According to today's disappointing world statistics, about 5% of families cannot have children at all. These numbers represent infertility in humans, which, unfortunately, is more difficult to correct. Infertility diagnostics has become the most demanded service.

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A large number of couples turn to doctors, who after the examination turned out to be absolutely healthy, but the long-awaited pregnancy still did not occur naturally. There are about 15% of married couples in any country.

What is infertility?

Infertility can be talked about when a couple cannot conceive a child for more than a year, if they do not use various contraceptives... Unfortunately, quite a lot of married couples now face such a problem in our country!

Modern medicine has already been able to achieve the highest accuracy in diagnosing various functional abnormalities, as a result of which such a state of health appears. However, often after the examination, doctors cannot find the problem and patients desperately grab any, even unthinkable, methods of treatment, in some cases there is also a surgical intervention.

Causes of infertility in women and men

The most common factors in the development of the disease are various anatomical disorders, namely abnormalities in the structure of organs directly reproductive system... To identify them, it is necessary to conduct an examination of the body.

Diagnosis of infertility in women is carried out to identify possible diseases and destination effective treatment... Most often the main reason are various gynecological diseases, also endocrine and infectious.

Infertility in male patients can be acquired or genetic, in some cases it can occur as a result of trauma, when exposed to unfavorable factors(alcohol consumption, psychostimulating substances, constant smoking, stress). In addition, in men, immunological and endocrine forms of the disease can occur, therefore, it is necessary to conduct an examination here.

The development of the disease in many cases can be caused by the simplest problems, so if a couple cannot naturally conceive a child, then first an examination and diagnosis of infertility in men should be carried out. Pregnancy in some cases may not occur due to genetic incompatibility of partners or the appearance of hormonal problems.

Infertility diagnostics at the Neo Vita clinic

The basis of treatment is an individual approach, as well as the search for the main cause. After the examination, a group of specialists carefully works with each patient of our clinic. This group includes a gynecologist, endocrinologist, urologist, osteopath, family psychologist, reflexologist, nutritionist, and psychotherapist.

We have the most effective ways treatment. Each of them serves to achieve one goal - the harmonization of processes in the body of a woman and a man so that conception can occur naturally.

To reveal true reasons diseases, doctors use the most effective, harmonious and complex methods:

Spermography. This is the main method for judging a man's reproductive capacity. The physical and chemical properties of sperm, the number of living sperm and their motility are analyzed. Based on this study, a conclusion is made about male fertility and the factor of male infertility in a couple is excluded or confirmed. Spermogram results may indicate certain diseases of the male genital area, which are often the cause of infertility.

Analysis of hormonal levels. Hormones regulate all processes in the body and reproductive function is no exception. Malfunctions of the endocrine system often cause infertility in both women and men. When diagnosing the causes of infertility, it is important to find out the hormonal status of both partners.

Comprehensive 4D diagnostics. This instrumental study gives a comprehensive picture of the state of the body and its functions, based on the analysis of the activity of the vegetative nervous system... 4D diagnostics allows detecting hidden diseases and disorders even at the earliest stages of their development. The method is very informative and is successfully used in the diagnosis of infertility along with traditional types of research.

Diagnostics of the psycho emotional state. In some cases, psychological sterility is not an ephemeral concept, but an objective reality. Unconscious fears and internal conflicts can have a very tangible impact on the reproductive system. This is possible because the function of the genital organs is regulated in a neurohumoral way and depends on the activity of the hypothalamic-pituitary system, which is sensitive to the slightest changes in the emotional state of a person. Our feelings and emotions can be the cause of psychosomatic disorders that inhibit reproductive function. In such a situation, for the treatment of infertility, it is necessary to combine the efforts of doctors with the work of a qualified and experienced psychotherapist.

Diagnostics of the osteopath. This specialist can identify circulatory disorders, spasms, excessive muscle tension that restricts the natural mobility of the pelvic organs and other pathologies that prevent successful conception. By providing a special manual effect, the osteopath activates the process of restoring the reproductive system.

Testing for possible genital infections. Sexually transmitted infections are the main cause of inflammatory diseases of the reproductive organs. Long-term inflammation leads to adhesions and obstruction of the tubes in women. In men, some infections can reduce sperm motility and cause obstructive infertility if the epididymis is affected.

Hysterosalpingography. Highly informative patency study fallopian tubes and uterus. During the study, adhesions, endometrial polyps, uterine malformations and other pathologies can also be detected.

Diagnostics of infertility in Moscow is carried out quickly and efficiently, as the clinic employs experienced specialists.

Infertility treatment at the Neo Vita clinic

Unfortunately, doctors often offer a solution to the problem of infertility with the help of IVF and patients agree to this unsafe procedure, not realizing the consequences of such an unsafe way to achieve the result.

Our specialists always proceed from the assumption that infertility treatment consists, first of all, in the elimination of all the reasons that prevent the natural onset of pregnancy, even if it takes a long time, because in most cases it is possible to help solve the problem with gentle methods that do not harm the health of the woman and the fetus. ...

A number of unique techniques have been developed at the Neo Vita clinic, with the help of which our doctors have been helping women for many years to get rid of such common causes of infertility as stenosis of the cervical canal, endometriosis, uterine fibroids, incompatibility of vaginal mucus with the partner's sperm, and psychological infertility. The experience of our specialists shows that there are very few cases when IVF is the only way out in the treatment of infertility, basically it is a complete obstruction or absence of fallopian tubes, which is quite rare.

At the Neo Vita clinic, a gynecologist-endocrinologist, the creator of unique author's methods of treating infertility, as well as uterine fibroids and endometriosis without surgery, provides free consultations on these problems. As a result of a comprehensive examination, an individual treatment is developed that combines the effects on each identified factor.

The purpose of our consultations is to help as many women as possible to identify the disease in time and to receive maximum information on the most correct, harmonious treatment.

You can get an online doctor's consultation on this issue
from anywhere in the world. The cost of a consultation is 3,000 rubles.

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July 9

The author's program of infertility treatment without IVF was presented in Novy Knizhny

On July 7, in Novy Knizhny on Malaya Sukharevskaya Square, a seminar was held by a gynecologist-endocrinologist of the Neo Vita clinic, candidate medical sciences Volkovinskaya Natalia

Content

Diagnosis of infertility includes examination of sexual partners for diseases of the reproductive system and involves the use of instrumental, laboratory, hardware, invasive surgical tactics. Thanks to modern research methods, it is possible to timely identify severe pathologies of the reproductive system: endocrine, congenital, infectious, genetic abnormalities. Diagnostic measures pursue the goal of choosing the optimal and fast options for treating infertility, observing an individual approach.

