Infertility. What types of infertility are there? Primary infertility in women causes

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The inability of an adult organism to produce offspring.

The problem of infertility has long been familiar to humanity - since ancient times, a woman who was unable to conceive and bear fruit was considered inferior. Roman law allowed divorce from infertile spouses, and rulers in Rus' exiled their wives to monasteries.

Even in the last century, it was believed that only the woman is to blame for a childless marriage. The development of science has made it clear that men can also suffer from infertility. Advances in medicine, increased prosperity, and increased life expectancy have led to people's desire to have their own children, despite health problems. At the same time, environmental deterioration, chronic stress, changes in the rhythm of life and a revision of family values (when career is put at the forefront, and planning for offspring is postponed until a very young age) affect the deterioration of the ability to conceive. Therefore, the problem of infertility today is quite acute. Medicine offers many ways to treat it - from hormonal therapy to surgery. And when all means have already been tried, and there is no result, IVF comes to the rescue.

Infertility in women is a serious problem that many couples face. According to statistics, about 60% of all problems with conception are explained by female diseases. Depending on whether there have been pregnancies in the past, there are:

Primary infertility, in which a woman who has regular sexual intercourse has never become pregnant.
Secondary infertility, when pregnancies have been previously observed and, perhaps, there are already children.

The reasons for which there is difficulty in conceiving and bearing can be divided into several groups:

Problems with the fallopian tubes - obstruction due to adhesions that appear as a result of injuries, inflammatory diseases, operations. The consequence of obstruction can be an ectopic pregnancy, which threatens the woman’s life and is treated by removing the tube along with the embryo - and this significantly worsens the chances of the next successful pregnancy.
Infertility due to diseases of the endocrine system, resulting in impaired maturation of eggs.
Gynecological diseases – cervical pathologies, sexually transmitted infections, endometriosis, etc.
Infertility in women can also be caused by early aging of the reproductive system, ovarian exhaustion and menopause. As a rule, menstruation continues until age 50-55, but sometimes it can stop completely at age 40 or even earlier.
The problem of infertility can have a psychological cause, when stress, anxiety, constant depression and fears prevent pregnancy.
Immunological incompatibility - antisperm antibodies (ASAT) are formed in a woman’s cervical mucus, which kill sperm. ASAT can also form in men, and then they impair the quality of sperm.
Developmental anomalies in which pregnancy is absolutely impossible - for example, when the patient has no or underdeveloped reproductive organs from birth.

Sometimes it is impossible to establish the cause of female infertility, and then it is called idiopathic - this happens in almost 25% of all cases. However, this does not mean that there is no problem - it’s just that the available diagnostic and treatment methods are not yet able to identify and eliminate diseases that prevent pregnancy.

Infertility in men

It has long been mistakenly believed that the inability to conceive and bear a child is a problem for women. In fact, infertility in men is almost as common - about 45% of cases of reproductive problems occur among them. The cause of the failure is a violation of the motility and viability of sperm, a decrease in their number, obstacles to ejaculation, and many diseases and unfavorable factors can contribute to this. What is infertility like in men?

Secretory, when the quality and quantity of sperm deteriorates.

It can be treated with medications and hormones.

Obstructive.

Associated with impaired patency of the vas deferens due to injury, damage during surgery on other organs, tuberculosis, syphilis and inflammation of the epididymis, leading to gluing of the ducts and the inability of sperm to exit into the seminal vesicles.

Immunological

The cause of immunological infertility in men is the production of antibodies to their own sperm. In a normal state, sperm are not influenced by cells of the immune system, since they have a special biological barrier (blood-testis). When this barrier is compromised due to injury and infection, antisperm antibodies attack the sperm, sticking them together and immobilizing them.

Relative

Relative infertility in men includes those types when the examination did not reveal significant problems, but pregnancy does not occur in his partner. The reason for this is, as a rule, stress and anxiety. A psychotherapist treats this form of male infertility.

The main symptom of infertility is the failure of pregnancy to occur in a couple of fertile age, if favorable conditions for conception are met:

Complete refusal of all contraceptives.
Sexual intercourse occurs frequently (at least several times a week).
The man has no problems with sperm quality.

As a rule, infertility does not have any specific signs, and it can be suspected by indirect symptoms and manifestations of diseases that lead to problems with conception and pregnancy:

Abnormalities in the menstrual cycle indicate problems with ovulation (for example, a cycle of less than 20 days is usually anovulatory). Timely consultation with a doctor allows you to cure the diseases that provoke the failure at an early stage.
An indirect symptom of infertility can be excess hair growth on the body and face, as well as lack of hair in the pubic area and armpits - all this indicates an excess of androgens ("male" hormones). Excessive androgen secretion is also indicated by oily skin with acne.
Hyperprolactinemia, or excessive production of prolactin by the pituitary gland, is manifested by the absence of menstruation and the release of milk from the mammary glands outside of pregnancy and lactation.
Sexually transmitted diseases can cause inflammation in the pelvis and obstruction of the fallopian tubes.
Lack of weight and sudden weight loss lead to a decrease in the production of estrogen, due to which follicles develop. The result of an excessive struggle with extra pounds is the absence of menstruation and the inability to get pregnant. The second option is also bad, when a woman is obese - in this case, the production of “female” hormones is disrupted, and cardiovascular diseases develop.
Medical abortions that violate the integrity and quality of the internal mucous membrane of the uterus cause uterine infertility - the embryo cannot attach to the thin, damaged endometrium.
Habitual miscarriage, when miscarriages occur several times in a row, is a sign of female infertility and indicates hormonal abnormalities, impaired hemostasis, and problems with the endometrium.

Causes of infertility

The following may be to blame for male infertility:

Sexually transmitted infectious diseases.

Infectious parotitis, which causes inflammation of one or two testicles at once, is no less problematic. Therefore, boys must be vaccinated against it to avoid infection.

Varicocele.

Varicose veins of the testicle and spermatic cord, due to which the temperature inside the testicle rises, sperm secretion and their quality suffer. Varicocele initially has no symptoms, and only at a later stage can the scrotum become enlarged and painful. The disease can be cured surgically. After the operation, sperm characteristics improve and conception becomes possible.

Trauma and congenital pathologies.

Another possible cause of infertility is trauma and congenital pathologies of the structure of the genital organs (cryptorchidism and testicular torsion). With cryptorchidism, the testicles are located outside the scrotum of a newborn: they can be located in the abdomen, subcutaneously on the pubis, and in other places. In the standard case, cryptorchidism is diagnosed in infancy, at which time surgery is performed to bring the testicles into the scrotum.

Hormonal disorders.

For example, lack of testosterone secretion leads to problems with erection and sperm secretion.

Prostatitis and urethritis disrupt the process of sperm production and worsen its quality.

Immune disorders

When the body produces antibodies to its own sperm, which entails their immobility.

Sexual disorders.

Impotence and premature ejaculation can also cause infertility in men.

Bad habits.

Tobacco smoking, alcoholism, drug addiction, taking hormones in order to get in good physical shape, abuse of tight clothing, hot baths, steam baths and saunas.

Unfavorable living conditions

Signs of infertility can be observed in those who live in a region with poor ecology or work in hazardous chemical production - all of this worsens the quality of sperm.

Stress and overwork.

Stress, insomnia and overwork also negatively affect male reproductive function - therefore it is useful to be able to fully rest and recuperate.

The problem of infertility in women requires looking for ways to treat it. To do this, you need to clearly understand what and how can affect the ability to conceive and bear a child:

Age of the expectant mother.

