home Endocrinology What types of infertility are there? What is primary infertility, how is it diagnosed and is pregnancy possible?

What types of infertility are there? What is primary infertility, how is it diagnosed and is pregnancy possible?

The real scourge of gynecology is infertility. Symptoms of this diagnosis are manifested in the inability of a woman to become pregnant within 1 year of active sexual activity with healthy man without using contraception. Primary infertility is the inability of a woman to become pregnant from the beginning reproductive age. That is, conception never occurred. Unfortunately, this diagnosis is not uncommon for modern married couples. A woman with grade 1 infertility has not yet experienced pregnancy or a single child. The suppressed feeling of being unable to become a mother only causes apathy towards everything that happens around you. But don't despair. Today there are not many diseases left that forever deprive a woman of the opportunity to find parental happiness. This article describes the main causes and methods of treatment for primary infertility.

Causes of 1st degree infertility. Treatment

A woman is unable to conceive a child as a result of congenital or acquired pathology, as well as due to experiences infectious diseases internal genital organs. For example, among the pathologies that develop in women are uterine fibroids, cervical erosion, cysts and other gynecological diseases. Ovarian pathologies are also very common. When the ovarian follicles do not function properly, problems with egg maturation may occur. Such diseases appear long absence menstruation and prolonged bleeding when they appear.

First degree infertility can occur after a woman’s first pregnancy is terminated. As a result of abortion female hormones, produced during the process of conception and fetal formation, turned out to be unnecessary and provoked hormonal disbalance in organism.

Another cause of primary infertility in this case is possible trauma to the internal genital organs due to abortion. Possible adhesions causing obstruction fallopian tubes. Because of this, the egg simply cannot pass into the uterine cavity and be fertilized. Read more about all the causes of infertility below.

Ovulation does not occur. A hormonal imbalance occurring in a woman’s body prevents the release of a healthy egg. This manifests itself as irregular periods and abnormal amounts of bleeding. Treatment consists of medication that stimulates ovulation.
Poor quality egg. The older a woman is, the worse the quality of the egg becomes. In women who want to become pregnant after 40 years of age, the released egg may be abnormal. A way out of the situation: a surrogate mother or implantation of an egg from a donor.
Endometriosis. The disease consists of the growth of endometrial tissue outside the uterus. Endometriosis manifests itself quite painful sensations during menstruation. It is fraught with miscarriages. Treatment is only surgical. The overgrown tissue is removed and the patency of the fallopian tubes is restored.
. Obstruction is said to occur when the egg cannot reach the uterus. In this way, the sperm will not reach the egg. First degree infertility in women of this nature may be the cause inflammatory processes in the genitals, as well as sexually transmitted infections.
Polycystic ovary syndrome. Multiple cysts in the ovaries cause failure hormonal levels, delay of menstruation, and therefore ovulation. Polycystic disease manifests itself as an unexpected increase in body weight, rapid growth of body hair, and acne. Treatment consists of taking medications that stimulate ovulation.

A diagnosis performed by a specialist will help determine the cause and begin to determine a treatment path. Primary infertility can be overcome. Modern medicine capable of working miracles in the truest sense of the word. An extreme option for solving the problem of 1st degree infertility may be IVF or surrogacy. Good mood, faith that everything will work out and fulfilling all the requirements of the attending physician - these are the components of success on the path to motherhood.

Obstetrician-gynecologist Andreeva O.V. speaks of primary and.

The diagnosis of “infertility” is made if pregnancy has not occurred within 1 year of regular attempts to conceive a child. There are 2 forms of infertility: 1st and 2nd degree.

Primary infertility is the inability to conceive a child at the beginning of reproductive age (from 20 to 27 years). The problem is compounded by worsening mental state women, and when trying to get pregnant, any disorders only worsen the situation.

Primary infertility in women is a fairly common factor. At correct positioning diagnosis of a disease that may have caused infertility competent treatment and recovery reproductive system.