When to see a doctor

The diagnosis of infertility according to WHO standards should be carried out within 3-4 months from the moment the couple applies for medical help.

Absence of pregnancy with active planning throughout the year, when not used oral contraceptives and barrier methods of protection, it becomes a reason for visiting a doctor. The inability to conceive may not be accompanied by other symptoms, but most often women note some bright or minor pathological signs.

It is necessary to undergo a fertility test for certain symptoms.

1. Irregular menstrual cycle, manifested by the onset of menstruation more than once every 24-25 days or less than once every 35 days.
2. Scanty or excessively profuse, painful menses.
3. Appearance in the middle of the menstrual cycle bloody discharge, as well as a brown daub at the beginning of menstruation.
4. Excessive growth of body hair, oily, problem skin, along with a violation of the cycle.
5. The appearance of painful sensations during intercourse (with the exception of the ovulatory period).
6. Infectious and inflammatory processes of the genital tract, manifested pathological discharge With unpleasant odor, itching, exacerbated cystitis and urethritis. Discharge may be mucopurulent, contain fresh or altered blood.
7. Discharge of milk from the breast.

Weakly positive tests and the subsequent onset of menstruation, a history of miscarriages, missed pregnancies are also considered reasons for contacting a specialist.

In the process of diagnosing infertility, the following diseases can be identified:

• folds of the uterus;
• endometriosis;
• ovarian cysts;
• fibroids;
• polycystic ovaries;
• pathology of the cervix (cervical stenosis, endocervicitis, dysplasia, polyps);
• endometritis;
• adnexitis;
• hyperplastic processes in the endometrium;
• adhesion process in pipes and small pelvis.

In the absence of detection of diseases of the reproductive tract in men and women, they are diagnosed with “idiopathic infertility” or infertility of unknown origin.

The reason for a visit to specialists and the diagnosis of infertility is also considered the presence of several cleansing in the anamnesis, which could lead to damage to the basal layer of the endometrium.

Diagnosis of female infertility

Diagnosis of infertility in women includes a number of methods, the list of which is determined by the duration of the complaints, as well as the type of infertility. Allocate primary infertility, in which pregnancy never occurred, as well as secondary, when the facts of conception were present earlier.

In the primary form, studies are carried out as part of the diagnosis of infertility, aimed at identifying obvious pathology:

• general examination and collection of anamnesis;
• examination of the cervix in the mirrors, palpation of the uterus and appendages;
• smears for genital infections, oncocytology;
• colposcopy;
• Ultrasound of the small pelvis, including folliculometry and dopplerometry;
• blood tests for sex hormones.

If necessary, appoint consultations of related specialists (endocrinologist, immunologist, therapist, surgeon). A man within primary diagnosis infertility is prescribed a semen analysis and smears for genital infections.

If there is no pathology, the couple is sent for further planning, while vitamin therapy, diet, rejection of bad habits, measurement basal temperature to identify the most suitable days for the purpose of conception.

Gynecologist's consultation and history taking

Diagnosis of diseases of the reproductive tract in women with suspected infertility includes taking anamnesis:

• the duration of the impossibility of conception in a particular marriage;
• information on the number of marriages, the presence and number of pregnancies;
• applied methods of protection;
• the presence of bad habits;
• features of the menstrual cycle, its debut and duration of establishment;
• family history of the female side;
• the presence of diseases of the genital organs and extragenital pathologies;
• analysis of previous treatment and diagnosis.

After receiving information about the reproductive status of a woman, the gynecologist forms a general picture of the situation, which makes it possible to optimally prescribe a list of measures for diagnosing infertility.

Physical examination

The collection of anamnesis during the diagnosis ends with the examination of the woman and the assessment of external pathognomonic signs that testify in favor of gynecological diseases.

1. Height, weight and BMI are subject to determination, which is normally 20-26. If the values ​​are outside the permissible intervals, find out the time of the beginning of the decrease or increase in body weight, the rate and possible causes.
2. Assessment of the degree and nature of hair growth, the presence of stretch marks, acne.
3. Palpation of the mammary glands.
4. Examination of the cervical part of the uterus in the mirrors, diagnosis of pathologies using smears (microscopy and cytology) and colposcopy.
5. Ultrasound of the pelvic organs.

The initial appointment with the doctor ends with the appointment of more detailed studies for the subsequent diagnosis of infertility.

Laboratory diagnostics

Laboratory methods for diagnosing infertility include testing for possible infections that affect reproductive status, as well as determining the level of sex hormones.

Diagnosis of endocrine infertility in women includes tests for:

• hormones of the first phase (follicle-stimulating, luteinizing, estradiol);
• a second phase hormone (progesterone);
• male sex hormones and metabolites (DEA-sulfate, 17-OH-progesterone, free testosterone);
• oocyte storage index (anti-Müllerian hormone, inhibin B);
• prolactin;
• thyroid hormones.

It is advisable to take an analysis for cortisol during diagnosis in case of an existing violation of the regularity of the menstrual cycle.

In addition to hormones, in the diagnosis of infertility and suspicion of polycystic ovary, the level of insulin, glycated hemoglobin, as well as a glucose tolerance test are determined.

If immunological infertility is suspected, an antisperm antibody test is performed.

Diagnostics of the endocrine form of infertility allows us to determine hypothyroidism, hyperestrogenism, hyperandrogenism of ovarian and adrenal genesis, ovarian depletion syndrome, suspect polycystic disease - the most common reasons infertility in women.

Diagnosis of infections involves:

• detection of the level of antibodies to cytomegalovirus, toxoplasma, rubella virus, herpes simplex viruses;
• examination of vaginal smears by microscopy for the diagnosis of thrush, gonorrhea, trichomoniasis, gardnerellosis, degree of purity;
• sowing secretions on nutrient media in order to identify the growth of opportunistic flora (diagnostics of dysbiosis);
• smears from the urethra and cervical canal for the presence of chlamydial, mycoplasma and ureaplasma infections, genital herpes, cytomegalovirus, papillomavirus (by PCR).

Vaginal microbiocenosis in the diagnosis of infertility can be assessed using the Femoflor analysis.

Chronic infections of the genital tract are becoming one of the leading causes of female and male infertility.

Hardware diagnostics

The most effective and simple method for diagnosing diseases of the genital organs is ultrasonography... Ultrasound diagnostics allows you to detect fibroids of various localizations, adenomyosis, ovarian cysts, large polyps, uterine anomalies (two-horned, saddle uterus).

In order to diagnose endometrial hyperplasia, polyps, endometriosis, ultrasound diagnostics is performed at the end of the menstrual cycle. It is advisable to diagnose any other pathology at the beginning of the cycle.

