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Female infertility: types, causes and treatment methods. Types of infertility in women, symptoms and diagnosis of the disease Treatment of infertility in women

The diagnosis of infertility is terrifying for many women who really want to get pregnant. There are many causes for this condition, and some types of the disease can be successfully treated.

How to determine the disease and what can lead to such a diagnosis, what are the main symptoms and is infertility treated in women? More about this.

Reasons for diagnosis

There are a huge number of causes of infertility, and they are all divided into different groups.

Hormonal

Physiological

  • Poor patency of the fallopian tubes or its complete absence is the main cause of infertility in women. In this case, sperm cannot reach the egg.
  • Scarring cervix. This phenomenon is the consequences of an illness or surgery. With scarring, the possibility of sperm reaching the egg is sharply reduced.
  • . This is a benign neoplasm in the uterus. Myoma leads not only to problems with conception, but also to miscarriages. Find out also how to treat uterine fibroids.
  • Endometriosis. The uterine mucosa actively grows and extends beyond the organ. This phenomenon leads to gluing of the fallopian tubes or to the formation of adhesions.

Diseases that are sexually transmitted

  • Chlamydia. This infection causes adhesions to form in the oviducts. In many cases, the disease is asymptomatic. Chlamydia is easily transmitted from mother to child.
  • Gonorrhea. Symptoms of this infection rarely appear. The disease is transmitted from mother to child during childbirth.

Other

  • Genetic diseases. Such diseases increase the risk of miscarriage because they cause chromosome changes.
  • Inability to bear a child. In this case, fertilization occurs, but at some point during pregnancy a miscarriage occurs.

Risk factors

  • Age. In nulliparous women over 35 years of age, fewer eggs mature, which means the ability to get pregnant is noticeably reduced, and the risk of developing chromosomal changes in the fetus increases.
  • Underweight or overweight. Excess weight often accompanied by hormonal diseases. With low weight, pregnancy may not occur, since the body is weakened and is in a state of “hunger”, while reproductive function decreases.
  • Nervous shocks. Constant stress leads to hormonal imbalance (the hormone prolactin is produced in large quantities).
  • Bad habits: smoking, abuse of alcoholic beverages and caffeine (more than 6-7 servings of coffee per day).

Signs and symptoms

The first sign of the disease is the absence of pregnancy with regular sexual intercourse without the use of contraceptives for a year.

In this case, the partner is checked. If he does not have any pathologies, female infertility is diagnosed.

The second symptom is absence of menstruation. Normally, they can be absent only in three cases: before puberty, during pregnancy and after menopause.

The menstrual cycle is often disrupted due to the use of contraceptives, but it is restored soon after stopping taking these drugs.

Irregular menstruation– another symptom, since ovulation is disrupted (the egg cannot mature normally, and the sperm cannot fertilize it).

What not to do

In some cases, you should not take ovulation-stimulating drugs: inflammation in the appendages and uterus, pathologies of the genital organs, polycystic disease, male infertility(while the woman is healthy), obstruction of the oviducts, neoplasms in the uterus or fallopian tubes, hormonal disorders.

Do not start treatment with drugs or folk remedies, if the cause has not been established, as this may lead to unexpected results.

Prevention measures

Prevention measures are very simple:

  • maintain genital hygiene;
  • eat well;
  • give up all bad habits: smoking, drinking alcoholic beverages, narcotic substances;
  • avoid severe stress;
  • do not be promiscuous.

Alternative methods to get pregnant

In addition to traditional methods of treatment, there are also ways to conceive a child. Their main goal is to improve the health and emotional state of a woman.

If the problem is caused by nervous shock and menstruation disorders, such methods will increase the effectiveness of the main treatment.

Here are the main alternative methods that will help you get pregnant:

  • Homeopathy. This method involves the use of natural extracts and minerals. Some of them are aimed at restoring ovulation, others help relieve stress.
  • Acupuncture. During the procedure at certain points on the body ( energy centers) thin needles are inserted.
  • Reflexology. The specialist massages special points located on the heels. The procedure improves well-being and improves the function of the reproductive organs.

Infertility is a serious diagnosis that should only be treated under the close attention of specialists.

Be sure to undergo the necessary examinations and find out why conception does not occur.

Finally, watch this video on how to get pregnant after 40:

Almost all women at some point in their lives begin to think about children. But the path from deciding to become a mother to realizing this dream can be long and difficult. Approximately 10-15% of couples face difficulties conceiving, and every year tens of thousands of women are diagnosed with infertility. However, infertility in women is not a death sentence.