Types and signs

There are several types and subtypes of infertility. Two main forms: primary and secondary (acquired, arising after injury or inflammatory processes).

There are 2 other varieties: absolute and relative. Absolute infertility is the complete inability to become pregnant due to the absence of a woman’s uterus and ovaries. Although the chances of conceiving a child are relatively high, you just need to carry out some operations. Primary infertility can be divided into 5 types:

Normogonadotropic anovulatory infertility or endocrine infertility - occurs due to diseases thyroid gland and gonads. Their job is to regulate the menstrual cycle, so any deviation can lead to complex hormonal imbalances. Anovulatory normagonadotropic infertility does not allow ovulation to occur or makes this process rare and incomplete. There are 3 reasons due to which anovulatory infertility occurs:

Disturbances in the functioning of the hypothalamus and pituitary gland: weight loss, stress, bleeding are observed. If the cause is prolactinoma (tumor), with proper treatment fertility will be restored.
Polycystic ovary syndrome: there is an excess of estrogen. If the form of the disease is severe, then the likelihood of restoration of the reproductive system is low.
Ovarian depletion is the most difficult stage, in which the chances of getting pregnant are reduced to almost zero.

Tubal-peritoneal – caused by obstruction of the fallopian tubes. Adhesions are formed in fallopian tubes and ovaries, so pregnancy does not occur until the canals are cleared. This procedure is usually done through a surgical technique called laparoscopy. Using a microscopic instrument in the cavity of the pipes, the channels are expanded and cleared of adhesions. If the form of the disease is severe and the tubes are practically impassable, doctors recommend refraining from laparoscopy and trying to conceive a child using IVF, including through surrogacy.
Genetic - caused by chromosomal abnormalities. Manifested by frequent miscarriages. Doctors recommend genetic testing if 2 miscarriages occurred in a row.
Immunological – observed with special activity of antisperm antibodies, which impair the ability of sperm to be fertile. Most often, immunological infertility of the 1st degree occurs due to incompatibility of cervical mucus and seminal fluid. During ovulation, the ovaries produce special substances that coat the cervix with mucus. Because of this, sperm cannot approach the uterus and die, and the egg is never fertilized. To establish the immunological form, women undergo a post-coital test immediately after intercourse. The test helps determine cervical mucus and establish the cause of difficult conception.
Infertility caused by artificial termination of pregnancy. Abortions negatively affect the state of hormonal processes and often provoke adhesions in the fallopian tubes. Even a mini-abortion can subsequently prevent a planned pregnancy. If the endometrium is damaged, the egg will not be able to attach to the uterus. Pregnancy will not occur until the endometrium is completely restored.

There is also such a thing as idiopathic infertility. Doctors use this term to describe a woman’s inability to become pregnant for unknown reasons. Both partners undergo a full examination, but no abnormalities are found in the body.

This is the most difficult form, since doctors cannot determine what needs to be treated to restore the reproductive system.

Causes of infertility

You can determine why pregnancy does not occur based on some signs:

unpleasant odor from the vagina;
grayish discharge;
frequent gripping pain in the lower abdomen;
itching in the genital area;
discomfort during sexual intercourse, pain;
disturbed menstrual cycle;
menstruation lasting less than 3 or more than 7 days;
delay in menstruation (also does not always indicate pregnancy).

All these signs indicate some reason that is preventing a woman from becoming pregnant. The main factors of 1st degree infertility include:

Endometriosis.
Obstruction in the fallopian tubes.
Increased secretion of prolactin.
Amenorrhea.
Spikes.
Defects in the organs of the reproductive system.
Psychosexual disorders.
Inflammation in the pelvic organs.
Hormonal imbalance.

Separately, it is worth mentioning the medicine that often causes infertility - Postinor.

Postinor

This potent remedy, which should only be used in extreme cases: broken condom during sexual intercourse, rape, unsafe sex, etc. This medicine is actually used emergency situations, however, many girls use it as a regular contraceptive. This approach leads to infertility.