Diagnosis of pathologies of the cervix using an extended colposcopy allows you to determine endocervicitis, pseudo-erosion, dysplasia, leukoplakia, erythroplakia. The surface of the neck is treated with solutions of acetic acid and iodine.

Thanks to the iodine-based reagent, it is possible to determine the boundaries of the junction of two types of epithelium, the transformation zone. Iodine does not stain the cylindrical appearance of the epithelium in Brown color, therefore, the doctor can easily visualize the boundaries and state of the tissue transformation zone.

Acetic acid acts on the vessels of the neck, leading to their short-term spasm. Normally, the spasm of the capillaries gives the surface of the neck a temporary pallor. But with dysplasia, leukoplakia, cancer, aceto-white epithelium is noted - a prolonged spasm of capillaries, as well as mosaic and puncture (pathological changes in the vascular pattern), atypical tortuous and corkscrew-like vessels.

Diagnosis of diseases of the cervix allows you to identify the cervical form of infertility.

The methods of hardware diagnostics also include MRI of the sella turcica to detect pituitary microadenoma, which is considered to be an increase in prolactin.

Surgical examination

At the second stage of infertility diagnostics, when attempts to conceive did not lead to success and the couple applied for a second examination, the gynecologist at mandatory prescribes invasive instrumental methods to a woman.

The examination for infertility in women at the second stage includes diagnostic hysteroscopy and laparoscopy.

Surgical diagnostic methods make it possible to examine in detail the intrauterine formations and pathological processes in the small pelvis.

The hysteroscope is equipped with a video camera and during its introduction into the uterine cavity it is possible to detect conditions that are not visible on ultrasound, in particular, adhesions, polyps.

In addition, invasive diagnostics of intrauterine pathologies makes it possible to determine:

• the state of the entrance to the lumen of the pipes, their patency;
• the presence of adenomyosis;
• endometrial hyperplasia of a diffuse and focal nature;
• submucous fibroids;
• anomalies of the uterus: saddle, two-horned uterus.

In the process of hysteroscopy of the diagnostic plan, the removal of pathological formations that initiated infertility is carried out in parallel.

After a successful hysteroscopy, pregnancy occurs within six months.

In addition to hysteroscopy, if there is a suspicion of obstruction of the fallopian tubes, two more studies are performed:

• hysterosalpingography;
• echohysterosalpingoscopy.

The first diagnostic technique tubal infertility in women, it involves the use of an X-ray and a radio-opaque substance that is injected into the tubes. Given the radiation exposure, specialists are increasingly resorting to such a diagnostic method as echohysterosalpingoscopy, which means the introduction of an echocontrast substance (Furacilin, distilled water, saline) into the tubes, then ultrasound is performed.

Diagnostic laparoscopy is a method of examining the pelvic cavity using endoscopic equipment. Diagnosis of female infertility using laparoscopy allows you to detect:

• tubal peritoneal infertility;
• obstruction of the fallopian tubes;
• endometriosis of the peritoneum, ovaries;
• intramural and subserous fibroids.

During the operation, the formations are removed, the adhesions are dissected. A few months after diagnosis and treatment by laparoscopy, many women have a natural pregnancy.

Applying functional tests

Functional diagnostic tests for infertility are used to assess hormonal regulation in a woman's body. Self-administered and outpatient tests are used. Women can assess the presence of ovulation by measuring the temperature in the rectum for at least three consecutive cycles.

Measuring basal body temperature is considered a simple and effective test for home use to determine the right time to conceive.

Doctors use several tests to diagnose the cause of hormonal imbalances.

1. Progesterone test. If, after its introduction, a woman begins to bleed uterine, the failure of the second phase is confirmed as the cause of infertility.
2. Test with estrogen and progesterone. A woman is injected sequentially with both drugs, when a menstrual reaction occurs, testing is considered positive, which means ovarian failure and excludes uterine pathology as a possible cause of infertility.
3. Dexamethasone test to diagnose the source of increased levels of male sex hormones. If, after the administration of the drug, a decrease in the level of 17-ketosteroids is noted, hyperandrogenism is of an adrenal nature, if 17-KS increases, it is ovarian.
4. Test for stimulating ovulation with clostilbegit. If there is no result in the diagnostic process, anovulation is hypothalamic-pituitary in nature.

After finding out the character hormonal disorders appropriate infertility treatment is prescribed.

Diagnosis of male infertility

Tactics diagnostic activities when determining the cause of infertility in men, it boils down to interviewing, performing laboratory and instrumental research, the main role in this belongs to the spermogram.

List of studies for the diagnosis of male infertility:

• tests for STIs;
• Ultrasound of the prostate;
• determination of the level of sex hormones;
• expanded spermogram;
• Sperm MAP test (for immunological infertility);
• semen analysis according to Kruger;
• tests for chromosomal sperm abnormalities (FISH analysis, for the integrity of the Y chromosome);
• analysis of prostatic juice.

When diagnosing male infertility by the Kruger analysis method, they rely on a standard of more than 4%.

The norm for the MAP test is considered to be less than or equal to 30%, other results are the reason for the diagnosis of immunological infertility.

If the values ​​of the MAP analysis are more than 30%, it is advisable to carry out IVF with the obligatory use of ICSI. Thanks to this procedure, the optimal sperm is selected and artificially introduced into the egg.

Examination of a couple for infertility

Infertility for the female factor is recorded in 45% of cases, for the male - in 40%, the rest of the causes of infertility is due to both male and female pathology.

If an infertile couple turns to a reproductive specialist for an appointment, a specific diagnostic algorithm is assigned:

• a man is prescribed a sperm analysis and, in the absence of pathology, at this stage, other measures are not carried out;
• postcoital test (diagnosis of the immune form of infertility);
• two-stage examination of a woman.

At the first stage, methods are used to exclude three common female diseases: ovulation disorder, tubo-peritoneal factor, infectious and inflammatory processes of the reproductive tract. This stage of diagnosis consists of a standard set of minimally invasive techniques.

The primary diagnosis of infertility in women, the stages of which are divided into blocks, includes:

1. Study of history and clinical data.
2. Infection screening: vaginal smears for purity, bacterial culture, PCR examination of cervical smears for chlamydia, urea and mycoplasma, herpes simplex, CMV, HPV, as well as blood for antibodies to toxoplasma.
3. Hormonal screening: on day 2 with short cycles, on day 2-5 (with a 28-32 day cycle), on day 6-9 (with a cycle length of 35 days), blood is donated for sex hormones, including FSH, LH, estradiol, free testosterone, prolactin, DEA-sulfate, 17-OH-progesterone. To determine the level of progesterone, the blood is examined on the 7th day after ovulation proved by ultrasound.
4. Ultrasound diagnostics of diseases of the mammary glands, pelvic organs, thyroid gland, adrenal glands.

