Infertility is termed as the failure to achieve pregnancy after a year, with having regular intercourse. In patients with suspected infertility background, or women aged 35 years or older, it is recommended to consider early investigation and treatment, as there is a decrease in the chances of conceiving and giving birth as the age of the woman progresses.
Initial assesment will also include recommendation to take folic acid.
The inquiry includes:
For the woman
- Medical history and physical examination
- Confirming the existence of ovulations
- Evaluation of ovulations
- Evaluation of the uterus
- Evaluation of the fallopian tubes and abdominal cavity
For the man
- Medical history and physical examination
- Sperm count
Ovulation disorders occur in approximately 15-20% of couples suffering from infertility and about 40% of women with infertility. The ovulation factor should be evaluated prior any treatment.
Endometriosis is found in about 45% of women with infertility. This is a condition in which endometrial cells implant in the pelvis and pelvic organs, and effect fertility by secretion of anti inflammatory factors, creation of adhesions, and more.
The male factor accounts for about 20% of couples who have difficulty conceiving, as a single factor, and the donor contributes to fertility disorders in about 40% of the couples. İt is usually the result of abnormal sperm counts.
Many studies have shown that couples concieved spontaneously although low observed sperm counts, but the average time to conveive, was longer. It is recommended to pre-test sperm count, if there is prior information showing an increased risk of injury to the testes such as past mumps infection, cryptorchidism or varycocelle.
Other causes of infertility include “hostile” cervical mucus, uterine disorders (congenital malformation, polyp, fibroids), and blockage of fallopian tubes.