Mozgovaya E.M., MD-Ph.D., obstetrician-gynecologist of the department for the treatment of infertility
Infertility is not just an inability to get pregnant during a year of active sexual activity without contraception, it is also a source of great grief and frustration for the family. If a year of efforts and attempts has passed, but there is no result, then each coming menstruation puts an end to a small hope … And, unfortunately, we can assume that infertility is taking place.
It is necessary to resort to the help of specialists: do not be left alone with trouble. Today 1 out of 8 couples suffer from infertility in Ukraine and, unfortunately, the number of such couples is only increasing.
For spouses over 35, it is observed 2 times more often than for young couples. That is why it is very important for couples who have crossed the thirty-year mark and are experiencing difficulties in conceiving, it is very important to immediately make a decision and seek help from a specialist. The sooner a problem is found, the more likely you are to get rid of it.
If a woman after 1-2 years of regular sexual activity without the use of contraceptives fails to become pregnant, then you should consult a doctor for advice on infertility. If there are obvious reasons for infertility – menstrual irregularities, ectopic pregnancies in the past, inflammatory diseases – then you should not wait a year, you need to be treated. This can be observation by a gynecologist friend, or better by a doctor who directly specializes in family planning.
Thanks to appropriate diagnostics and specially selected treatment, more than half of infertile couples were able to conceive a child.
In a number of cases (about one third of couples), this problem is caused by male infertility, in another third of cases, a woman suffers from infertility, and in the last third of couples, the cause of infertility has not been identified. However, at present, some reasons for childlessness cannot be established. In such cases, doctors use assisted reproduction techniques to overcome this problem. Today, more and more people are seeking medical treatment that will help them produce a baby. Infertility is not just a disease. This is a condition that can be caused by hundreds of reasons, both on the part of the woman and on the part of the man. And the most difficult thing is to find the cause of infertility in a particular couple. This is the key to success. Not many gynecologists and urologists can do this. This requires not only good experience, but also ample opportunities for examining patients.
Such situations are often encountered: an infertile couple comes for a consultation at a clinic that does not have the possibility of modern diagnostics. And the courses of trial treatment begin under the motto “What if you have it?” Some hormones are changed to others several times, and several courses of powerful antibiotics are necessarily added to this. In the end, everything returns to normal, but the man and the woman are already in such a “healed” state that even a healthy, hardy couple cannot get pregnant. A lot of time has been lost, a lot of money has been spent, hopes are fading.
Any method of treatment has a flip side of the coin, so doing it at random is unacceptable. To help effectively, the doctor must be a specialist in infertility. He must have extensive experience in this area, high qualifications, be able to conduct the necessary research, consult with other specialists. In addition, he should send a man for examination and treatment, since in 30-40% of infertile couples, the ability to conceive is reduced in a man. It is in vain that the stronger sex tries to stay away from the problem. Therefore, it is better to come to the consultation together, together with your husband.
All this is fully possible only in specialized centers dealing with the treatment of infertility. It is there that doctors work who deal with this issue at the highest level. The best reference point is the fame of the institution, its name. You can ask your local gynecologist or friend to recommend a specialized center for the treatment of infertility. If you do not immediately contact such an institution, you can constantly rush from one doctor to another, losing time, money and hope. This is a very typical situation for infertile patients, because it is difficult to help them.
If you do not live in a large city, then most likely there is no infertility clinic nearby. Then you can write a letter to the address of the specialized center. Describe the situation, list the studies conducted and their results, treatment and its effect. If the institution values its reputation, then you will be told what to do next, what other examinations to undergo and when to come to the appointment.
Almost all methods of treatment and examination related to infertility are paid. But, unfortunately, in modern domestic commercial medicine, the quality of care does not always correspond to the cost, and the cost does not always correspond to the level of services. Therefore, when choosing a clinic, one cannot act according to the principle “where it is more expensive” or, conversely, “where it is cheaper.” You can give a lot of money just for good advertising. And you can queue at the clinic for free. The famous saying of the British about cheap things can be paraphrased: “We are not rich enough to be treated where it is cheaper.”
So take your choice. Or immediately, albeit a little more expensive, but relatively effective. Or at first it is cheap, then many times it is cheap (in total it is still expensive). Until, finally, you accidentally get to a good specialist or become pregnant by the will of fate.
There are many reasons for infertility, and in order to identify them, you will have to go through a whole program of research: hormonal, ultrasound, infectious, immunological. As well as hysterosalpingography (checking the patency of the fallopian tubes), spermogram and much more, if necessary. In some cases, you have to “get to the bottom” of molecular, genetic and immunological mechanisms.
Only after finding out the reason, you can start treatment. The reproductive system works very delicately, and aggressive, improper treatment can only aggravate the condition. But do not forget: with age, the ability to conceive and bear a child decreases. The chances of getting pregnant are greatly reduced the older the woman is and the longer treatment for infertility she has undergone. If treated for a very long time, then you can reach an age when the body can no longer become pregnant.
In specialized centers, the period of examination for infertility should not exceed 2-3 months, and the treatment should give a result no later than two years from the date of contacting the clinic.
In preparation for treatment, you can save a little. Do some of the research needed to determine the causes of infertility at your place of residence. This can be an ultrasound examination, a spermogram, a study for genital infections. Then the cost of the examination will decrease. You will only have to undergo special examinations prescribed according to the indications of a doctor – hormonal, immunological. Knowing these seemingly little things will greatly facilitate the entire process of preparation and treatment.
We must be prepared for the fact that the very fact of treatment for infertility affects the woman’s body. Most often have mood changes, failures are especially acutely perceived, regret arises about wasted money, and in the end the woman abandons attempts to give birth to at least one child.
There is an opinion that almost any infertility can be bypassed by using the method of in vitro fertilization, to get a baby from a test tube. Is it so? Is it worth hitting the sparrows with a cannon?
If the violations are not irreparable, then infertility can often be dealt with with conventional drugs, by correcting the hormonal background and minimal external influences on the body, or by using laparoscopic surgery. In vitro fertilization is usually resorted to as a last resort. This is an expensive and difficult method. One attempt to get pregnant costs several thousand dollars, and in Europe it is several times more expensive. Several attempts are often required, since the efficiency of one is just over 30%. In addition, many are stopped by the psychological barrier to this unusual method. But if finances allow, nothing interferes, then you can try and outwit nature.
Of course, medicine is not omnipotent, and not everyone is able to help. Pregnancy rates after fertility treatments range from 20 to 80%. This depends mainly on the nature of the violations. For example, hormonal disorders lend themselves well to correction, and obstruction of the fallopian tubes requires repeated attempts at artificial insemination. After a complete examination in 5-10% of couples, the cause of infertility remains unexplained.
It should also be noted that communication with a fertility specialist almost always goes beyond professional recommendations. It is important to trust a doctor, a reproductive physician is partly a psychologist who can calm you down, instill hope for successful treatment. The main thing is not to deviate from the intended goal and believe in a positive outcome of treatment and the onset of pregnancy! Therefore, believe that everything will work out. And wish for a child.