After 35 years, fertility rapidly decreases due to the fact that the chromosomes in the eggs are destroyed.

Underweight or overweight.

The cause of infertility can be obesity or dystrophy, since the amount of fatty tissue in the body affects the production of estrogen, and therefore the menstrual cycle.

Infections.

Inflammation in the pelvis - sexually transmitted infections lead to inflammatory diseases of the reproductive organs, and this disrupts the patency of the fallopian tubes, affecting the attachment and gestation of the fetus.

Hormonal disorders.

Infertility in women is caused by hormonal disorders, due to which ovulation does not occur, hormones are not produced to maintain pregnancy, and the endometrium does not grow of the required quality. Hormonal imbalance often leads to the development of polycystic ovary syndrome, when the body is unable to produce mature eggs, and cysts with fluid inside form in their place. Pathologies of the thyroid gland and impaired secretion of “male” hormones can also cause infertility.

Endometriosis.

Endometriosis is a disease in which the endometrioid cells of the inner layer of the uterus end up outside the uterus and grow, which disrupts the patency of the fallopian tubes and makes ovulation difficult. In addition, there are studies proving the negative impact of endometriosis on sperm.

Immune causes.

In some women, cervical mucus contains antibodies that have a detrimental effect on the viability of sperm. A sign of infertility in this case is a pregnancy that does not occur for a long time despite the apparent health of both partners.

Bad habits (smoking, alcohol, caffeine abuse in large doses), exposure to chemicals when working in hazardous industries affect the reproductive sphere and reduce fertility.

Factors that increase the likelihood of infertility

Up to 30% of couples today experience signs of infertility, and therefore the problem of fertility has become a pressing issue for health care and the public. The number of people who suffer from diseases that affect the ability to conceive and bear a child is increasing. This is especially true for those who live in big cities and large industrial areas.

One of the main factors of infertility - tubo-peritoneal - is a leader among other causes of impaired fertility and is a consequence of previous sexually transmitted infections. Doctors attribute this to the promiscuity of sexual contacts, the early onset of intimate life, and the low literacy of young people in matters of safe contraception.

The increase in infertility statistics is influenced by the increased activity of the population in moving, long-term separation of spouses, a large number of divorces and frequent changes of sexual partners. Neglect of contraception and self-medication of gynecological diseases instead of seeing a doctor have a negative impact - as a result, women develop inflammation of the ovaries and internal cavity of the uterus, cervical erosion, endometritis and endometriosis.

A life scenario full of stress and anxiety, lack of sleep and overload leads to changes in hormonal levels, endocrine disorders, ovulation disorders, and aggravates common diseases that can interfere with conception.

Another problem associated with infertility is that couples turn to the doctor only at a late fertile age (from 35-40 years), when there is not much time left for treatment, the ovarian reserve is depleted, the spermogram is poor, and the body is burdened with other diseases. Therefore, doctors have no choice but to offer IVF with a donor egg or sperm, which, for moral and ethical reasons, does not suit everyone - many couples do not want to raise only half of “their” child.

Infertility is a mysterious disease because it is often unclear why a couple cannot get pregnant - in this case it is called idiopathic (unexplained). The diagnosis can be made when a man and woman have undergone a full range of examinations and no pathology has been identified, but pregnancy has not occurred for more than a year of regular intimate relationships without contraception. The woman must have a healthy uterus and fallopian tubes, and no ASAT or endometriosis. A man must have a good spermogram and a negative test for the presence of antisperm bodies in the blood.

What could be a factor in unexplained infertility?

Genetic disorders in the egg.
Anovulation for an unknown reason.
Lack of capture of the fallopian tube by the egg.
The inability of the sperm to undergo certain biochemical reactions and penetrate the egg.
Stopping the embryo from dividing, making it impossible to attach to the wall of the uterus.

What to do if the doctor reports signs of infertility of unknown origin? There are several options:

Waiting – it is offered if the woman has not reached 30 years of age, and there is a reserve of time to try to conceive naturally.
Stimulation of ovulation with medications.
Artificial insemination.
In vitro fertilization.

Types of infertility

Primary infertility

Infertility in a woman is called primary when she has never previously been pregnant in any form (even with ectopic implantation of the embryo, fetal loss, miscarriage or abortion), has regular unprotected sexual relations for at least one year, and cannot become pregnant .

Primary infertility in men is said to occur when in no intimate relationship, none of his partners was pregnant by him in the absence of contraception.

Secondary infertility

Secondary infertility (2nd degree) means that a woman has had pregnancies in the past and may already have children, but is unable to conceive at the moment. It would seem that if you managed to get pregnant before, why can’t you now? There are many reasons:

Age – fertility declines steadily after age 35, and the first signs of deteriorating fertility appear when a woman turns 30.
Secondary infertility can be a consequence of constant emotional tension, stress, chronic fatigue that accumulates over the years.
Hormonal disorders (polycystic ovary syndrome, adrenogenital syndrome, etc.), diseases of the endocrine and immune systems.
Gynecological problems - inflammation or infectious diseases of the genital organs, fibroids, adhesions and obstruction of the fallopian tubes.
Secondary uterine infertility is caused by gynecological interventions (abortion, curettage), due to which the endometrium is damaged and thinned, and the fertilized egg cannot attach to the wall.

Secondary infertility in men means that for a long time, conception does not occur due to the male factor, while in previous relationships the partner had children, or pregnancy occurred from him. The cause of second degree infertility can be:

Inflammatory diseases of the genitourinary system.
Varicocele.
Injuries and surgical operations on the scrotum.
Immune and hormonal disorders.

1st degree of infertility

First degree infertility is characterized by the inability to conceive a child even once throughout the entire previous life. There is no need to panic - this does not mean that there will never be children. Most diseases that cause infertility can be cured:

Infections and inflammatory diseases of the pelvic organs.
Hormonal abnormalities.
Impaired blood flow in the uterine cavity.
Problems in the endocrine system and hemostasis.
Immune disorders.
Gynecological diseases (endometriosis, fibroids, ovarian and cervical cysts).
Spermatogenesis disorders and infectious diseases in men, formation of ASAT.

If a couple lives in unfavorable conditions, and stress, lack of sleep, hard work and emotional burnout are factors in infertility, simple normalization of the regime and good rest can help to get pregnant.

2nd degree of infertility

The second degree of infertility is its secondary form, in which people cannot conceive a child, despite pregnancies in the past. There are many reasons for this:

Decrease in fertility with age, early menopause in women.
Impaired spermatogenesis.
Gynecological diseases (fibroids, endometriosis, inflammation of the appendages, etc.).
Hormonal disorders.
Immune abnormalities.
Thyroid diseases.
Complications after a previous pregnancy and childbirth, as well as after abortions.
Unhealthy lifestyle, bad habits.

Depending on what caused the second degree of infertility, one or both spouses are prescribed special treatment. The chance of conception after treatment is high, and if you fail to get pregnant, assisted reproductive technologies will come to the rescue - artificial insemination, IVF, surrogacy.

3rd degree of infertility

The term “third degree of infertility” is practically not used in medicine. It means that a person will never be able to conceive and give birth to a child. This happens in the case of congenital absence of the ovaries, uterus, and testicles. As a rule, this happens extremely rarely, and even then there are still options for becoming parents - resorting to a donor egg or sperm, surrogacy. In other cases, there are even more possibilities for treatment, and their effectiveness is higher. Therefore, doctors do not undertake to claim that the third degree of infertility is forever. The development of science and medicine gives hope that tomorrow incurable diseases will be cured, and problems with conception will be solved.