Postinor - a provocateur of infertility

The product must be taken immediately after unprotected sexual intercourse, within 72 hours. One package contains 2 tablets, which must be taken sequentially. The first tablet - in the next hour or two, the second - 12 hours after the first. The sooner the medicine is taken, the lower the risk of becoming pregnant. If used incorrectly, infertility may occur after postinor.

The medicine deals a severe blow to the body and depletes the functions of the ovaries. With regular use of the drug, the reproductive system completely dies. Postinor and infertility are indeed connected, but if you use it strictly according to the instructions, no harm will be done to the body.

Postinor after ovulation slows down the movement of the egg and sperm.

Cervical factor infertility

Cervical factor infertility is a disorder in the cervix that prevents fertilization. There are 2 forms of deviations:

Poor quality of cervical mucus composition.
Narrowed cervical canal.

Treatment of cervical factor is related to the cause of its manifestation. The most common: hormonal imbalance, poor cervical microflora, inflammatory processes. After making a diagnosis, the doctor prescribes complex therapy, which includes taking restorative medications and a special diet.

Treatment and prevention

Before prescribing treatment, the doctor conducts a complete examination of the patient for all forms of infertility. All methods are aimed at restoring reproductive functions body. Here can be used and medications, And surgical instruments. Depending on the type of infertility, therapy is established:

For endocrine disorders it is prescribed hormonal correction, stimulating the work of the ovaries. If there are physiological abnormalities, they are eliminated: normalizing weight, maintaining proper nutrition. Hormone therapy helps follicles to mature properly, while the level of hormones in the blood is controlled.
If the problem is in the fallopian tubes, treatment is aimed at improving their patency (laparoscopy method).
Endometriosis is eliminated in the same way. The probability of pregnancy is 40%.
At immunological infertility preference is given to the method artificial insemination. In this case, the father's sperm is introduced into the uterine cavity using a special tube. This option allows sperm to bypass the immune barrier and quickly penetrate the egg.
The most difficult treatment is when the cause of infertility is unknown. In this case, the patient is prescribed various procedures and examination for all known factors of infertility.

To maintain the reproductive system, every woman needs infertility prevention.

As a rule, it includes regular visits to the gynecologist (1-2 times a year), contacting a doctor at the first symptoms of any disease, proper nutrition, observing personal hygiene rules, using contraceptives only as recommended by a doctor.

Primary infertility in medicine is called 1st degree infertility. This concept characterizes a condition when a mature person is unable to produce offspring due to congenital or acquired pathologies of the reproductive system.

There are many reasons for deviation. Abortion and other methods of terminating pregnancy lead to primary infertility. There is a greater chance of harm to the body during the first pregnancy. Terminating a pregnancy means abruptly stopping the hormonal processes associated with it. The body is not able to quickly adapt and failures occur.

Among the provoking gynecological diseases: uterine fibroids, cysts and erosions. There is a greater chance of infertility with chronic or prolonged illnesses. With ovarian pathologies, the egg does not have the opportunity to mature due to improper functioning of the follicle. Pathology is expressed in the absence of menstruation or its severe course. The adhesions of the fallopian tubes completely close the passage to the uterus. Women with genital injuries are also at risk.

In men, primary infertility is also common. The reason for this is dysfunction of the reproductive system or problems with sperm. Due to its insufficiency or absence, ejaculation occurs with glitches. It happens that primary infertility is diagnosed in both partners.

There are several types of primary infertility:

congenital (pathology present at the time of birth) or acquired (as a result of a disease that occurred after birth and before the onset of sexual activity);
temporary (transition state according to natural reasons not requiring treatment) or permanent (arising for reasons that cannot go away on their own);
absolute (irreversible pathologies, impossibility of conception) or relative (pregnancy does not occur for reasons that can be eliminated).

The last types are the most unstable. As science and medicine develop, ways appear to cure previously irreversible pathologies of the reproductive system. The breakthrough was the invention ( in vitro fertilization). With his help, even those women who do not have fallopian tubes have hope. Experiments have led to the fact that today it is possible to transplant a uterus. Until recently, these reasons were considered absolute.