In most cases, infertility can be successfully treated. And modern reproductive technologies make it possible to “deceive” nature and, despite everything, achieve conception and successful pregnancy.

Signs of female infertility

In women, infertility can be suspected if pregnancy does not occur within 12 months of regular sexual activity without the use of contraception. For women over 35 years of age, this period is reduced to 6 months.

There are no obvious signs of infertility other than the inability to conceive, but there are some factors that increase the risk - these include having a body mass index that is too high or too low, a history of severe inflammatory or infectious diseases of the reproductive system, an irregular menstrual cycle or amenorrhea - complete absence of menstruation.

It should be borne in mind that the reason for the inability to conceive can be both female and male infertility, or even problems in both partners, therefore, if infertility is suspected, both the man and the woman should undergo a detailed examination. In this article, we will focus only on female infertility, its causes, diagnosis and treatment.

Causes of infertility in women extremely varied. Often, inflammatory diseases of the pelvic organs are to blame for the inability to conceive and bear a child, both in acute states and chronic ones, and even those that were suffered many years ago. Very often, inflammation of the reproductive system organs leads to the occurrence of adhesions in fallopian tubes oh and their obstruction.

The causes of infertility in women also include congenital or acquired pathologies and deformations of the uterus, often resulting from multiple abortions, endometriosis of the uterine body, intrauterine septum, adhesions, and myomatous nodes.

Infertility in women can also have genetic causes: conception is possible, but the risk of miscarriage is extremely high. Genetic causes include various abnormalities of chromosomal composition.

Less commonly, infertility is caused by psycho-emotional reasons, but this is also possible - some mental disorders, depression, and constant severe stress reduce female fertility.

Advanced endometriosis is often diagnosed in women who consult doctors about their inability to conceive a child. In approximately 35% of cases the cause female infertility problems arise with the maturation of follicles in the ovaries and ovulation, after which the egg enters the fallopian tube. 45% of patients with infertility have inflammatory processes in the pelvic organs and the pathologies of the fallopian tubes caused by them (adhesions inside or around the fallopian tubes, dysfunction of the fallopian tubes). Often the cause of infertility is not one factor, but several.

Diagnostics

To diagnose infertility, in addition to collecting anamnesis and visual gynecological examination, a number of tests and studies are required:

  • Tests for sexually transmitted infections , both partners must pass.
  • Blood test for hormones . These studies make it possible to confirm the endocrine nature of infertility. Blood for studying different hormones is taken at different phases of the cycle: analysis for FSH, LH, prolactin, TSH, T3, T4 is taken on the 2-5th day of the cycle, and for progesterone - on the 18-22nd.
  • Radiography and ultrasonography pelvic organs . Contrast radiography makes it possible to determine whether infertility is caused by deformation or pathology of the uterus, fallopian tubes, or whether there are adhesions or neoplasms. Ultrasound is also widely used to clarify the condition of the fallopian tubes.
  • Histology . Examination of a tissue sample from the uterine mucosa provides information about the cellular structure of the endometrium.
  • Hysteroscopy . A visual examination method in which a miniature video camera is inserted into the uterus. Allows you to see polyps, neoplasms, changes in the structure of the mucous membrane, and also take tissue samples. The information content of the method is extremely high, and the accuracy is close to 100%.

Treatment methods for infertility in women

A complete diagnosis of infertility usually takes no more than 2–3 months. After which the doctor makes a diagnosis and chooses treatment tactics. In the vast majority of cases, infertility is curable. Treatment methods for infertility in women largely depend on its causes.

Drug treatment

Are used hormonal drugs, stabilizing hormonal levels and making possible the maturation of the follicle and ovulation (rupture of the follicle with the release of the egg to the fallopian tube), as well as subsequent implantation of the embryo. Drug treatment infertility in women gives a good effect if the inability to conceive is associated with endocrine disorders. Its effectiveness depends on the woman’s age, the duration of infertility and the viability of the ovaries.

Surgery

This type of treatment is indicated if the cause of infertility is a pathology of the uterus or fallopian tubes. With the help of laparoscopy - a minimally invasive operation - you can try to restore the patency of the fallopian tubes by eliminating adhesions, carry out coagulation if the problem is endometriosis, and remove myomatous nodes. Such operations are relatively simple and do not require a long rehabilitation period. However, resuming attempts to conceive a child will have to wait: to consolidate the effect after the operation, a course of drug therapy is carried out. It should also be mentioned that surgery cannot always help with pathology of the uterus or fallopian tubes. Sometimes, if the anatomical defects are too serious, surrogacy is the only option. The effectiveness of surgical treatment of infertility largely depends on the type of pathology and in some cases can reach 90%, and on average is 30–40%.

