle.

Infertility treatment in women

Like diagnostics, treatment regimens are completely dependent on which factor caused infertility.

Infertility treatments

Infertility treatments

If you once managed to get rid of the problems that prevent getting pregnant, this does not mean that they will not recur in the future, therefore the effect of infertility treatment in women is often temporary.

Drug treatment

It includes drugs whose action is aimed at leveling hormonal levels, eliminating inflammatory processes or suppressing the immune system, if the cause of the absence of pregnancy was an immune factor.

Specific drugs in this case are difficult to name, since the treatment regimen is individual and can be aimed at eliminating several diseases at once, due to which infertility has been diagnosed.

– применяются при лечении ЗППП , наличие которых обусловило воспаления органов репродуктивной системы. Antibacterial agents are used in the treatment of STDs , the presence of which has caused inflammation of the reproductive organs.

– применяются при сбоях работы эндокринной системы, а также для достижения Ребаунд-эффекта (зачатие ребенка на фоне отмены оральных контрацептивов). Hormonal drugs are used in case of endocrine system malfunctions, as well as to achieve a reboot effect (conceiving a child against the background of canceling oral contraceptives).

– предназначены для подавления иммунного ответа организма на сперматозоиды партнера. Means of immunosuppressive therapy - designed to suppress the body's immune response to partner sperm.

Physiotherapy treatment

Most often used in cases where the patient is diagnosed with adhesions in the fallopian tubes, with partial obstruction.

Electrophoresis is used with drugs that have a resolving effect (lidaza, sodium triosulfate).

In the hospital, douching drugs are used, which also have the ability to dissolve mature collagen and have an anti-inflammatory effect.

Surgery

It is used in cases when conservative therapy has no effect, or when it is initially clear to doctors that medical treatment will not bring any results.

Surgical intervention is required in the following cases:

  • Complete or partial obstruction of the fallopian tubes.
  • Plastic tubal ligation.
  • Anomalies of the structure of the uterus and appendages.
  • Endometriosis.
  • Ovarian cysts.
  • Tumors of the uterus.

Artificial insemination

IVF, ICSI and AI are infertility treatment methods that can help when even surgery is powerless. However, their use is fraught with two difficulties: the high cost of the procedures and a rather low percentage of embryo survival.

  1. IVF - involves mixing several eggs and spermatozoa in one tube, and subsequent 1-2 or 3 fetal eggs in the uterus.
  2. ICSI - involves the artificial insertion of a single sperm under the egg shell. The resulting embryo will also be transferred to the uterus for subsequent implantation.
  3. AI - involves the input portion of the processed sperm directly into the uterus, bypassing its passage through the cervix.

During IVF and ICSI, a puncture of the eggs from the ovary is taken from the woman after stimulation of superovulation.

5 general recommendations

5 recommendations for expectant mothers

Не откладывайте визит к врачу, если в течение года регулярной половой жизни без использования средств контрацепции беременность так и не наступила. 1. Do not postpone the visit to the doctor if during the year of regular sexual life without using contraceptive methods the pregnancy has not occurred. Remember: time does not work for you, and the woman’s reproductive function is significantly limited.

Не занимайтесь самолечением – это может усугубить уже имеющиеся проблемы. 2. Do not self-medicate - this may aggravate existing problems. Only a gynecologist or gynecologist-reproductologist can prescribe competent treatment (its functions and powers are much wider than those of a simple gynecologist).

В профилактических целях 1 раз в год посещайте гинеколога, сдавайте кровь на гормоны и делайте УЗИ органов малого таза. 3. For preventive purposes, visit the gynecologist once a year, donate blood for hormones and do an ultrasound of the pelvic organs.

Обширного воспалительного процесса в фаллопиевых трубах можно избежать, если начать лечение при обнаружении небольшого количества спаек. 4. An extensive inflammatory process in the fallopian tubes can be avoided if treatment is started when a small amount of adhesions is detected.

Аборт часто становится причиной бесплодия, потому что он наносит репродуктивной системе гораздо больше вреда, чем обычные не отягощенные роды. 5. Abortion often causes infertility because it causes the reproductive system to do much more harm than normal unburdened childbirth.

Therefore, sexual intercourse and contraception should be taken seriously in order to prevent unwanted pregnancy, from which then you will need to get rid of.

Interesting
Olga Makhina
2017-05-26 12:54:12
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