Diagnosis of infertility

History taking and examination for signs of infertility

Diagnosis of infertility begins with a medical history and medical examination. Based on this, the doctor can guess the cause of the problem and make a list of further examinations.

History may be:

In general, when the doctor finds out the state of health in general, learns about the presence of common diseases, general well-being, possible fluctuations in weight, blood sugar and blood pressure. The doctor may be interested in some factors of infertility: bad habits, exposure to stress, working conditions (hard physical labor, contact with harmful substances, etc.).

Gynecological - here the doctor finds out:

At what age did the first menstruation occur, what is the duration of the cycle now, is it accompanied by pain, what is the nature of the discharge.
When did a woman become sexually active? How regularly does he conduct it now? Do you experience discomfort during sex?
How long does it take for pregnancy to occur, have there been abortions or miscarriages before, are there any children?
What type of contraception was previously used.
How long did it take for the previous pregnancy to occur, and how did it go? Have there been any complications during childbirth?
Are there pains and discharge from the genitals, have infections and developmental anomalies been diagnosed before and now?
Have there been any surgeries on the reproductive organs or any injuries?
What examination and treatment for gynecological diseases was previously prescribed to the woman?
Has your spouse been treated for male infertility, and with what result?

During the examination, the gynecologist assesses the general condition and determines visual symptoms of infertility:

The condition of the mammary glands, their development and the presence of discharge.
The nature of the hairline (male or female type).
Body type.
Development of the genital organs and their pathologies.
The presence of rashes on the skin and mucous membranes of the genitals, which may indicate infections.

In addition, the doctor examines the condition of the facial skin, palpates the pancreas, abdomen and groin area, and measures blood pressure and temperature.

The second step in diagnosing infertility is general tests:

General blood analysis.
Blood test for HIV and hepatitis.
Blood test for group and Rh factor.
Blood tests and smears for PCR diagnostics of TORCH infections.
Hemostasiogram to identify disorders in the blood coagulation system (they can cause infertility).
Determination of lupus anticoagulant, antibodies to phospholipids.
Test for antisperm antibodies in cervical mucus, semen and blood.

To diagnose male infertility, the partner must undergo a spermogram - a test of sperm to determine its fertilizing ability and identify diseases of the genitourinary system. The result can be either a normal number of sperm of the correct shape (normozoospermia), or a complete absence of sperm in the seminal fluid (azoospermia), as well as an increase in the number of morphologically irregular cells.

Tests for hormone levels

To determine the causes of infertility, patients need to undergo a series of tests for hormone levels. The specific list of studies is determined by the attending physician based on the medical history:

Sex hormones

When diagnosing infertility, it is necessary to determine the amount of:

FSH is a follicle-stimulating hormone that affects the maturation of eggs, the secretion of estrogen and progesterone.
LH is a luteinizing hormone produced by the pituitary gland and ensures the secretion of progesterone by the ovaries.
Prolactin, responsible for follicle maturation and ovulation.
Testosterone is a “male” sex hormone, which should normally be present in small quantities.
17-OP-progesterone, indicating the presence of a hereditary disease - adrenogenital syndrome, in which the adrenal glands synthesize an increased amount of androgens.
Progesterone is a hormone responsible for the normal amount and growth of the endometrium inside the uterus.
Estrogen (estradiol), which ensures the maturation of follicles and eggs, the maturation of the endometrium and its preparation for implantation of the fertilized egg.
Anti-Mullerian hormone (AMH), which shows the reserve of follicles in the ovaries.

In order for the tests to be informative and the diagnosis of infertility to be correct, blood for sex hormones must be taken on certain days of the cycle:

On the 2-3rd – AMH, prolactin, FSH, LH.
On the 8th-10th – 17-OP, testosterone.
On the 19th-21st - estradiol, progesterone.

Adrenal cortex hormones

Hormones of the adrenal cortex are also important for diagnosing female infertility, because they affect ovulation and the production of cervical mucus:

DEA sulfate (regulates the functioning of the ovaries).
DHA-S is a “male” hormone responsible for secondary sexual characteristics. Its increase is indirectly indicated by excessive body hair.
Cortisol
17-KS (determined in urine) is also a “male” hormone, and an excess of its level above the norm indicates gynecological problems.

Thyroid hormones influence follicular development and ovulation. You need to take the test in a calm state, and the day before you should avoid stress and cancel sports training. The following will help identify the cause of infertility:

Thyroxine T4.
Triiodothyronine T3.
Thyroid-stimulating hormone.

Hardware and instrumental diagnostics

Diagnosis of infertility using special devices and instruments includes:

Ultrasonography

Allows you to assess the size and position of the uterus, its cervix and appendages, and see the condition of the endometrium. Ultrasound preliminarily diagnoses polyps, adhesions, tumors, endometriosis, fibroids, endometrial hyperplasia, inflammation of the appendages, cysts, ruptures and inflammation of the ovaries. A special ultrasound examination - folliculometry - makes it possible to evaluate the maturation and development of follicles during one menstrual cycle.

Colposcopy

Examination of the vagina with an optical device using a colposcope to detect erosion, cervicitis, and tumor diseases.

Diagnostic curettage of the uterine cavity

Diagnostic curettage of the uterine cavity is necessary when it is necessary to histologically check the condition of the endometrium and understand whether its growth corresponds to the day of the menstrual cycle.

Tuberculosis tests (Mantoux, Diaskin test, chest x-ray) and culture of menstrual blood for the presence of Koch's bacillus.

Infertility often occurs with genital tuberculosis, therefore, to diagnose the pathology, it is necessary to perform an X-ray of the lungs in combination with tests (Mantoux, Diaskin test) and bacterial culture of menstrual blood, mucus, and the contents of the uterine cavity.

Hysterosalpingography (HSSG)

X-ray examination of the uterus and tubes, which makes it possible to see abnormalities in the structure of the uterus, tumors, adhesions, and evaluate the patency of the fallopian tubes.

Radiography

If the symptoms of infertility indicate damage to the pituitary gland (in a woman outside the lactation period, milk is produced in the mammary glands, there are no menstruation), an x-ray of the sella turcica and skull should be taken.

If other methods of diagnosing infertility disease have not helped to accurately determine the problem, the woman is prescribed surgical examination through hysteroscopy or laparoscopy.

Hysteroscopy

Hysteroscopy is an examination of the uterine cavity and cervical canal under anesthesia using an optical device (hysteroscope). The hysteroscope is inserted through the cervix, without punctures or incisions. The procedure allows you to identify the causes of uterine infertility - cysts, polyps, check the quality of the endometrium, and take a fragment of it for histological examination. At the same time, small tumors can be removed using hysteroscopy - that is, the manipulation is not only diagnostic, but also therapeutic. Indications for this are:

Primary and secondary infertility.
Failed IVF in the past.
Myoma growing into the inner cavity of the uterus.
Suspicion of diseases and anomalies leading to uterine infertility - polyps, adenomyosis, pathologies of the structure and development of the organ.
Cycle disturbances (heavy periods, bleeding between periods).

Laparoscopy

Laparoscopy is an endoscopic examination of the pelvic organs under general anesthesia. Today this type of diagnosis is recognized as the “gold standard”, giving almost 100%. The surgeon, through a special optical device called a laparoscope, sees everything with his own eyes, and is not guided by the results of non-invasive examinations, which are often subjective. Laparoscopy allows not only diagnosis, but also treatment - in one visit you can cut adhesions, restore tubal patency, and remove foci of endometriosis. The study is carried out by introducing laparoscopic instruments through small incisions in the abdominal wall, so healing after surgery is quick and painless and does not cause negative consequences in the form of adhesions.