There is also combined infertility - infantilism of both partners.

Causes of primary infertility

The most common causes of primary infertility include endocrine pathologies, developmental abnormalities, complications of diseases, and an excessive number of attempts to become pregnant. Based on the source, the causes of infertility are divided into endocrine, uterine, tubal and immunological.

Of all women with primary infertility, more than half received their diagnosis due to work disorders endocrine system. At risk are women with:

ovulation disorders due to stress and overwork;
hypothyroidism (insufficient amount of thyroid hormones);
obesity;
adrenogenital syndrome (disorders in the synthesis of corticosteroids).

Primary infertility in women is caused by:

There is no ovulation (the process of forming a new egg). Occurs against the background of hormonal instability, manifests itself heavy menstruation and cycle failures.
Aging of the egg. After forty years, eggs are practically incapable of fertilization. Transplanting a healthy egg helps.
Endometriosis or the growth of uterine tissue beyond its boundaries. Manifests severe pain during menstruation. Requires surgery.
Obstruction of the fallopian tubes.
Complete overgrowth of the virgin pleura (hymenal atresia).
Polycystic disease or the presence of cysts in the ovaries. Manifests itself in delayed menstruation and ovulation, excess weight, rapid growth hair, acne.
Absence of the uterus, ovaries and fallopian tubes.
Bend of the uterus at right angles to the fallopian tubes (hyperanteflexia).
towards the spine (hyperretroflexion).

Primary infertility in men is caused by:

Varicocele or abnormal. As a result, the testicles overheat and harm the sperm. This is the most common cause of male infertility (40% is primary, and 80% is due to).
Infection urinary tract. Various fungi and viruses promote sperm gluing.
Genetic anomalies (do not allow the option of surrogate pregnancy, because diseases are inherited).
Hormonal factors.
Gastrointestinal diseases (especially pancreatic anomalies).
Diseases respiratory tract(most often bronchial asthma).

Common reasons:

Injuries to the genital organs.
Traumatic brain injuries.
Misuse of combined oral contraceptives.
Use of emergency means to prevent pregnancy.
Genital infantilism (underdevelopment of the genital organs due to inflammation of the hypothalamus and pituitary gland).
Gonadal dysgenesis (underdevelopment of the ovaries or testes due to chromosome abnormalities).
“Childhood” diseases (scarlet fever, diphtheria).
Diseases that are sexually transmitted.
Genital tuberculosis.
Diabetes.
Tuberculosis.
Cirrhosis of the liver.
Long-term bad habits (smoking, alcoholism, drug addiction).
Severe exposure, exposure to radiation, chemical poisoning.
Living or operating in a hazardous environment.
Stress.
Chronic fatigue and constant overwork.
Wrong lifestyle.
Antigenicity of egg and sperm.

It happens that it is impossible to find out the cause of infertility. This type of infertility is called unclear or unknown.

Medical history and symptoms

Basic alarm signal to infertility - absence of pregnancy for a year with active attempts. Depending on the cause, there may be such manifestations:

disruptions in the menstrual cycle;
absence of menstruation for several months in a row (amenorrhea);
reduction in the days of menstruation and the amount of discharge (hypomenstrual syndrome);
severe pain during menstruation, similar to contractions (algomenorrhea).

However, most menstrual irregularities do not show up at all. The only symptom is the absence of pregnancy.

With genital infantilism, the symptoms are:

absence or insignificant amount of hair on the pubis, armpits;
underdevelopment of the mammary glands, external and internal genitalia;
absence of the first menstruation after 15 years.

At gynecological examination the doctor notes abnormal dimensions of the vagina, incorrect placement of the labia, and a cylinder-shaped uterus with a long conical neck. In the absence of a uterus, the external genitalia develop correctly and there is no menstruation. If the vagina is underdeveloped, the symptom may be pain during sexual intercourse or its absolute impossibility.