Psychological help

According to statistics, about 30% of cases of infertility are partially due to psychological reasons. Fear of responsibility, inevitable changes in life or childbirth, lack of self-confidence or in a partner, personal dramas and stress at work - any psychological overload can affect reproductive health. Sometimes the inability to get pregnant is caused by an unpreparedness for this step: the woman is not yet ready to give birth, but her family or partner is putting pressure on her. Often the root of the problem, paradoxically, lies in an obsession with motherhood, the concentration of all mental strength on this dream and a complete abandonment of other interests in life. We've probably all heard stories about couples who, after years of infertility, gave up and adopted someone else's child, only to have the woman discover just a few months later that she was expecting her own. In this case, psychotherapy can help, and it is advisable to undergo it together with a partner.

As a woman ages, her fertility decreases – this is a natural process. It is difficult to give exact figures, since the health status of each woman is individual, but on average, the chances of pregnancy begin to decrease from about 35 years old - by approximately 3-5% per year. After 40 years, the likelihood of pregnancy becomes even lower, but the risk of miscarriage and fetal pathologies, on the contrary, increases. At this age, it is safer to resort to IVF, and the sooner the better, since the older the woman is, the less likely it will be to obtain (even with IVF) high-quality eggs and, accordingly, high-quality embryos.

Assisted reproductive technologies

If all of the above methods for treating infertility in women have failed, it makes sense to think about assisted reproductive technologies. These include in vitro fertilization, intrauterine insemination with the sperm of a husband or donor, the use of donor eggs in an IVF program, and surrogacy. They differ both in complexity (intrauterine insemination is simply the introduction of pre-cleaned and concentrated sperm directly into the uterine cavity, and IVF is a complex set of measures to stimulate ovulation, in vitro fertilization of the egg and its implantation), and in efficiency.

Prevention of infertility in women

Since infertility is very often the result of inflammatory and infectious diseases of the reproductive organs, it is necessary to regularly check their condition and visit a gynecologist at least once a year. Unscheduled examinations are necessary when changing a partner or method of contraception, or when any changes or symptoms appear. In addition to the gynecologist, a woman should also visit an endocrinologist and mammologist.

It is also important to monitor your diet, avoiding vitamin and mineral deficiencies, and maintain weight without going to extremes - both thinness and extra 20–30 kilograms can become an obstacle to motherhood. No matter how trivial it may sound, smoking and drinking alcoholic drinks also detrimental to women's health and significantly reduce the chances of pregnancy, so you need to give up bad habits even before planning a pregnancy.

Having children is one of life's most important tasks. It should be approached with full awareness and responsibility. Preparing for conception not only allows you to get pregnant quickly, but also makes it possible to avoid many problems during pregnancy, childbirth and recovery after them. This is the key to the health of the child and his mother.

Approximately 15% of married couples in Russia are diagnosed with infertility. According to the World Health Organization, a marriage is considered infertile in which pregnancy does not occur within a year of regular sexual activity without the use of contraception.

Unfortunately, for many couples the path to the birth of a long-awaited child can be very long. Expert of the educational program “Happiness of Motherhood for Every Woman!” Antonina Kozlova, Ph.D., reproductive specialist at the MirA Medical Center:

“One of the most common causes of female infertility is damage or obstruction of the fallopian tubes, which prevents the egg from meeting the sperm and the subsequent transport of the already fertilized egg to the uterus. In addition, dysfunction of the fallopian tubes due to previous inflammatory diseases or impaired production can also lead to this. sex hormones.

Another serious reason is violations menstrual cycle and egg maturation. If a woman has irregular or absent menstruation, there is a reason for examination. Ovulation disorders are often associated with hormonal imbalances. Fortunately, it is not difficult to diagnose, and treatment is simple and quite effective.

The next factor is various lesions of the uterus, as a result of which the physiological process of implantation, or engraftment, of the embryo is disrupted. Such lesions of the uterus include: uterine fibroids, endometrial polyps, adhesions in the uterine cavity, congenital deformities, and sometimes the complete absence of the reproductive organ.

In addition, changes in the composition of cervical mucus (produced in the cervix) may also affect your ability to conceive.

Separately, it is necessary to note the importance of the woman’s age. This is especially true now, when there has been a change in women’s reproductive behavior. Modern ladies are trying to first make a career, secure a stable social position, and then give birth to a child. But we must not forget that after 35 years of age, female fertility (the ability to conceive) begins to decline sharply, the chances of getting pregnant are 2 times lower than at 20 years old, and by the age of 40 the probability of spontaneous pregnancy is only 10% compared to 20 years old. summer age.