Indications for the study are:

Determining the causes of primary and secondary infertility.
Endometriosis.
Cysts, torsion and rupture (apoplexy) of the ovaries.
Ectopic pregnancy.
Tubal obstruction.
Uterine fibroids.
Adhesions in the abdominal cavity and pelvis.

Infertility treatment

Treatment of male infertility is based on the following principles:

His wife should not have problems with conception and pregnancy. If they are, the woman should be treated, and her treatment program should be coordinated with the husband's examination and treatment program.
Unfavorable factors that prevent pregnancy should be excluded: infrequent sexual activity, stress, difficult working conditions, taking medications (if they are not vital).
If the cause is established, treatment for male infertility consists of eliminating it. When it is not established why the sperm is of poor quality, only means to improve blood microcirculation and metabolism, vitamins and tonic drugs are prescribed.
Inflammatory diseases of the genitourinary organs require the prescription of sanitizing drugs, depending on which pathogen is identified. Both spouses should undergo treatment to exclude the possibility of re-infecting each other.
Varicocele should be treated through surgery, regardless of the severity of the disease. Uncomplicated excretory azoospermia, when sperm are produced in the testicles but do not enter the seminal fluid, also requires surgical treatment.
Treatment of immune infertility in men requires special methods (plasmapheresis, removal of antibodies from the genital organs, drugs to reduce the production of ASAT). If this does not help, the couple is recommended IVF with preliminary cleaning of sperm from “adherent” antibodies.
Treatment of infertility in men due to sexual dysfunction involves conservative treatment and work with a psychotherapist.
Treatment of male infertility due to hormonal disorders should be tailored to individual characteristics. The advisability of treatment with hormones depends on the type of disease and the specific situation. If therapy is prescribed, it should last at least 70-75 days, which corresponds to the sperm development cycle.

Sometimes the problem of male infertility cannot be solved conservatively or surgically, and then modern reproductive technologies come to the rescue:

PEZA, MEZA, TEZE

In case of complicated azoospermia, when it is impossible to restore the patency of the vas deferens, a procedure is prescribed for obtaining sperm from the epididymis or the testicle itself (methods are called PEZA, MEZA, TEZE). The sperm are then used in the IVF procedure.

Artificial insemination

Sperm is introduced into the vagina or uterine cavity in such a way that it falls on the area of the throat of the cervix (during natural sexual intercourse, only a small amount gets there). The likelihood of conception after such manipulation increases several times. The indication for insemination is a decrease in the number of motile sperm in the ejaculate.

Fertilization of a woman's egg with her husband's sperm in the laboratory, followed by transfer of the embryo into the uterine cavity. IVF is indicated for poor sperm quality, when the number of living, motile sperm is extremely small.

Intraplasmic sperm injection is one of the auxiliary methods used during IVF. The essence of the method is that the sperm, selected visually by the embryologist, is introduced into the cytoplasm of the cell with a special pipette. In this case, a practically immobile sperm can be used.

PIXIE

High-quality selection of sperm for the ICSI procedure. The embryologist finds the best (most mobile, mature and correctly formed) sperm and checks its chemical and biological characteristics using PIXI cups. These cups contain special media containing hyaluronic acid. Nature intended that the acid participates in the selection of sperm during fertilization - the receptors of high-quality male cells are sensitive to hyaluron. The interaction of the sperm with hyaluron in the cups indicates that it has properly functioning receptors and fertilization will occur successfully. After this, the sperm is injected into the cytoplasm of the cell, that is, the ICSI procedure is performed.

Treatment of female infertility

To cure female infertility, you need to establish its cause and try to eliminate it. Unfortunately, this is not always possible. Therefore, the directions of infertility treatment are:

An attempt to restore fertility using conservative or surgical methods.
Assisted reproductive technologies, if previous treatment did not help or the couple is physically unable to conceive naturally.

What methods are used to treat female infertility?

If the cause is endocrine disorders, hormonal treatment and ovarian stimulation are performed. In addition to medications, women are advised to normalize their weight and engage in physical exercise. Physiotherapy is also indicated.
Infertility due to diseases of the fallopian tubes is usually treated surgically - laparoscopic surgery allows you to restore patency in 35-40% of cases. If this does not help, the patient is offered an IVF program.
Endometriosis involves laparoscopy and cauterization of the lesions, and then a short course of medications is prescribed to consolidate the result (drugs that cause artificial menopause (IC) and prevent endometrial growth). You need to try to get pregnant after leaving the IR, before endometriosis recurs.
Infertility of the uterus (severe malformations) requires operations to reconstruct the organ. If this is not possible, a woman can use the surrogacy service.
Treatment of immunological infertility, when ASAT is detected in the cervical mucus, begins with barrier contraception for up to six months. Drugs are then used to reduce the production of antibodies. If this does not give the desired effect, the couple is recommended artificial insemination, in which the sperm bypasses the cervical canal and does not experience the negative effects of ACAT.

When the cause of infertility is not established, ART (assisted reproductive technologies) methods are used:

Intrauterine insemination.
IVF (with ICSI, PIXI and other ways to increase the effectiveness of the procedure).
Surrogacy.

When is IVF used?

Initially, the in vitro fertilization method was developed to eliminate one cause of infertility - problems with the tubes. Gradually, the list of indications for IVF has expanded and includes:

Tubal pathology, which can be congenital or acquired, is a consequence of ectopic pregnancy, inflammation, endometriosis, abdominal surgery.
Polycystic ovary syndrome is a disease in which the ovaries contain many cysts with fluid content. In this case, the level of male hormones in a woman’s body is increased, and therefore there are disruptions in the menstrual cycle (amenorrhea), abundant growth of hair on the chest and face, and obesity. Sometimes patients experience severe uterine bleeding. Treatment of the disease is first carried out conservatively (hormones) or surgically (ovarian resection, cauterization of cysts). IVF for infertility due to polycystic disease is prescribed when other methods of therapy have been exhausted and pregnancy has not occurred.
Endometriosis is a disease, the essence of which is the growth of endometrial cells into the fallopian tubes or abdominal cavity. Normally, the endometrium should line only the inner uterine surface. Its spread outside the uterus leads to infertility due to the fact that the maturation of eggs and ovulation is disrupted, and the patency of the tubes is reduced - after all, endometrioid lesions contribute to the formation of adhesions. As in the case of polycystic ovary syndrome, IVF for infertility due to endometriosis is prescribed when the possibilities of drug (hormonal) and surgical treatment have been exhausted and have not brought the expected result.
The age of patients can become an obstacle to a natural pregnancy due to changes in the properties of the eggs. Assisted reproductive technologies (IVF with ICSI, hatching) can overcome these problems.
Anovulation in the absence of effect from therapeutic treatment, stimulation of ovulation and artificial intrauterine insemination is also an indication for IVF.
Infertility of unknown origin, in which a clear cause for difficulties in achieving pregnancy has not been identified.
Male infertility associated with a decrease in the fertilizing ability of sperm. Assisted reproductive technologies (IVF with aspiration of sperm from the epididymis or their extraction from the testicle, ICSI - injection of sperm into the egg) increase the chances of pregnancy.