In the absence of menstruation, blood is donated for hormones any day.

Primary diagnosis and treatment of infertility, revealed by the results of a study in women, implies the normalization of hormonal balance, removal of pathological formations, vitamin therapy.

Diagnostics at the second stage is always individual. The set of methods usually includes studies based on the pathologies identified during the first stage of infertility diagnostics, and also includes:

• analyzes that detect genetic abnormalities (karyotypes, determination of HLA compatibility of partners);
• blood tests for mutations in hemostasis, thrombophilia, antiphospholipid syndrome;
• instrumental diagnostic methods (MRI of the Turkish saddle, laparoscopy, hysteroscopy, hysterosalpingography).

48% of infertile women are diagnosed with 1 factor of infertility, 52% - more than two.

If, in the process of diagnosing infertility, diseases that cannot be fully cured, for example, ovarian depletion syndrome, severe endometriosis, asthenozoospermia, false aspermia, azoospermia, bilateral adhesive process in tubes, couples offer IVF or artificial insemination.

Conclusion

Diagnostics should be consistent and time-limited. Each of its stages must be directed to the implementation specific task in order to prescribe the optimal treatment. In the absence of the results of diagnosis and treatment of infertility in men and women within a year, it is necessary to seek a second consultation. It is considered advisable to change the clinic or specialists.

Infertility diagnostics is a series of examinations carried out to determine the disturbances in the functioning of the human reproductive system, which are the cause of the onset of the disease. Such a diagnosis allows not only to find out what caused infertility, but to determine the most effective methods treatment to restore reproductive function.

Survey procedure:
Infertility diagnostics is carried out for both men and women. Naturally, for representatives of different sexes, methods are also used differently.
Diagnosis of male infertility usually consists in the study of sperm (spermogram), which determines its various functional and morphological properties.
Female infertility often requires a more versatile approach to the problem. This is due to the fact that the causes of problems with reproductive function in women, and, accordingly, the methods of their determination, significantly more.

The main types of diagnostics for women are:

• endoscopy and laparoscopy - allow you to determine the presence or absence of fibroids, polyps, adhesions, tumor formations or other abnormalities of the uterus;
• Ultrasound examination to identify anatomical pathologies, such as, for example, tubal infertility, which is caused by complete or partial obstruction of the fallopian tubes;
• laboratory endocrine examination (hormone analyzes), etc.

Also, for both female and male representatives, the causes of infertility are determined by the method of DNA diagnostics, which identifies possible genetic causes of sterility.

Where to get diagnosed to identify problems associated with infertility?

In order to find a good reproductive clinic or find out where you can undergo infertility diagnostics, you can use our catalog. A convenient search system and a large selection of medical institutions will allow you to quickly find the most suitable for the price and convenient location option.

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Diagnosis of infertility in women is an important step towards determining the cause of an infertile marriage. Today there are many diagnostic methods and in this article we will talk about them in great detail.

Diagnosis of female infertility begins with a preliminary examination of the patient in the clinic and the antenatal clinic. In some cases, after this stage, it is possible to identify the problem and prescribe an effective therapy. In an outpatient setting, types of infertility due to ovulation disorders and gynecological diseases that are not associated with occlusion of the fallopian tubes respond well to treatment.

If there are indications, they proceed to the second stage of the examinations. The patient is assigned specialized diagnostic methods (non-invasive hardware, endoscopy, hormonal studies). Treatment in such cases, depending on the identified pathology, can be both conservative and surgical (using laparoscopic, laparotomy and hysteroscopic methods).

In some cases, the only way out for the patient is assisted reproductive technologies (ART). These include IVF procedures as well as artificial insemination(these activities can be performed in different modifications).

Specialized medical care can be obtained at the state center for reproduction and family planning, gynecological departments hospitals, in private centers for the treatment of infertility, at clinical bases of research institutes and departments dealing with these problems.

Infertility diagnosis plan for women

1. Collecting a woman's anamnesis (somatic, gynecological and reproductive).

2. General examination (weight, height, skin, examination of the mammary glands).

3. Gynecological examination.

4. Analysis of the husband's semen.

5. Blood test: general and biochemical blood test, coagulogram, RW, HIV, HbsAg, blood test for glucose, blood group and Rh factor.

6. General urine analysis.

7. Comprehensive examination for STDs.

8. Ultrasound of the pelvic organs.

9. Colposcopy.

10. Hysterosalpingography.

11. Functional diagnostics of ovarian activity:

Measurement of basal temperature for 2-3 months;

Weekly hormonal colpocytology;

Daily study of the phenomenon of mucus arborization;

To determine the diameter of the follicle, ultrasound is done on the 12-14-16th day of the cycle;

Plasma levels of estrogen, testosterone, prolactin, FSH, LH are determined;

On the 3-5th day of the menstrual cycle, in the middle of the cycle and in phase 2, the level of progesterone in the blood and pregnandiol in the urine are determined;

The level of 17-KC in urine is determined 2 times a month.

12. Hormonal tests.

13. Application complementary methods studies according to indications:

Hormonal examination: cortisol, DHEA-S (dehydroepiandrosterone - sulfate), insulin, TK, T4, TSH, antibodies to thyroglobulin;

Shuvarsky-Guner postcoital test;

Determination of antisperm antibodies in women in the mucus of the cervical canal on preovulatory days (the levels of immunoglobulins IgG, IgA, IgM are determined);

Kurzrock-Miller test (penetration of sperm into the cervical mucus of a woman during ovulation);

Freeberg's test (determination of antibodies to spermatozoa using a microagglutination reaction);

Kremer's test (detection of local antibodies in the husband during contact of sperm with cervical mucus;

Isojima immobilization test;

Immunological tests.

14. Examination by a mammologist, mammography.

15. Radiography of the Turkish saddle and skull.

16. Examination of the fundus and visual fields.

18. Laparoscopy.

Taking anamnesis for female infertility

The examination of a woman suffering from infertility begins with a thorough history taking. The first conversation with the patient is carried out in accordance with the WHO recommendations. In this case, the doctor must clarify the following points:

Does the patient have children and how many there are at the moment.

How long does infertility last?

How many pregnancies and childbirth have been in the past and what was their outcome.

Complications after childbirth and abortion.

What methods of contraception did the woman use and for how long.

Are there any chronic diseases(problems in the work of the adrenal glands, thyroid gland, diabetes, tuberculosis, etc.).