A factor that should also not be forgotten, especially for young people who are keen on various diets, is weight. Significant deviations from normal body weight, whether overweight or lack of body weight as a result of sudden weight loss, can lead to decreased fertility, and sometimes to infertility in both women and men. According to one study, 12% of primary infertility is associated with weight problems.

Thus, a woman's fertility can be affected by various factors such as: sexually transmitted diseases, stress, sexual disorders and some common diseases.

Infertility is not just a female factor

It so happened that infertility was previously considered an exclusively female problem. However, today in 30% of married couples infertility is associated with disorders in the woman’s body, and in the other 30% - in the man’s body. In another 30% of couples, the cause of infertility is a combination of disorders in both partners. In 10% of cases, the cause of infertility cannot be identified. may be caused by various diseases that ultimately lead to deterioration in sperm quality, up to the complete absence of sperm, and ejaculation disorders.

Infertility is curable!

But even if you have heard the diagnosis of infertility, do not despair! Modern medicine now offers many methods to conceive a child. The main thing is not to waste time and contact specialists on time.

When a couple goes to a clinic specializing in sterility, an examination begins to identify the causes of infertility. The initial examination must provide answers to 3 main questions:

  • Does a woman ovulate and how regularly?
  • Is a man's sperm capable of fertilization?
  • Are a woman's fallopian tubes patent? Are there other anatomical obstacles to the passage of sperm to the egg and fertilization?

The examination of spouses is carried out simultaneously. Only after excluding pathology in a man is a diagnosis of infertility in a woman made.

If the initial examination does not reveal the cause of infertility, additional tests and diagnostic procedures may be needed. Sometimes the traditional battery of diagnostic tests fails to make a diagnosis for both partners. Then they resort to additional examinations, such as transvaginal ultrasound, hysteroscopy, laparoscopy, endometrial biopsy, and immunological test.

Taking into account the medical history and examination of both spouses, consultation and treatment can be prescribed not only from gynecologists, andrologists, reproductive specialists, but also from other specialists (endocrinologist, neurologist, therapist, psychotherapist).

Based on the results of the examination, a treatment method is selected for this couple:

  • drug correction of hormonal and immunological disorders;
  • surgery;
  • a combination of surgical and medical methods;
  • the use of assisted reproductive technologies (intrauterine husband or donor, in vitro fertilization with subsequent transfer of embryos into the uterine cavity).

Hormonal drugs, endoscopic methods, and IVF are modern, highly effective methods of treating infertility, which are links in one chain, final goal which is the restoration of reproductive ability.

The IVF procedure includes several stages:

  1. Ovarian stimulation. During 1 menstrual cycle, a woman matures one egg. Retrieving multiple eggs increases the chances of IVF success.
  2. Receiving an egg by puncturing the follicles. The puncture is performed through the vagina under ultrasound control.
  3. Fertilization of eggs with sperm in a special nutrient medium.
  4. Cultivation of the obtained embryos in a special medium.
  5. Transfer of embryos into the uterine cavity.

To increase the chances of IVF success, 2-3 embryos are transferred into the uterine cavity.

The success of IVF depends on many factors: the response of the ovaries to stimulation, the receipt of “high-quality” eggs capable of fertilization, the ability of sperm to penetrate the egg, the development of the resulting embryo, the readiness of the uterine mucosa to accept the embryo, attachment (implantation) to the uterine wall and further development embryo.

To date, the overall effectiveness of infertility treatment is more than 50%.

The use of modern techniques makes it possible to establish the cause in 99.6% of married couples within 2-3 months of examination and to restore fertility in 70% of couples within 12-15 months.

But, despite the available medical capabilities, the main thing is not to miss your chance to become parents and see a doctor on time! By working together you will achieve the desired result!

To achieve their goal of becoming parents, spouses require patience, mutual understanding, strict adherence to all recommendations and complete trust in the doctor. Only together with a specialist will you be able to go from the first visit to the clinic to that desired moment when your baby is born. Tatyana Yanochkina, head of the IVF department of the Health Clinic: “The main thing is not to lose heart, not to panic, if a woman stops fighting, the possibilities of medicine are limited. And no doctor will cure if the person does not want it. In addition, between the doctor and the patient There must be complete trust and mutual understanding, only then can a positive result be expected.”

Antonina Kozlova,
Ph.D., doctor-reproductologist of the Medical
center "MirA", educational program expert
"The happiness of motherhood is for every woman!"