How is infertility treatment done using the eco-method? The essence of the technology is to stimulate ovulation of several eggs in a woman, puncture the resulting eggs and fertilize them with her husband’s sperm in the laboratory. The resulting embryos develop for 3-5 days in special incubators under the supervision of doctors, and then they are transferred into the uterine cavity. Each stage is important to achieve the final result.

To stimulate ovulation, special hormonal drugs are used that accelerate the growth and maturation of follicles and eggs. To monitor the process of cell maturation and the condition of the endometrium, the doctor prescribes laboratory tests (monitoring the levels of estradiol, progesterone and LH) and ultrasound.

Puncture of mature follicles is performed under intravenous anesthesia. A disposable needle with suction is connected to a special ultrasound sensor, and then through the vagina it is inserted one by one into all follicles, and their contents are sucked out. The fluid obtained as a result of puncture is transferred to embryologists to prepare for fertilization.

Fertilization can occur either independently - the embryologist only connects the processed sperm and eggs (IVF), or using the ICSI method - the sperm is injected directly into the egg. ICSI is usually used when sperm quality is poor and its fertilizing ability is reduced. In addition, other modern methods are used for infertility in men - IMSI (injection of sperm into the cytoplasm of the egg) and PICSI (additional sperm selection before ICSI).

Growing (cultivation) of embryos begins the day after follicle puncture. First, the embryologist evaluates the fact of fertilization, signs of which can be observed 17-18 hours after the union of male and female cells. Then the doctor observes the process of embryo division for 3-5 days, identifies among them the most promising ones that do not have genetic abnormalities, and determines the best time for transplantation into the uterus. As a rule, embryos that reach the blastocyst stage have the best chance - and this happens on the 5th day.

Embryo transfer and implantation is the most exciting stage of infertility treatment using IVF, because it is then that it becomes clear whether the doctors have managed to make another married couple happy. Direct transfer of embryos into the uterine cavity occurs using thin soft tubes (catheters) under ultrasound control - this allows them to be placed in a place in the uterus convenient for implantation. Before it is possible to take hCG and find out the results of IVF, the woman is prescribed drugs to maintain pregnancy in the early stages.

The period after IVF

Treatment of infertility through IVF has two outcomes.

Successful when pregnancy occurs and the happy family leaves the clinic to prepare for the birth of the long-awaited baby. You can find out whether IVF succeeded 14 days after the embryos are transferred into the uterine cavity by taking a blood test for hCG. A little later, the presence of implanted embryos in the uterus must be confirmed by ultrasound, and then contact a gynecologist for pregnancy management. Carrying a child after IVF initially requires hormonal therapy, the purpose of which is to maintain sufficient levels of progesterone. Therefore, signs of pregnancy may be more pronounced and specific compared to normal conception. Which points to an interesting point:

Severe nausea and vomiting (toxicosis).
Irritability and insomnia.
Breast swelling.
Increase in basal temperature.
Sensitivity to odors.
Moderate pain in the lower abdomen, lower back and sacrum.
Headache.

Unsuccessful - pregnancy did not occur. Why does this happen?

Ovulation occurred before the follicles were punctured.
It was not possible to extract high-quality eggs during puncture.
Fertilization did not occur.
The fertilized cell has stopped dividing and developing.
The embryo did not implant after transfer into the uterine cavity.

Unsuccessful IVF, although it deals a blow to the mental state of a couple suffering from infertility, gives doctors a lot of useful information:

How did the ovaries react to stimulation of ovulation?
Why was the egg not fertilized?
What quality were the embryos?
How the endometrium grew.
Did implantation occur and did the embryo continue to develop?

It is very important to study the circumstances of failure, because the tactics of further infertility treatment depend on this - whether it makes sense to do repeated IVF, what changes need to be made to the program, what additional procedures need to be carried out. So, if the pregnancy has stopped developing at the implantation stage, the hatching procedure can solve the problem in some cases, when the non-elastic membrane of the fertilized egg is pierced or cut so that the embryo can “hatch” and attach to the endometrium.

Pregnancy after infertility can have specific complications that are the result of health problems.

The consequence of hormonal disorders is the threat of miscarriage and non-developing pregnancy in the early stages. This is due to the existing pathology of the ovaries, which provokes a lack or excess of hormone secretion.

Obstruction of the fallopian tubes, adhesions in the pelvis can cause ectopic pregnancy, rupture of the tube and severe intra-abdominal bleeding that threatens the woman’s life. Therefore, after a positive pregnancy test, you need to go for an ultrasound and make sure that the fertilized egg is in the uterine cavity and not attached to the tube.

Immune problems lead the couple to undergo artificial insemination or IVF to avoid contact of sperm with cervical mucus. Therefore, in this case, there are practically no complications during pregnancy if the woman does not have other diseases.

Impaired sperm production can cause a genetic disorder in the embryo - a “bad”, defective sperm, when fused with an egg, carries incorrect genetic information and chromosomal abnormalities, which is why the embryo stops developing at an early stage. Sometimes pregnancy still continues, but the child may die immediately after birth, or have a serious illness. To avoid such an outcome, it is recommended to undergo all routine screening ultrasounds, which can detect pathology in a timely manner.

Previous gynecological diseases are a common cause of pregnancy complications after infertility:

Previous sexually transmitted infections can worsen due to decreased immunity, and this leads to intrauterine infection of the fetus.
If pregnancy occurs against the background of uterine fibroids, in the early stages this can interfere with embryo implantation, and in the later stages it can contribute to the rapid growth of the myomatous node, as well as its swelling and necrosis. If the placenta is attached to a myomatous node or scar after removal of such a node, intrauterine hypoxia and fetal growth retardation are possible, and there is a threat of miscarriage.
Inflammation of the uterine appendages, its mucous membrane, cervical erosion, previous curettage of the internal cavity of the uterus can cause abnormal attachment of the placenta - low or blocking the internal os, and this often leads to premature detachment and bleeding.

Abnormal placentation and infectious diseases are risk factors for the development of placental insufficiency, in which the baby in the womb does not receive the required amount of nutrients and oxygen. Pregnancy after infertility in this case is complicated by malnutrition (underweight) and hypoxia in the baby.

Infertility is a disease that usually does not cause physical suffering, but “kills” the family mentally. It’s hard to live with the thought that everyone around us has long become happy parents, and some have to go from one clinic to another. But don't despair. Medicine is developing rapidly and offering new treatment methods. You just have to be patient, listen to all the doctors’ advice, look for “your” doctor who you can trust - and then you will definitely be lucky!

First degree infertility or primary infertility is a serious problem in the modern world. The main symptom is the inability of a married couple to conceive a child for twelve months, provided that they had regular sex life without protection. When they talk about primary infertility, this means that a woman has never been able to become pregnant since the beginning of her reproductive development. And unfortunately, this diagnosis is not so rare.

Many, upon hearing about primary infertility, fall into depression and apathy, but modern medicine has stepped forward so much that the chance of getting pregnant or simply having your own child is increasing more and more every day. And in this article we will look at what leads to primary infertility and how it is treated.

What is primary infertility in women

There are congenital pathologies that result in a woman being unable to become pregnant. For example, pathologies include cervical erosion, fibroids, cysts, etc. Problematic ovaries are common, and if the functioning of the ovarian follicles is disrupted, then the maturation of the egg becomes problematic, with deviations from the norm. These diseases can occur if the patient has not had periods for a long time, or, conversely, if they last too long.