Underdevelopment of the uterus and vagina accompanies not only primary infertility, but also many diseases of the kidneys and urinary tract.

From a psychological point of view, primary infertility causes depression. The inability to conceive and bear a child makes a woman nervous, irritable and aggressive. She is susceptible to neuroses, has low self-esteem, and is shielded from society. Infertility is often the cause of divorce, because the couple cannot use their parental potential.

Primary infertility: diagnosis

The treatment regimen is based on the root cause of infertility and accompanying abnormalities. There are many studies and tests that can identify the primary deviation:

taking anamnesis;
examination of the patient;
analysis of the correspondence of height, weight, hair growth and size of the mammary glands to age;
rectal and bimanual tests;
laboratory and instrumental studies;
functional diagnostics;
examination of hormonal status;
smear analysis;
Ultrasound of the pelvic organs and thyroid gland;

Antibiotics are indicated for infections. If the cause is a pituitary tumor, the woman needs to consult a neurosurgeon. For infantilism, physiotherapy and gynecological massage are used. Among the drugs prescribed are vitamin A, B, E and folic acid to prevent abnormalities in the unborn child. If the above is ineffective, they resort to artificial stimulation of ovulation. It is also effective for infertility due to endocrine causes.

If all efforts are in vain, after a year of treatment, the woman is recommended to have surgery. Laparoscopy allows you to treat peritoneal lesions without serious damage to the skin.

Treatment for a man begins with giving up bad habits. After consultation with an andrologist, it is necessary to examine the sperm for abnormalities.

For polycystic disease: wedge resection, cauterization.
Obesity: diet, physical exercise, medicines.
Genital infantilism: hormone therapy, vitamins, physiotherapy.
Problems with ovulation: drug stimulation.
Tubal infertility: physiotherapy, drugs for inflammation, immunomodulators, hydrotubation with enzymes and corticosteroids. If unsuccessful, surgical intervention (tubal plastic surgery, laparoscopic adhesiolysis) will be required.

For all types of primary infertility, psychotherapy is mandatory. Alternative treatment considered IVF.

According to WHO statistics, approximately every seventh family faces the problem of infertility. Infertility refers to the inability of a sexually active married couple of childbearing age to reproduce. This diagnosis is made if pregnancy does not occur after a year of sexual activity without using any contraceptives. About half of such cases occur in primary infertility, when a woman has never become pregnant. Secondary include problems with reproduction if there has already been a pregnancy, even if it was ectopic, frozen, or with an early miscarriage.

The main causes of infertility are associated with hormonal and anatomical pathologies of various origins. For example, due to menstrual dysfunction, ovulation does not occur, or the underdevelopment of the uterus makes embryo implantation impossible. There are many reasons for this, and they can be combined with each other.

Modern research in gynecology has shown that types of infertility can be grouped according to different signs. First of all, this is the primary and secondary infertility. Each of them is divided into several types.

Depending on the gender of the partner with fertility problems, male, female, and combined infertility are distinguished.
Depending on the ability to correct the causes, infertility is divided into absolute and relative.
Depending on the type of reproductive system disorder, infertility occurs:

Primary infertility in women and men

Primary infertility in men is as common as in women. This diagnosis can be made if one or more partners with whom they had unprotected sexual intercourse never became pregnant. The causes of this condition can be different, congenital and acquired. For example, this may include:

abnormalities of the genital organs (cryptorchidism, absence, underdevelopment of the testicles or seminal ducts, hypospadias);
genetic pathologies;
varicocele;
infectious diseases (STDs, epididymitis, mumps);
endocrine disorders.

Treatment of primary infertility should be aimed at eliminating its cause. It is usually possible to achieve conception naturally if you eliminate the infectious factor, correct hormonal levels, and correct some abnormalities surgically.

Unfortunately, even with the modern level of development of medicine, not all pathologies can be cured, especially if we're talking about about congenital absence of an organ, chromosomal changes. In such cases, auxiliary reproductive technologies.

