Treatment of infertility or infertility in women and the most important dangerous factors leading to infertility

 


 



 


Risk factors leading to infertility and infertility in women:


 Age:


 The number and quality of eggs in a woman begins to decline with age.  The rate of follicle loss accelerates in the mid-30s, resulting in fewer eggs and fewer eggs than before, as well as an increased risk of miscarriage.


 smoking:


 Smoking affects the health of the uterus and fallopian tubes, and increases the risk of miscarriage and ectopic pregnancy.  In addition to the early depletion of eggs.


 weight:


 Being overweight or obese affects the normal process of ovulation.  Maintaining body weight within normal proportions enhances the chances of pregnancy.


 sexual relations:


 STIs may damage the fallopian tubes.  Or having unprotected sex with more than one partner, leads to an increased risk of sexually transmitted diseases, which may cause fertility problems and sterility later.


 Alcohol:


 Excessive alcohol consumption also affects the health of the body and fertility.


 Strenuous exercise:


 Exercising in moderation is very beneficial for health and for various bodily functions.  But exhausting sports may cause changes in the menstrual cycle, and lead to poor ovulation.


 Using the contraceptive injection:


 In some cases, the use of these injections leads to a temporary weakness of ovulation.  For some women, just stopping the contraceptive medication, their body is ready for pregnancy right away.  As for others, it may take a few months to a year to be able to get pregnant again.


 Other health problems:


 Such as thyroid disorders, whether hypothyroidism or hyperactivity, may cause a disturbance in the level of hormones, and affect pregnancy.


 Tests and Diagnosis:


 Ovulation test: This test can be done at home without the need for a prescription to check the level of the luteinizing hormone (LH) before ovulation. Blood test: to detect the level of progesterone, which is the hormone that is produced after ovulation, may be an indication that ovulation has occurred.  In addition to measuring the levels of other hormones such as prolactin, thyroid hormones and pituitary gland because they control reproductive processes. X-ray of the uterus to detect the presence of any abnormalities. Ovarian test: to determine the quality and number of eggs in the ovary that are available for ovulation. Ultrasound image  Laparoscopy: It is a mini-surgery that involves making a small incision under the navel, and inserting a small and precise device equipped with a camera to examine the fallopian tube, ovaries and uterus.  This test detects the presence of uterine inflammation or any scarring, blockage or irregularity in the fallopian tubes, ovaries or uterus. Genetic tests: help detect any genetic abnormality that causes infertility.


 Treatment of infertility and infertility in women:


 Treatment depends on determining the cause of infertility, the age of the woman, and the period of time she suffers from infertility.


 Given that infertility is a complex disorder, treatment involves physical, physical, psychological and long-term commitments.  Treatment to restore a woman's fertility depends on either medication, surgery, or helping the woman become pregnant with some modern techniques.


 Fertility restoration with ovulation-stimulating drugs:


 These medications stimulate and regulate ovulation.  It is considered the primary treatment for cases of infertility caused by ovulation disorders.


 Fertility drugs have the same effect as the natural hormones that induce ovulation: follicle-stimulating hormone (FSH) and luteinizing hormone (LH).


 These medications are also used for women who are able to ovulate, but to stimulate a better quality of eggs or a higher number.  Ovulation-stimulating medications include:


 Clomiphene Citrate: (Clomid)


 It is taken orally.  It stimulates ovulation by stimulating the pituitary gland to release a larger amount of the hormone.  .FSH and LH.  Which stimulates the growth of ovarian follicles that contain the egg


 Gonadotropins:


 Instead of stimulating the pituitary gland to release more hormones.  Gonadotropins are injected to directly stimulate the ovaries, to produce more eggs.

 Gonadotropins include:


 Human menopausal gonadotropin (HMG) and FSH. Or another type of human chorionic gonadotropin (HMG) medication that is used to stimulate the maturation process of eggs and stimulate their release at the time of ovulation.


 But relying on these devices may stimulate the pregnancy of several fetuses together and the occurrence of premature births.


 Metformin (Glucophage .)


 Used when diagnosing the causes of infertility is resistance to the hormone insulin.  This is usually in women who have polycystic ovary syndrome.


 Letrozole: Letrozole


 It is an aromatase inhibitor and works on the same principle as clomiphene.  Stimulates ovulation.


 Bromocriptine: Bromocriptine


 It is a dopamine activator.  It is used when diagnosing the cause of infertility, which is the increased production of the hormone prolactin by the pituitary gland.


 Side effects and risk factors associated with fertility drugs:


 Multiple pregnancy:


 The incidence of a double pregnancy when taking these drugs orally is less than 10%.  In most cases, the pregnancy is twins.  But if the drug is used by injection, the rate of double pregnancy rises to 30% (it may reach triplets or more).


 In general, the greater the number of twins, the greater the risk of premature birth.  In addition to the risk of giving birth to a low-birth-weight child, and later, problems in development and growth.


 Ovarian hyperstimulation syndrome (OHSS .)


 The use of fertility induction injections may cause ovarian hyperstimulation syndrome, which leads to swelling and pain in the ovaries.  Symptoms usually go away without treatment, and include pain and flatulence, nausea, vomiting and diarrhoea.


 Long-term increased risk of ovarian tumors:


 And this may happen if you continue to take fertility-stimulating drugs for more than a continuous year without a successful pregnancy.


 Surgical operations to treat infertility and infertility in women:


 There are several surgical options for treating infertility and improving a woman's fertility.  But in general, reliance on surgery is very rare, because most cases are treated with medications and show effective results.  Types of infertility surgery include:


 Laparoscopic surgery:


 This method relies on correcting or removing abnormalities to enhance the chances of pregnancy.  It includes correcting the shape of the uterus, removing benign tumors in the uterus or some types of uterine fibers that affect the shape of the uterine cavity and chances of pregnancy, in addition to removing pelvic or uterine adhesions.


 Tubal surgeries:


 If the cause of infertility is a blockage in the fallopian tube or its filling with fluid, the doctor recommends a laparoscopic surgery, to remove adhesions and expand the fallopian tube, or create a new opening for it.  However, it is considered a rare operation, because in such cases, IVF is relied upon for pregnancy.  For cases of fluid-filled fallopian tubes, removing the tube, or closing it close to the uterus, may enhance the chances of IVF pregnancy.


 Pregnancy Enhancement Methods:


 Intrauterine insemination (IUI .)


 During this mechanism, millions of healthy sperm are placed inside the uterus near the time of ovulation.


 Artificial insemination (in vitro fertilization):


 It involves taking the mature egg from the woman's body, fertilizing it with the partner's sperm in a laboratory, and then transferring the embryo into the uterus after fertilization.  IVF is the most effective technology assisted reproductive method.  The IVF cycle takes several weeks and requires frequent blood tests and daily hormonal injections.

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