Primary infertility in women

Abortions are common among women. After all, those hormones that were produced during the conception of a child, as well as during the formation of the fetus, turn out to be no longer necessary, and a malfunction occurs in the body.

Often, it is curettage during an abortion that leads to injuries to the genital organs, resulting in adhesions that lead to obstruction of the fallopian tubes. Therefore, the egg simply cannot enter the uterus for implantation to occur.

Causes of primary infertility

Lack of ovulation. The reason for this is hormonal imbalance, irregular menstruation, heavy bleeding or, conversely, the absence of bleeding for quite a long time, leading to the fact that a healthy egg cannot be released. This is usually treated with medication to restore the woman's normal ovulation cycle.
Endometriosis disease occurs when the endometrial cells of the uterus grow outside the uterus. Women usually feel the painful onset of this disease, especially during menstruation. It is during endometriosis that the number of miscarriages increases. This disease is treated only surgically, removing unnecessary tissue and restoring the patency of the fallopian tubes.
With age, the quality of the egg deteriorates, and it becomes increasingly difficult for women after forty to become pregnant, and there is a risk of all sorts of pathologies. In this case, a surrogate mother or the implantation of an egg from a donor is recommended.
Poor patency of the fallopian tubes– this is when the sperm cannot reach the egg. Doctors say that in case of first degree infertility, the cause of obstruction may be inflammatory processes in the genital organs and infections.
Polycystic. During this disease, a large number of cysts appear on the walls of the ovaries, which causes hormonal disruption, disruption of the menstrual cycle, and lack of ovulation. Symptoms of polycystic disease are increased body hair, rashes, weight gain. Polycystic disease is treated with medication.

However, only a specialist can correctly diagnose the disease, determine the nature of its course, and prescribe high-quality and correct treatment. Today, type 1 infertility is treatable, and there are a huge number of methods. And in case of extremely complex infertility, there is an option with IVF or surrogacy. Therefore, do not lose faith in yourself and in medicine, go for it, and you will succeed!

Divided into primary and secondary.
Primary female infertility is a disease of women who have not previously become pregnant, if, with regular sexual activity with a healthy man without the use of contraceptives, pregnancy does not occur within one year.

Infertility is considered secondary if a woman has already had at least one pregnancy, but after that the woman can no longer become pregnant for a long time. And it doesn’t matter whether she gave birth to a child or whether the pregnancy ended in abortion, miscarriage, or ectopic pregnancy.

The causes of these two types of infertility may even be the same, but abortion most often leads to the appearance of secondary infertility. When a healthy body, already tuned in to pregnancy and preparing for the birth of a child, is unexpectedly and forcibly rebuilt, it experiences stress.

Causes of primary female infertility:
1. underdevelopment of the female genital organs (infantilism), deviations in their development and accompanying hormonal disorders;
2. incorrect position of the uterus, creating conditions unfavorable for conception;
3. functional insufficiency of the gonads, manifested in menstrual irregularities.

Causes of secondary female infertility:
1. hyperfunction of the thyroid gland. With increased production of thyroid hormones, the production of pituitary hormones decreases, and this directly affects the production of female reproductive hormones. Because of this, various diseases of the genital organs can occur: endometriosis, uterine fibroids, polycystic ovary syndrome. At the same time, hypofunction of the thyroid gland leads to increased production of pituitary hormones, and because of this, the production of ovarian hormones is suppressed and the processes of fertilization and gestation are disrupted;
2. inflammatory diseases of the female reproductive system: fallopian tubes and ovaries, cervix, vagina;
3. sexually transmitted infections: gonorrhea, trichomoniasis, chlamydia, mycoplasmosis, herpesvirus and cytomegalovirus infections and others;
4. complications after abortion or gynecological curettage. In this case, the follicles can mature and be fertilized, but the uterus can no longer attach them to itself. This may be the result of a violation of the rules and technique of the operation. In this case, the woman’s chances of becoming pregnant again are minimal;
5. traumatic injuries of the perineum, postoperative complications, as well as hidden scars, adhesions, polyps formed as a result of injuries or after operations;
6. diseases of the endocrine glands (endocrine diseases);
7. ionizing radiation, radiation;
8. debilitating diseases, chronic intoxication, as well as poor nutrition (especially in childhood or ill-conceived diets in pursuit of an ideal figure);
9. “biological incompatibility,” which, as a rule, hides the inability to explain or identify the causes of infertility. Either the couple was simply “lucky” for the first time, or infertility arose after the first birth. It is most difficult to treat such couples for infertility, since if the diagnosis is unclear, then the treatment methods are also unclear.

The most likely age for women to give birth to a child is the period from 15 to 30 years. At the age of 30, a slight decline in the ability to have children begins, and after 35 years, fertility declines sharply in most women, and almost 25% of women generally become infertile.

It is known that about 25% of couples being treated for infertility are already parents. Some had problems with their first conception, but most encountered this problem when trying to conceive a second child. Thus, a successful first conception does not guarantee a successful pregnancy in the future.

People experiencing secondary infertility are less likely to seek medical help than those who initially cannot conceive. In some cases, they simply refuse to believe that such a problem exists. In this case, there is no point in delaying treatment, as this only aggravates the problem, turning it into incurable.

The definitions of “primary” and “secondary” infertility apply not only to women. If we talk about a man, then primary infertility means that none of his partners became pregnant from this man. And we can talk about secondary pregnancy when this man had at least one pregnancy, in at least one of his partners.

We can also talk about primary or secondary infertility of a married couple as a whole.

If you have been unable to get pregnant for a long time, make an appointment with an experienced fertility specialist by calling the numbers listed on the website.

Primary infertility is expressed in the inability of a woman to become pregnant for a long period of time after the onset of the reproductive period (the time of the onset of menstruation).

Characteristics of primary infertility

Primary infertility is diagnosed in girls who have never become pregnant.

Primary infertility is diagnosed in more than 1.5% of women in the world aged 20 to 44 years.

Causes of the disease

Primary female infertility can occur for many reasons. This disease can be triggered by neuroendocrine disorders, as well as the abnormal structure of the girl’s reproductive system.

The disease can occur due to complications of previously suffered diseases of the reproductive organs. In 70% of women, this disease is caused by endocrine dysfunction.

This condition can cause frequent use of combined oral contraceptives, frequent stressful situations, physical fatigue, anorexia or, conversely, obesity.

With endocrine dysfunction, the necessary hormones are not produced by the body, and this leads to a failure in the process of egg maturation.

The table shows the main causes of primary infertility in women.

Cause	Short description
	Formation of small ovarian cysts
Hypothyroidism	Insufficient production of thyroxine and triiodothyronine
Adrenogenital syndrome	Congenital adrenal dysfunction and androgen excess
Genital infantilism	Delayed growth and development of reproductive system organs
Hyperretroflexion of the uterus	Bend the organ back
	Benign tumor in the myometrium
Hyperanteflexia of the uterus	Bend the organ forward
	A location of the inner layer of the uterine wall outside of its normal location.

In 65% of women, primary infertility is a consequence. Also the cause may be the so-called (damage to sperm by antisperm antibodies).

Classification of the disease

Primary infertility has several types:

Congenital.
Acquired.
Temporary.
Permanent.
Absolute.
Relative.

Congenital primary infertility is the inability to conceive due to existing birth pathologies (improper structure of the tubes, malformation of the uterus, congenital disorders in the endocrine system).