The causes of primary infertility in women, as well as in men, are associated with congenital and acquired anatomical features, hormonal imbalance, STIs. The list will be somewhat wider, due to more complex structure female reproductive system.

Rarely, there are cases of such type as combined infertility, when both partners simultaneously have any problems with fertility. If the causes have been established and infertility treatment has been carried out in a timely manner in full, then the woman’s chances of becoming a mother increase sharply.

Congenital pathology of anatomical structure

Primary infertility in women can be absolute due to birth defects development of the sexual sphere associated with the absence of:

uterus;
ovaries;
fallopian tubes.

Pathologies of the structure of the uterus (hypoplasia, intrauterine septum, bicornuate uterus, organ duplication) or fallopian tubes (their duplication, fusion, underdevelopment). Because of this, the meeting of the egg and sperm is impossible, that is, the possibility of natural fertilization is completely excluded.

Diagnosis of primary infertility

The diagnosis of primary infertility is made to a patient who complains of the absence of pregnancies during regular sexual activity, after a series of diagnostic studies. The doctor conducts an anamnesis, an external examination, assessing the condition of the skin, hair, subcutaneous fat layer, breasts, and genitals. A number of laboratory tests are carried out instrumental examinations, including minimally invasive diagnostic operations.

Secondary infertility in women

If a woman cannot conceive for more than a year, but she previously had a pregnancy, regardless of its completion, then we are talking about secondary infertility. Its varieties in women are associated with factors such as:

tubal obstruction;
infectious and inflammatory processes;
hormonal disorders, in particular polycystic ovary syndrome and early menopause;
biological incompatibility of partners;
endometriosis;
psychological problems.

Tubal obstruction

After gynecological operations, including abortions, inflammation of the uterus and appendages, adhesions occur in the fallopian tubes. Their inner surface as if glued together, fused. The lumen is blocked. Due to obstruction of the tubes, sperm do not reach the egg, and conception does not occur. Adhesive process can spread to the pelvic organs; this type of infertility is called tubo-peritoneal.

Inflammatory diseases of the pelvic organs

The onset and normal development of pregnancy are prevented by infections that cause inflammatory diseases uterus, cervix, tubes or ovaries. These could be STDs, including sexually transmitted diseases, tuberculosis and others. The causative agents are:

The infection can enter, for example, the ovaries through sexual contact, during gynecological procedures, during childbirth, menstruation, or through blood flow from another diseased organ. More often, women with chronic stress, weakened immunity, and leading a promiscuous sex life suffer from diseases of the genital area.

Infectious processes can act as a factor in infertility. Thus, inflammation of the cervix changes the properties of mucus cervical canal, it becomes too thick, which prevents the transport of sperm into the woman’s uterus. When the ovaries become inflamed, their functioning is disrupted, problems with ovulation appear, and the menstrual cycle is disrupted. Inflammation of the uterus affects normal work endometrium, to which the fertilized egg attaches.

The danger of sexually transmitted infections is that in about half of the cases they are asymptomatic or have mild symptoms. Neglected infections without proper treatment with antibiotics become chronic, sluggish and lead to adhesions of the pelvic organs, causing infertility.

Endocrine infertility

Hormonal imbalances in the body are another common cause of infertility. They are caused by gland dysfunction internal secretion, involved in the functioning of the reproductive system and reproduction of offspring: ovaries, hypothalamus, pituitary gland, thyroid gland and adrenal glands.

The main symptom indicating an endocrine imbalance will be disruption of the menstrual cycle, up to the complete absence of menstruation (amenorrhea), as a result of which ovulation does not occur. Failures in the body of this kind cause:

head injuries;
brain tumors;
obesity;
dramatic weight loss in a short time;
hypo- and hyperfunction of the thyroid gland, adrenal glands;
ovarian neoplasms;
stress;
genetic abnormalities;
somatic diseases.

For example, the pituitary gland produces the hormone prolactin. When its level in a woman’s blood increases, the onset and development of pregnancy is impossible. Fortunately, endocrine infertility can be treated using replacement therapy. After adjusting the hormonal levels, 7-8 out of 10 women manage to get pregnant.