What medications she took or is taking (tranquilizers, psychotropic drugs, cytotoxic drugs).

Have you undergone operations associated with the risk of adhesions (interventions on the ovaries, uterus and its tubes, kidneys, urinary tract, intestines, surgery for appendicitis).

Have pelvic inflammation and sexually transmitted infections been identified in the past? (If such diseases have occurred, it is necessary to clarify the type of pathogen and the details of the treatment).

Whether galactorrhea was observed and was it associated with lactation.

Have there been any sexual dysfunctions such as contact bleeding, dyspareunia?

What diseases of the cervix were diagnosed and what therapy was prescribed (conservative, electrocoagulation, cryotherapy, laser).

It is also necessary to ask about the patient's lifestyle, the presence of bad habits (smoking, addiction to alcohol or drugs), to clarify the impact of industrial, epidemic and hereditary factors(to find out the presence of hereditary diseases in the patient's relatives of the 1st and 2nd degree of relationship).

Of great importance in the diagnosis of female infertility is the menstrual history of the infertile woman (menarche, especially the cycle, irregularities in the cycle, discharge between menstruation, sensations during menstruation).

Physical examination in women with infertility

At this stage of the examination, the following diagnostic measures are carried out:

The patient's height and weight are measured.

Calculate the body mass index (weight in kilograms divided by the square of the height in meters). Normal values ​​of this indicator are from 20 to 26. If obesity is noted (mass index exceeds 30), find out when the obesity appeared, how quickly it developed and what could be the cause.

Carefully examine the condition skin(dry skin or oily, wet), pay attention to the presence of traces of sprains, acne. The character of hair growth is assessed. If there is hypertrichosis, determine its degree using the scale D. Ferriman, J. Galwey. Find out when there is excessive hair growth.

Examine the mammary glands, assess the degree of their development, conduct a study for discharge from the nipples and palpable formations.

Bimanual gynecological examination, study the condition of the cervix using mirrors, perform colposcopy.

At this stage, you also need a medical opinion from a therapist about the possibility of a safe pregnancy and successful childbirth. If signs of mental, endocrine or any other diseases, malformations are found, then it will be necessary to consult a specialized doctor - psychiatrist, endocrinologist, geneticist, etc.

Laboratory diagnostic methods for female infertility

Infection screening for infertility in women

In accordance with the order of the Ministry of Health of the Russian Federation No. 572n, infectious screening is performed. It implies such activities:

Taking a smear from the cervix for cytological analysis.

- A smear on flora from the cervical canal and urethra.

Research on the degree of cleanliness of the vagina.

PCR analysis for 12 infections: chlamydia, human papillomavirus infection, mycoplasmosis, ureaplasmosis, trichomoniasis, gonorrhea, etc. To do this, take a swab from the cervical canal.

The use of the culture method (when sowing of samples from the vagina and cervical canal is carried out to study the flora and assess its sensitivity to antibacterial drugs).

Blood tests for HIV, syphilis, hepatitis B and C.

If the patient has one of the infections mentioned above, a course of etiotropic therapy will be required, followed by another (control) examination. At this stage, the patient may be referred for specialized treatment to an immunologist (if HIV is detected) or a dermatovenerologist (in the case of gonorrhea or syphilis).

TORCH-complex

The TORCH-complex includes:

Detection of antibodies (immunoglobulins - Ig) G and M to rubella, cytomegalovirus, toxoplasmosis, herpes simplex virus (types 1 and 2). If IgG antibodies rubella was not found, the patient needs vaccination.

Hormone Screening

In order to confirm or exclude the endocrine nature of the pathology (anovulatory infertility), hormonal screening is performed as part of the standard polyclinic examination program. In case of cycle disorders and violations of ovulatory function, a study of the hormonal background helps to identify the cause of the pathology.

Hormone screening includes an assessment of the level of such hormones: luteinizing and follicle-stimulating hormones, prolactin, estradiol, cortisol, testosterone, 17-hydroxyprogesterone, thyroid stimulating hormone, dehydroepiandrosterone sulfate, free thyroxine (on the 2nd or 3rd day at any normal time in case of a disturbed cycle) and progesterone (on the 21-23rd day of the cycle).

If studies have shown abnormalities in hormone levels, the patient will need further diagnostics aimed at finding out the causes of hormonal imbalance. At this stage, specialized instrumental and laboratory diagnostic methods can be used:

Computed tomography of the Turkish saddle area.

Ultrasound examination of the thyroid gland.

Hormonal tests.

Such diagnostics belongs to the competence of a specialized specialist - a gynecologist-endocrinologist. The same doctor, based on the results of examinations, determines the therapy regimen.

Immunological methods for the diagnosis of female infertility

Also, the diagnosis of infertility in women resort to immunological studies - the detection of antibodies in samples from the cervical canal (IgG, IgM, IgA).

Instrumental methods for diagnosing infertility in women

During the outpatient examination of infertile patients, an obligatory method is pelvic ultrasound. Also, ultrasound is recommended to assess the condition of the mammary glands and exclude neoplasms in them (up to 36 years old). If indicated, an ultrasound scan of the thyroid gland is performed.

If there are suspicions of intrauterine or tubal causes of infertility, the patient undergoes hysterosalpingography (HSG). The study is performed in the period from the 5th to the 7th day of the cycle with normal menstruation or oligomenorrhea. For patients with amenorrhea, GHA can be performed at any time.

At the same time, the diagnostic capabilities of the GHA in the study of the fallopian tubes cannot be considered satisfactory. The fact is that during the study of the patency of the tubes, there is a significant discrepancy between the results (up to 50%) of the GHA and the laparoscopic study, supplemented by chromosalpingoscopy with methylene blue. This means that it is possible to diagnose tubal-peritoneal infertility (TPB) and fully clarify the picture of tubal changes only by the laparoscopic method. As for the GHA, this method is informative in the diagnosis of intrauterine diseases.

TO X-ray methods diagnostics for female infertility include:

Tomography (computed or magnetic resonance imaging).

Craniogram.

Hysterosalpingography.

Mammography (after 36 years).

Tomography of the skull and the sella turcica is performed for endocrine infertility, which is associated with hyperprolactinemia or pituitary insufficiency (with low FSH levels). This method allows physicians to detect pituitary macro- and microprolactinomas. In addition, it makes it possible to diagnose empty Turkish saddle syndrome.

If there is a suspicion of a surgical pathology of the genitals, the patient may be referred for a spiral CT scan of the pelvis. Such a study allows one to obtain full information about the state of organs, after which you can plan a surgical intervention. Instead of spiral tomography in such cases, the use of MRI is also allowed. However, it must be borne in mind that the diagnostic potential of this method is not so high, and it will take more time to obtain images.