Acquired primary infertility occurs as a result of previous diseases. Typically, the inability to get pregnant occurs due to obstruction of the fallopian tubes, which provokes previously suffered such diseases:

Lymphogranuloma venereum.
Gonorrhea.
Diphtheria.
Mycoplasmosis.
Pelvioperitonitis.
Salpingitis.
Syphilis.
Scarlet fever.
Trichomoniasis.
Chlamydia.
Endometritis.

Temporary infertility is a transitional condition, such as puberty. When puberty ends, the girl will be able to get pregnant, that is, temporary infertility goes away on its own, you just need to wait a certain amount of time.

Permanent primary female infertility is a situation that is caused by a number of factors or diseases that will not go away on their own.

Permanent infertility requires competent medical intervention and treatment.

Absolute primary infertility in women is the inability to ever become pregnant, that is, the girl has no uterus or irreversible pathological changes in the reproductive system occur. Relative infertility is defined when the cause can be eliminated.

Main symptoms of primary infertility

The main symptom of infertility is the inability to become pregnant for a year without using contraception.

Many women suffering from this disease notice symptoms of amenorrhea (absence of a menstrual cycle for more than 6 months).

Hypomenstrual syndrome often appears (decreased volume of menstrual flow, shortened duration of menstruation). All other symptoms depend directly on the cause of primary infertility.

With genital infantilism in women, upon examination, there is weak hair growth in the pubic area and in the armpits, underdevelopment of the labia, and an elongated conical neck. With polycystic disease, there is no ovulation and excess weight appears.

Methods for diagnosing the disease

A gynecologist-reproductologist can make a diagnosis of primary infertility only after undergoing a series of examinations. The first stage of diagnosis is an examination by a gynecologist-reproductologist.

The doctor must determine the shape, position and size of the uterus and appendages. The gynecologist also pays attention to the patient’s weight and height, BMI, degree of hair growth and condition of the mammary glands.

Then the doctor collects anamnesis and refers the girl to undergo an ultrasound examination of the pelvic organs.

When making a diagnosis, it is mandatory to take hormone tests:

AMH (anti-Mullerian hormone).
Estradiol.
Testosterone.
Thyroid hormones.

It is mandatory to be tested for sexually transmitted infections.

In some cases, the doctor prescribes additional tests:

Hysterosalpingography (examination of the condition of the uterine cavity and the patency of the fallopian tubes).
Hysteroscopy (examination of the uterine cavity using a hysteroscope).
Examination of cervical mucus.
Colpocytology (examination of vaginal discharge to assess hormonal levels).
Genetic consultation.
Consultation with an endocrinologist.
Laparoscopy.
USGSS (non-invasive ultrasound of the uterus).
Ultrasound of the thyroid gland.
Folliculometry (monitoring the growth and development of follicles in the ovaries).

Women will also need to take a smear for flora and provide the doctor with a schedule. The schedule is necessary to assess the nature of the menstrual cycle.

In parallel with the woman, the regular sexual partner is also examined. He will also need to be tested for STDs and to determine the man's fertility.

Treatment of the disease

How to cure primary infertility? The treatment method depends directly on the cause of the disease.

If a woman does not have a uterus or ovaries, then treatment of primary infertility is impossible, because there are no main reproductive organs. For such women, the only option is surrogacy.

If the problem is endocrine disorders, then the doctor performs hormonal therapy. If the cause is genital infantilism, then the woman is prescribed cyclic hormonal therapy with estrogens and gestagens.

For polycystic disease, laparoscopic surgery is performed and medications are prescribed to stimulate the growth of follicles in the ovaries. In case of obstruction of the fallopian tubes, surgical correction is performed to eliminate it.

Conclusion

Primary infertility syndrome is the cause of an abnormal structure of the organs of the reproductive system, previous diseases (especially STDs), obstruction of the fallopian tubes, as well as cervical erosion.

Today, this disease is successfully treated in most cases, with the exception of situations with congenital malformations of the reproductive organs.

Video: Infertility 1 and Infertility 2 - primary and secondary

According to statistics, today every 7th couple cannot get pregnant. They have to undergo a huge number of various studies over several months and even years, and undergo treatment in order to conceive a long-awaited child. At the same time, doctors distinguish between secondary and primary infertility, which can be diagnosed in both men and women. However, not everyone understands what kind of pathology this is and whether a complete recovery is possible.

According to medical terminology, primary infertility is a pathological inability to conceive a child from the very beginning of reproductive age. This diagnosis is made if a couple does not become pregnant within 1 year through unprotected sex, and conception has never occurred before. The pathology does not depend on gender characteristics (that is, both women and men can suffer from it). However, its reasons can be completely different.

Medical educational program. The diagnosis of primary infertility may also be listed as first degree infertility.

Causes

First, you need to find out the causes of primary infertility - the factors that make conception impossible. Moreover, they will be different for men and women.

Among women

Underdevelopment of the female genital organs, which is called infantilism.
Abnormalities of the uterus or its incorrect position.
Weakening of the functions of the gonads.
Infection of the genital tract with various types of infections.
Inflammation in the genitals.
Diseases of the uterus: fibroids, cysts, erosion, endometriosis (is it possible to get pregnant with endometriosis, read).
Any pathology of the ovaries, disruption of their functionality: polycystic disease, lack of ovulation.
Hormonal imbalance that prevents the maturation of a healthy egg.
Poor-quality egg due to aging of the body. After age 40, eggs may be abnormal.
Obstruction of the fallopian tubes, when a healthy egg cannot reach the uterus.
Regular use of emergency contraception medications. The same famous “Postinor” contains a very large dose of hormones, which interferes with the fertilization of the egg in the future.

In men

Infectious diseases. Inflammation is promoted by the activation of various fungi, viruses, bacteria, which causes sperm to stick together and become unproductive.
Poor patency of the seminal tract.
Production of antibodies to sperm.
Varicocele - dilated veins of the spermatic canal.

Are common

The causes of primary infertility, common to men and women, are also:

Wrong, unhealthy lifestyle: poor nutrition, lack of physical activity, various addictions (alcohol, drugs, tobacco), etc.
Unfavorable environmental conditions - poor environmental conditions.
Constant stress.
Serious congenital or acquired pathologies (health problems). Systemic diseases such as liver cirrhosis, diabetes, tuberculosis, bronchial asthma, traumatic brain injury.
Genetic abnormalities of hereditary nature.
Radiation, constant or prolonged contact with harmful chemicals.

It is very important to identify all these unfavorable factors in order to eliminate them in a timely manner - this will be the main course of treatment. But first you need to make sure that we are talking about primary infertility, and not about some other pathology.

Keep in mind! Young couples too downplay the role of stress in the process of conceiving a child. If you have persistent depression, your ability to get pregnant is significantly reduced.

Symptoms

The main symptom of primary infertility is the absence of pregnancy for a year with constant sexual activity and the absence of contraception. All other signs may be subtle and indicate other diseases and pathologies, so it is mandatory to identify additional, more accurate symptoms from a doctor during examination.

Among women:

prolonged absence of menstruation, constant disruptions in the menstrual cycle, prolonged bleeding during menstruation - these are signs of hormonal imbalance;
painful periods may indicate endometriosis;
large (or small) body weight, rapid growth of body hair, acne - symptoms of polycystic disease;
unpleasant smell of discharge.

For men:

pain when urinating;
obesity;
pain and burning sensation in the scrotum, discomfort while walking, increased sweating, sexual dysfunction - symptoms of varicocele.