Polycystic ovary syndrome

Variety endocrine pathology is polycystic ovary syndrome (polycystic ovary syndrome, PCOS). The disease is widespread. In about a quarter of women who have problems conceiving, it acts as the main factor in infertility. With this diagnosis, the ovaries visually become similar to bunch of grapes. They contain many small cystic formations. These are immature follicles. Patients, along with cycle disruptions, experience excess hair growth, multiple acne, obesity, skin pigmentation, increased insulin levels, and metabolic disorders.

Immunological infertility

If a woman cannot become pregnant for a year or more, all known variants of infertility have been excluded during examination, then it is recommended to conduct a postcoital analysis for the presence of antisperm antibodies in the couple’s blood. A positive result may indicate that sperm are destroyed in the body of a man (more often) or a woman, as a result of which fertilization does not occur.

There is also genetic incompatibility between men and women. In such cases, conception occurs, but the mother’s body begins to reject the fetus, and it dies. During the first pregnancy, the risk of rejection is minimal, but increases with each subsequent pregnancy.

Immunological incompatibility is one of the rarest and most difficult to treat types of infertility.

Endometriosis

Pathological growth of the inner mucous membrane of the uterus is the cause of associated primary or secondary infertility. The endometrium has the ability to take root, reaching other organs and tissues. Can spread throughout the body through blood and lymph flow. Problems with conception arise for two reasons.

Adhesive process in the tubes and uterus, due to chronic inflammation in places of endometriotic lesions.
Problems with egg maturation, its quality and ovulation in the presence of endometrial tissue on the ovaries.

Early menopause

Early menopause, or exhausted ovarian syndrome, refers to rare reasons infertility. It is diagnosed when a woman under or after 40 years of age stops having periods and develops characteristic symptoms, such as hot flashes, sudden withering of the skin, weakness, irritability, pressure surges, heart pain.

Among the factors for the development of pathology, gynecologists identify:

Premature menopause is characterized by a decrease in the size of the ovaries and complete absence there are follicles in them. Lack of egg maturation makes conception impossible. Assisted reproductive technologies (ART) are usually used as a treatment method.

Psychological infertility

If the couple has passed all types of examinations, doctors do not find any obstacles to conceiving a child, and desired pregnancy does not occur, then you should think about psychological infertility. The trigger may be chronic stressful situation. There were cases when excessive focus on a cherished desire did not allow the dream to come true, and as soon as the woman switched her attention to something else, the test showed two stripes.

The causes of psychological infertility may lie in the subconscious. For example, reluctance to give birth from specific man, fear of childbirth. Psychotherapeutic methods are used for treatment.

Secondary male infertility and its features

A couple should think about secondary male infertility if the man has suffered a genital injury, any disease, conception does not occur, but the partner has previously had a pregnancy with any outcome. The diagnosis is confirmed after full examination, which includes semen analysis, blood tests, ultrasound and scrotal Doppler.

Prerequisites for the occurrence of pathology:

STI;
history of viral diseases (flu, herpes, etc.);
endocrine pathologies;
varicocele;
surgical operations on the genitals;
regular intake of alcohol, anabolic steroids, narcotic substances;
smoking;
effect on the testicles high temperatures(working in a hot shop, visiting a bathhouse, sauna, too hot water while taking a bath);
strict diets and stress.

All these factors influence the quantity, transport of sperm produced, and its quality. Sperm do not enter the ejaculate or are not viable, which makes the process of fertilization impossible.

Diagnosis of secondary infertility

Various types of infertility in women can be combined with each other, as well as with male infertility in different combinations. The most common pathologies inflammatory in nature. That's why primary diagnosis aimed at searching for infections and their causative agents.

Women should begin the examination by visiting a gynecologist; consultation with a urologist or andrologist for men. A number of laboratory diagnostic measures include ultrasound, hardware, instrumental study uterus and appendages, blood tests for hormone levels. The results obtained will help to find the causes of childlessness in order to select the most effective therapy.