For an ultrasound examination of the thyroid gland, patients are sent who, with endocrine infertility, have signs of hypo- or hyperthyroidism, abnormalities in the level of thyroid hormones, hyperprolactinemia.

Ultrasound of the adrenal glands is indicated with an increased level of adrenal androgens and hyperandrogenism. If necessary, CT of the adrenal glands is performed.

Endoscopic diagnostics for female infertility

Endoscopic diagnosis involves laparoscopy and hysteroscopy. If there is an endometrial pathology, a biopsy is performed during the procedure.

Laparoscopy is considered the most informative method for peritoneal and tubal infertility factors. Moreover, it makes it possible to correct the detected pathologies: restore the patency of the tubes, separate adhesions, remove fibroids (intramural, subserous) and retention formations in the ovaries, and perform coagulation of endometrioid heterotopies.

The hysteroscopy method is used in such cases:

Suspicions of intrauterine pathology according to the results of the survey, examination and ultrasound examination.

The presence of dysfunctional uterine bleeding in the patient, regardless of their intensity.

Hysteroscopy of the uterus helps to identify many different pathologies: polyps, adenomyosis, myomatous nodes, HPE, endometritis in chronic form, synechiae, malformations, as well as the presence of a foreign body. During this procedure, a specialist for diagnostic purposes can perform curettage of the cervical canal and uterine cavity. In addition, under hysteroscopic control, it is possible to perform surgical intervention for various intrauterine pathologies.

Sexual partner diagnostics

In parallel with the examination, the patient is referred for diagnosis and her partner. This is necessary in order to exclude the possibility of a factor of male infertility. The main study in this case is the spermogram. If the analysis showed abnormalities in sperm counts, a man must be examined by an andrologist. After that, you can decide on possible ways to solve the problem (male treatment or IVF).

In addition to spermogram, when examining men, the MAP test method is used (detection of antibodies to sperm). If the indicator of this test exceeds 30%, we can say that the man's infertility is of an immune nature. In such cases, IVF or artificial insemination is indicated.

If there is a suspicion of one of the surgical pathologies (ovarian cyst, tube occlusion, uterine malformation, endometrioid or myomatous process, intrauterine synechiae, peritoneal adhesions), the patient should be referred to a specialized medical institution. There they will carry out further diagnostics, make a final diagnosis and carry out the necessary treatment (by surgical or endoscopic method). The diagnosis of male infertility is described in detail in another article on our website.

If a woman has not gone through the entire range of necessary studies, it is impossible to make a final diagnosis. Consequently, the therapy will be ineffective. It is important to consider this point: the maximum duration of any conservative treatment is two years (this also applies to treatment after surgical interventions to eliminate one or another gynecological pathology). If, after two years of therapy, pregnancy does not occur, the woman is immediately referred to an ART center. It is also not worth postponing a visit to the center because the patient's age (over 35 years old) can make it difficult to successfully apply such techniques. It must be remembered: in infertile women of this age category, the stage of therapy involving the use of techniques aimed at restoring the natural ability to conceive (outpatient stage) should be excluded altogether.

A woman is diagnosed with infertility when she is unable to become pregnant after a year of unprotected intercourse.

According to statistics, more than 10% of married couples worldwide suffer from infertility, while this disease both men and women are affected. According to official information from the Centers for Disease Control and Prevention, 1/3 of diagnoses are associated with female infertility, 1/3 with male infertility, and the rest of cases of infertility are due to joint factors from both partners. The exact figure is quite difficult to determine, but in percentage terms it is about 20% of couples.

Influence of age onfertility

All women are born with a certain number of eggs. Thus, as a result of the reproductive process, the number and quality of eggs will decrease. Consequently, the likelihood of having a baby decreases by 3% to 5% per year after the age of 30. It should be understood that a particular decrease in the birth rate is noted to a much greater extent after the age of 40.

Symptoms of indifference in women

The main symptom of infertility is the couple's inability to get pregnant. There are a number of factors here, two of which are the most important:

1. Menstrual cycle: either too long (35 days or more) or too short (less than 21 days).

2. Irregular or absent menstruation as one of the signs of a lack of ovulation.

When to see a doctor for infertility

When to ask for help depends, in part, on your age. If you are under the age of 30, most doctors recommend trying to get pregnant for a year before starting testing or treatment. If your age is between 35 and 40, you should discuss your concerns with your doctor after six months of trying. If you are over 40 years old, then you need to start treatment immediately.

Causes of female infertility

Female infertility can be caused by a number of the following factors:

Damage to the fallopian tubes that carry eggs from the ovaries to the uterus can prevent contact between the egg and the sperm. Pelvic infections, endometriosis, and pelvic surgery can lead to scarring as well as damage to the fallopian tubes. Hormonal reasons due to which some women have problems with ovulation. Synchronous hormonal changes leading to the release of the egg from the ovary, as well as thickening of the endometrium (the lining of the uterus) - lead to the fact that fertilization of the egg does not occur. These problems can be detected with basal body temperature charts, blood tests to check for hormone levels. A small group of women may have a cervical structure that prevents sperm from passing through the canal.

This problem is usually solved with a preliminary examination and a small surgical procedure. In about 20% of married couples, the cause of infertility is not determined even with the use of modern methods research.

Also common are diagnostic tests: hysterosalpingography and laparoscopy, which can be helpful in detecting scar tissue and uterine obstruction.

The main factors causing female infertility

- Ovulation disorders. Ovulation disorders, in which ovulation occurs extremely rarely or does not occur at all, account for 25% of infertile couples. It can be caused by deficiencies in the regulation of sex hormones in the hypothalamus or pituitary gland, or problems in the ovaries themselves.

- Polycystic ovary syndrome (PCOS). In PCOS, complex changes occur in the hypothalamus, pituitary, and ovaries, resulting in hormonal imbalances that affect ovulation. PCOS has been linked to insulin resistance, obesity, and abnormal growth of facial and body hair. Today it is the most common cause of female infertility in the world.

- Dysfunction of the hypothalamus. Two hormones responsible for stimulating ovulation every month - follicle-stimulating hormone (FSH) and luteinizing hormone (LH) - are produced by the pituitary gland in a specific pattern during the menstrual cycle. Increased physical or emotional stress, significant gain or loss of body weight, can disrupt the balance in hormone production and affect ovulation. The main symptom of this problem is irregular or absent menstruation.