If a couple aged 20 to 40 years has regular sexual intercourse for a year with a complete, long-term refusal of contraception, but they do not end in pregnancy, and conception has not occurred before, we can talk about primary infertility. If there are also the above-mentioned additional symptoms, the risk of confirming the diagnosis increases. However, final conclusions can only be drawn after laboratory diagnostics.

Stubborn statistics. About 15% of couples are infertile. In 40% of cases the cause is a male factor, in 50% it is a female factor, and only in 10% the diagnosis is given to both.

Diagnostics

Advanced diagnosis of primary infertility includes a number of measures. This includes collecting data from anamnesis (interviewing patients, studying their medical histories), physical examinations (examination, palpation), and laboratory techniques.

Physical examination

The body mass index is outside the normal range (20-26).
The condition of the skin indicates endocrine disorders.
Underdevelopment of the mammary glands in women.
Pain, lumps in the genital area during gynecological palpation.
Examination of the cervix using colposcopy or a vaginal speculum.

Laboratory methods

Infectious screening for STIs (sexually transmitted infections).
Hormonal screening to exclude primary.
Ultrasound of the pelvis and thyroid gland.
Hysterosalpingography (HSG) - x-ray of the fallopian tubes.
MRI for a tumor in the brain that inhibits the production of hormones.
Spiral computed tomography (SCT) of the pelvic organs helps to identify anatomical primary infertility.
Laparoscopy (examination of the abdominal organs) finds adhesions, tumors, and ovarian cysts.
Hysteroscopy (examination of the uterine cavity).

As a result of all these studies, a diagnosis of primary infertility is made to one of the partners and appropriate treatment is prescribed.

Helpful advice. Do not refuse laboratory methods for diagnosing primary infertility that your doctor will offer you. Sometimes the cause of the pathology is a disease that was accidentally discovered and had never manifested itself before.

Drug treatment

The main drug treatment of primary infertility comes down to eliminating the disease or pathology that provokes it.

Anovular

Anovulation (non-release of an egg from the ovary) is treated as follows:

correction of hormonal changes;
stimulation of ovulation;
support of the II phase of menstruation.

In this case, after pregnancy, hormonal therapy continues.

Infection-dependent

Treatment of primary infertility caused by an infectious-inflammatory process involves the use of the following drugs:

broad-spectrum antibiotics, taking into account microorganisms that are pathogens;
vitamins;
immunostimulants;
hormonal agents.

Adhesive

In case of adhesive obstruction of the fallopian tubes, laparoscopic intervention is indicated.
Plastic surgery - to eliminate deformations of the fallopian tube.

Endometriosis-associated

Carrying out complex therapy aimed at eliminating disorders.
Treatment of hormonal disorders: combined oral contraceptives, progestin drugs, antigonadotropins, gonadotropin-releasing hormone agonists.
Dissection of adhesions.
Stimulation of ovulation.
Support of the II phase of menstruation.

Immune, idiopathic

Methods of assisted reproduction.

If the cause of primary infertility cannot be eliminated (genetic disease, age, etc.), doctors may offer the couple extreme measures:

IVF - in vitro fertilization.
Surrogacy.

In each case, the question of prescribing medication to eliminate primary infertility is prescribed individually. Self-medication with traditional methods is possible only with the permission of a doctor after determining the cause of the pathology. On the advice of a friend or acquaintance, it is strictly forbidden to use this or that herbal recipe.

It is a fact! If you have been diagnosed with primary infertility, be sure to find out its type. The most difficult case, difficult to treat, is idiopathic primary infertility.

Traditional treatment

Red Brush Root

Primary infertility is a scourge not only of our time. This disease has plagued married couples for many centuries. In the absence of the proper level of medicine, we had to look for some traditional methods of treating this defect: after all, the desire to have a child was above all. As a result, people were poisoned and died trying to find one remedy or another. And someone was successfully cured. Some traditional medicine methods have now been approved by clinical trials and do not pose any danger if used correctly and competently.

Red brush

Normalizes local immunity, helps cure primary immunological infertility, reduces the amount of androgens that prevent conception. Brew a tablespoon of root in 300 ml of boiling water and leave for an hour. Drink 100 ml three times a day on an empty stomach. The course of treatment is 1.5 months.

Royal jelly

Royal jelly heals the body, puts the endocrine system in order, and promotes regular ovulation. Take 100 mg three times a day, completely dissolving. The course is from 4 to 6 months.

Dianthus

Promotes regularity of the menstrual cycle, eliminates erratic intermenstrual bleeding. Infuse two tablespoons in 300 ml of boiling water for 1 hour. Drink a tablespoon four times a day. Course - 1 month.

Plantain seeds

They treat adhesions, inflammation of the appendages, immunological infertility, low sperm motility. Steam half a tablespoon of seeds with 200 ml of boiling water, boil for 5 minutes over low heat, strain. Drink 2 tablespoons per day. There is one strict contraindication - thrombus formation.

Geranium oil

It has anti-inflammatory, antitumor, anti-edema effects. Relieves depression, stress and psychogenic primary infertility. Pour vegetable oil (250 ml) into a jar filled with fresh geranium flowers (50 g). Infuse for 14 days in complete darkness. Dissolve 4 drops of prepared geranium oil in 100 ml of warm water, add a tablespoon of honey, drink before meals twice a day. The course of treatment is 2 months.

Hog queen

Borovaya uterus normalizes hormonal levels, treats endometriosis, and relieves inflammatory diseases of the uterus. Contraindication: low estrogen levels. It is recommended to start therapy on days 3-7 of the cycle. It is purchased at the pharmacy in the form of a tincture. Take 40 drops three times a day, diluted with water. The course of treatment is six months. Breaks are taken during menstruation.

Sage

Sage contains hormone-like substances similar to estrogens. So this plant actively stimulates the work of the ovaries and accelerates the ripening of follicles. Steam 1 tablespoon with a glass of boiling water. Leave for 20 minutes, strain. Drink 100 ml three times a day on an empty stomach. The course of treatment is 3 months.

Leeches

Hirudotherapy affects the immune system, normalizes the circulatory system, and has a resolving and anti-inflammatory effect. Treatment is carried out exclusively by a specialist. Leeches are placed on the sacrum and lower abdomen. The course of therapy is 10-15 sessions.

Honey tampons for women successfully cope with uterine inflammation, erosions, tumors, and adhesions. They leave them overnight and remove them in the morning. Course - 15 times.

Do you want to support the main course of treatment of primary infertility with folk remedies? In this case, inform your doctor about this and listen to what he tells you. You may have to discard some of the recipes you found. But sometimes a gynecologist can suggest something else, also from herbalists, but more suitable in your case.

With active treatment of pathology with medications and folk remedies, the prognosis can be the most favorable. And in order for the long-awaited pregnancy to occur as quickly as possible, you must always remember about preventive measures.

Interesting fact. Doctors say that the missionary position, which many people neglect, increases the chances of getting pregnant.

Prevention

To maintain reproductive health, you need to regularly carry out preventive measures so that the problem of primary infertility does not affect you. What is needed for this?

Treat any diseases in both partners.
Normalize menstruation.
Protect yourself from unwanted pregnancy using safe methods.
Don't allow abortions.
Avoid hypothermia.
Maintain a sexual culture that reduces the risk of inflammation of the female genital area.
Timely treatment and observation by a gynecologist.

Undoubtedly, primary infertility is a serious problem that has serious consequences (medical and social). Therefore, it is strongly recommended to begin a diagnostic search as early as possible to clarify the possible cause of the pathology. Having identified the underlying disease, in most cases doctors provide very effective treatment that guarantees complete recovery.