General principles of infertility treatment

There are many types of female infertility, each of them requires a specific treatment regimen. Therapy aimed at restoring reproductive health is selected individually, depending on the reasons that violated it.

The treatment provided can be broadly divided into two types.

Conservative - taking various medications, including hormonal ones, physiotherapy. So, for infections, the patient is prescribed antibiotics, and for endocrine imbalance, replacement therapy is selected.
Surgical, including surgical, minimally invasive, laparoscopic, endoscopic intervention. For example, there is no point in treating the symptoms of tubal infertility without surgery.

It makes sense to contact alternative methods, for example, and so on. Currently, the Internet is replete with many advertisements for various food supplements that help get rid of infertility. Reviews talk about positive effect of these drugs, but this does not yet indicate a proven clinical effect.

A combination of methods is possible. For example, after surgery, antibacterial and anti-inflammatory drugs are prescribed. Or on the contrary, after drug treatment infection, an operation is performed to eliminate adhesions.

If traditional methods did not lead to positive result, then modern assisted reproductive technologies such as IVF, ICSI and others can help a childless couple.

Today, the problem of primary infertility is very relevant. There is no need to worry if you cannot get pregnant within two to three months of active sexual activity without using contraceptives. Doctors make the diagnosis of “primary infertility” to women who have not had a single conception since the beginning of their reproductive life. Before finding out the causes of the disease and developing the correct and effective treatment infertility, it is also necessary for your partner to be examined, since one of the reasons that it is not possible to conceive a child may be low mobility sperm or decreased sperm concentration in a man.

Main causes of the disease

There are many causes of primary infertility. All problems associated with the occurrence of the disease should be considered. The main problems are: menstrual irregularities, pathologies of the genital organs, hormonal disorders, injuries, cysts, etc. All these reasons and many other factors influence the inability to get pregnant.

To eliminate menstrual irregularities, you should pay attention to general state body. Chronic diseases, stress, incorrect diet or difficult conditions life significantly affect the menstrual cycle, but if health improves, periods are restored.

Due to chronic diseases or inflammatory processes in the genitals, fallopian tubes, ovaries, as well as surgical interventions, adhesions occur, scar changes in tissues that adversely affect the patency of the fallopian tubes. During the examination, doctors determine the degree of this pathology and prescribe treatment methods.

Hormonal imbalances also significantly affect pregnancy. Long-term use contraceptive medications that contain a large number of hormones, leads to the inability to get pregnant over a long period.

One more thing to pay attention to important reason primary infertility: this. As a result of this pathology, ovulation is disrupted. With polycystic disease, hormonal imbalance occurs and menstruation is delayed.

Treatment methods for primary infertility

Used for the treatment of primary infertility surgical methods, conservative therapy, medications. At hormonal disorders use medications that eliminate hormonal imbalance, bringing hormone levels back to normal.

Modern surgery allows endoscopic operations, after which the body quickly recovers. Surgical intervention is the most effective method treatment of this pathology.

Infectious diseases of the genital organs are treated medications, and both partners undergo treatment. The drug is prescribed by the doctor depending on the causative agent of the infection.

Treatment of inflammatory processes includes several auxiliary techniques. This includes physiotherapy, massage, acupuncture, etc.

In cases where treatment with various methods turns out to be ineffective, doctors recommend alternative modern methods artificial insemination.

From preventive measures depends reproductive health women. From the very beginning of the reproductive life period, women should remember the basic rules, the implementation of which prevents the onset of primary infertility. Special attention requires adherence to sexual culture, basic rules of personal hygiene - this will minimize the risk of inflammatory processes in the genitals, prevent unwanted pregnancy, thereby preventing abortions, and also protecting yourself from hypothermia.

Treatment of primary infertility requires patience and a thorough medical examination. It is very important to find out the cause of the disease as early as possible and carry out effective therapy, the result of which is a long-awaited and desired pregnancy.