- Premature ovarian failure. This disorder is usually caused by autoimmune reaction when your body mistakenly attacks ovarian tissue or premature egg loss due to genetic problems, environmental influences such as chemotherapy. This leads to a loss of the ability to produce eggs in the ovary, as well as a decrease in estrogen production before the age of 40.

- Excess prolactin. Rarely, but there are cases where the pituitary gland can cause excess production prolactin (hyperprolactinemia), which decreases estrogen production and can cause infertility. This is most often due to problems in the pituitary gland, but it can also be due to medications you have been taking for a medical condition.

- Damage to the fallopian tubes (tubal infertility). If the fallopian tubes are damaged or blocked, sperm cannot enter the egg and promote its fertilization. Causes of blockage or damage to the fallopian tubes may include:

Pelvic inflammatory disease, infection of the uterus or fallopian tubes due to chlamydia, gonorrhea, or other sexually transmitted infections.
- Previous surgery in the abdominal cavity or pelvic region, including surgery associated with an ectopic pregnancy.
- Pelvic tuberculosis, which is the leading cause of tubal infertility worldwide.

- Endometriosis. Endometriosis occurs when tissue that normally develops in the uterus begins to grow elsewhere. This additional tissue growth and subsequent surgical removal can lead to scarring that can compromise the elasticity of the fallopian tube, thereby making fertilization more difficult. It can also affect the lining of the uterus, disrupting the development of a fertilized egg.

- Myoma of the cervix. A uterine fibroid is a benign tumor of the muscle layer of the uterus. The development of fibroids, as a rule, occurs rather slowly: one muscle cell, for reasons not yet understood, begins to divide, creating tumor muscle cells, which form a node - fibroids, as a result of which the likelihood of miscarriage increases.

- Changes and abnormalities of the cervix. Benign polyps or tumors common in the uterus can also interfere with fertilization by blocking the fallopian tubes or interfering with sperm entry. However, many women with fibroids or polyps can become pregnant.

- Unexplained infertility. In some cases, it is simply impossible to establish the causes of infertility. There is a possibility that this is due to a combination of several minor factors of both partners. But at the same time, it is possible that this problem may eventually be solved by itself.

Risk factors for female infertility

Let's take a look at some of the factors that contribute to a high risk of developing infertility:

- Age. With increasing age, quality and quantity female eggs begins to decline. By about age 35, the rate of follicular loss accelerates, with the result that egg quality decreases and deteriorates, and conception is more difficult with an increased risk of miscarriage.

- Smoking. In addition to damaging the cervix and fallopian tubes, smoking increases the risk of miscarriage and ectopic pregnancy... As a result, the ovaries are prematurely depleted, losing eggs, thereby reducing your ability to get pregnant. This is why it is very important to quit smoking before starting fertility treatment.

- Weight. If you have overweight or, conversely, underweight, it can also interfere with normal ovulation. Mass index needs to be achieved healthy body(BMI) to increase the frequency of ovulation and increase the likelihood of pregnancy.

- Sexual story. Sexually transmitted infections such as chlamydia and gonorrhea can certainly damage the fallopian tubes and fallopian tubes. Having unprotected intercourse with multiple partners increases your chances of contracting sexually transmitted diseases, which can later lead to fertility problems.

- Alcohol. Excessive alcohol consumption is directly associated with an increased risk of ovulation disorders and endometriosis.

Scheduling a visit to the doctor

To identify and assess the degree of infertility, it is necessary to undergo comprehensive examination an endocrinologist specializing in reproductive diseases that prevent couples from conceiving. Your doctor will likely want you and your partner to identify possible causes of infertility ahead of time. Here are the most common examples of questions to which you need to prepare your answers in advance:

Schedule menstrual cycles and their symptoms over the course of several months. Mark on a calendar when your period starts and ends, and write down the days you and your partner had sex.

Make a list of medications, vitamins, herbs, or other supplements you are taking. Include doses and frequency of administration.

Bring the previous medical records... Your doctor will want to know what tests you have and what treatments you have tried.

Think about the most important questions you want to ask.

Here are some basic questions you can ask your doctor:

When and how often should we have sexual intercourse if we want to conceive?
- What lifestyle changes can we make to improve our chances of getting pregnant?
- What medications can be purchased to improve fertility?
- What kind side effects Can Prescribed Drugs Cause?
- What treatment do you recommend in our situation?
- What is your success rate in helping couples achieve pregnancy?
- Do you have brochures or other printed materials that you can provide us with?
- What sites do you recommend to visit?

Feel free to ask your doctor to repeat the information or ask additional questions.

Some potential questions your doctor might ask:

How long have you been trying to get pregnant?
- How often do you have sexual intercourse?
- Have you never been pregnant before? If so, what was the result of this pregnancy?
- Have you had any pelvic or abdominal surgery?
- Have you been treated for any gynecological diseases?
- At what age did menstruation first start?
- On average, how many days elapse between the start of one menstrual cycle and the start of the next?
- Have you encountered premenstrual symptoms such as: breast tenderness, bloating or cramps?

Diagnosis of female infertility

The standard fertility rate includes physical, medical, and sexual history of both partners. Men take a semen analysis, which evaluates the number and movement of sperm. Look at the percentage of active sperm and their level of movement. Often, it is not possible to determine the specific cause of the disorder. But there is a theory that a very low sperm count may be due to genetics - an abnormality in the Y chromosome.

The first thing that a doctor checks for women is whether ovulation occurs. This can be determined with a blood test that detects and displays levels of female hormones, an ultrasound of the ovaries, or an ovulation test kit that is used at home. You should also pay attention to the menstrual cycle, since an irregular cycle can be the main reason for non-ovulation.

- Ovulation test. An ovulation test that detects the spike in luteinizing hormone (LH) that occurs before ovulation can be done without any problems at home. If you do not receive positive results, you need to take a blood test for progesterone, a hormone produced after ovulation, and document the onset of ovulation. Other hormone levels, such as prolactin, can also be confirmed with a blood test.

- Testing ovarian reserve. This testing helps determine the quality and quantity of eggs available for ovulation. Usually, this study women at risk of losing eggs pass, including women over 35.

- Research on the level of hormones. Other hormone tests will measure levels of ovulatory hormones, as well as thyroid and pituitary hormones, which control reproductive processes.

- Visual tests. A pelvic ultrasound examines the cervix in detail or shows fallopian tube disease. It is often used to see details inside the uterus that are not visible on regular ultrasound.

- Laparoscopy. This minimally invasive surgery is a small incision under your belly button where a thin catheter is inserted with a device to examine your fallopian tubes, ovaries, and uterus. Laparoscopy can detect endometriosis, scarring, tubal obstruction, and problems with the ovaries and uterus. During this procedure, a laparoscope (a thin tube equipped with a fiber optic camera) is inserted into abdominal cavity through a small incision near the navel. The laparoscope allows the doctor to look outside the uterus, ovaries, and fallopian tubes to look for new growths, similar to endometriosis. The doctor may also check to see if the fallopian tubes are open.

- Genetic testing. Genetic testing helps determine if there is a genetic defect in the chromosomes that has led to infertility.

- Hysterosalpingography. This procedure involves an ultrasound or x-ray of the reproductive organs, in which a dye or saline solution is injected into the cervix through fallopian tubes... This allows you to identify whether the fallopian tubes are open or not.

Fertility treatment for women

Female infertility can be treated in several ways, including:

- Laparoscopy. Women who have been diagnosed with tubal or pelvic disease or defects may undergo surgery to repair their reproductive organs or try to conceive through in vitro fertilization (IVF). Using a laparoscope inserted through an incision in the navel will remove scar tissue, ovarian cysts, and also restore the patency of the fallopian tubes.

A hysteroscope is placed into the uterus through the cervix and is used to remove polyps, fibroids, scar tissue, and open blocked fallopian tubes.

- Drug therapy. For women suffering from ovulation problems, medications such as Clompiphene (Clomid, Serophene) or gonadotropins (such as Gondal F, Follistim, Humegon, and Pregnyl) may be prescribed, which can lead to ovulation.
Metformin (Glucophage) is another type of drug that helps restore or normalize ovulation in women who have insulin resistance and / or polycystic ovary syndrome.

Intrauterine insemination refers to a procedure in which sperm is taken from a partner during maturation, washed with a special solution to isolate healthy non-defective sperm, and then placed into the uterus at ovulation. Sperm is injected through the cervix using a thin plastic catheter. This procedure can be performed in combination with the previously listed ovulation-stimulating drugs.

- In Vitro Fertilization (IVF). IVF refers to a method in which the resulting embryo is kept in an incubator, where it develops for 2-5 days, after which the embryo is then introduced into the uterus for further development.

After monitoring to confirm maturation of the eggs, they are collected using a vaginal ultrasound probe. Spermatozoa are also collected and washed and added to the oocytes in vitro (in vitro). A few days later, the embryos, or fertilized eggs, are returned to the uterus using an intrauterine catheter.

Any additional eggs and embryos can be frozen for further use with the consent of the spouses.

ICSI. Intracytoplasmic sperm injection is used also for problems associated with the lack of fertilization. This is a method in which a pre-selected viable sperm cell under a microscope is injected into the egg cell "manually" using special microsurgical instruments. With ICSI, only one sperm is required for each mature egg.

- Egg donation. Egg donation can help women who do not have a well-functioning ovary, but who do have a healthy uterus to achieve pregnancy. Egg donation involves the collection of eggs, also called oocytes, from a donor's ovary that has undergone ovarian stimulation using special hormonal drugs. The donor's eggs are placed with the partner's sperm for in vitro fertilization, after which the fertilized eggs are transferred to the recipient's uterus.

Drug therapy and artificial insemination may increase the likelihood of a long-awaited pregnancy in women diagnosed with unexplained infertility.

Risks of using drugs to treat anxiety in women

The use of fertility drugs can carry some risks, such as:

Multiple pregnancy. Oral drugs carry a fairly low risk for singleton pregnancies (less than 10 percent), with the increased risk mainly related to carrying twins. Injectables carry the greatest risk of conceiving twins, triplets or more ( multiple pregnancy higher order). Hence, the more fruit you carry, the greater the risk premature birth, low birth weight and problems associated with late development.

Ovarian hyperstimulation syndrome. Usage injectables to increase ovulation, can lead to ovarian hyperstimulation syndrome, in which your ovaries can swell and be painful. Signs and symptoms usually last a week and include: abdominal pain, bloating, nausea, vomiting, and diarrhea. If you manage to get pregnant, these symptoms can last up to several weeks.

Long-term risks of developing ovarian tumors. Most studies have shown that long-term risks are unlikely for women using drugs to get pregnant. However, some studies show that women who take hormonal drugs for 12 months or more without a successful pregnancy, may have an increased risk of developing borderline tumors ovaries in later life. Just like women who have never had a pregnancy, they are at increased risk of ovarian tumors, so this may be due to the underlying problem rather than the treatment.

Surgical female infertility treatment

Certain surgical procedures can correct problems or significantly improve female fertility. Let's consider the main ones:

Laparoscopic or hysteroscopic surgery. Surgery can remove or correct abnormalities that reduce the chances of pregnancy. Using this method, you can correct the shape of the uterus, remove the effects of endometriosis and some types of fibroids. This will definitely improve your chances of achieving pregnancy. If a woman has previously had a tubal ligation for permanent contraception, the operation will help restore the ability to conceive. Your doctor can determine if you are a good candidate for this, or if you need to resort to in vitro fertilization (IVF).

Emotional support

Treating female infertility can be physically and emotionally exhausting. To cope with the ups and downs of mood, multiple testing and the treatment process itself, doctors unanimously tell their patients, "Get ready."

Maximum information. Ask your doctor to explain in detail the steps of the therapy you have chosen so that you and your partner can prepare as much as possible for each one. Understanding the process will help reduce your anxiety.

Support for loved ones. While infertility is a deeply personal issue, reach out to your partner, close family members, or friends for support. Online support groups are common today to keep you anonymous while you discuss fertility issues. Feel free to seek professional help if the emotional burden becomes too heavy for you or your partner.

Moderate exercise and healthy eating will help improve appearance and keep you on your toes despite fertility problems.

Prevention of infertility in women

If you plan on getting pregnant soon, in the future, you can improve your chances of normal fertility by following a few important guidelines:

Maintaining a healthy weight. Both overweight and underweight women are at increased risk of ovulation disorder. If you need to lose weight, exercise in moderation. Strenuous, intense exercise for more than seven hours a week has been shown to be associated with decreased ovulation.

Stop smoking. Tobacco has a negative effect on fertility, not to mention your overall health and the health of your unborn child. If you smoke and are planning a pregnancy, then it's time to quit this addiction right now.

Avoid drinking alcohol. Alcohol abuse can lead to decreased fertility. Any alcohol consumption can affect the health of the developing fetus. If you are planning to become pregnant, avoid alcohol, and do not consume alcohol during pregnancy.

Reduced stress. Several studies have shown that couples experiencing psychological stress had worse outcomes during fertility treatments. If you can, find a way to reduce the stress in your life before trying to get pregnant.

Limit caffeine. Some doctors suggest limiting caffeine intake to less than 200 to 300 milligrams a day.