I want a child, so I've been careful about my eating habits and have used ovulation tests many times. But I still get my period every month. My friends around me are having babies one after another.
When placed in such a situation, my chest is about to be crushed, "Is it possible that I am infertile?"
Should I go to the hospital?
What does infertility treatment do?
It is true that when a woman who is struggling with pregnancy goes to the hospital, it takes a lot of anxiety and courage.
This article introduces the overall picture of infertility treatment, such as when to go to the hospital for the first time and treatment methods.
Knowing what to expect from fertility treatments can help alleviate anxiety. Please read to the end.
Find out in this article
- When to go to the hospital for infertility
- 6 infertility tests
- 3 steps to treat infertility
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What is infertility
Infertility is defined by the Japan Society of Obstetrics and Gynecology as the inability to conceive for a certain period of time despite unprotected intercourse between healthy men and women who wish to conceive . A certain period of time is generally one year.
It is said that 1 out of 10 couples suffer from infertility, but some say the actual number is much higher. This is because in recent years, the age at which people think about pregnancy is getting older due to late marriage.
According to the Ministry of Health, Labor and Welfare's vital statistics, the number of marriages peaked at about 1 million couples in 1972 and has been declining year by year. At the same time, the average age of mothers at the time of giving birth to their first child is rising. In 1985, it was 26.7 years old, but in 2017 it is 30.7 years old, an increase of 4 years.
What causes infertility
- male cause
- female cause
- both male and female causes
Although it can be roughly divided into three types, there are cases where infertility occurs without any cause.
When do you go to the hospital?
According to the definition of infertility, it is said to be infertility if there is no pregnancy for one year. However , if you start to wonder if you are infertile, then go see a doctor at that time .
This is because the treatment may take longer than expected if the woman is not ovulating or has some underlying disease.
In addition, aging is considered to be one of the factors that make it difficult to conceive. For example, women are most fertile in their late teens to late 20s. The peak is around age 30, after which it becomes increasingly difficult to conceive.
It is known that not only women but also men become less likely to become pregnant with age, so if your wife, husband, or both are older, please consider seeing a doctor early.
Main test items for infertility
Here are 6 tests to diagnose whether infertility requires treatment.
It is important to clarify the cause of infertility in order to overcome infertility and reach pregnancy. Effective treatment can be selected only after the cause of infertility is known .
All tests have important meanings, so please understand not only the method of the test, but also "What can you learn from this test?"
Measurement of basal body temperature
The body temperature in a state of rest both physically and mentally is called basal body temperature, and it is measured while lying down after waking up and before getting up .
To measure basal body temperature, we use a special thermometer called a women's thermometer, which displays more detailed values than general thermometers.
By recording the basal body temperature as a graph over 2 to 3 cycles
- Are you ovulating normally?
- When is the ovulation day?
- Is progesterone secreted?
You can be sure.
Pelvic examination/transvaginal ultrasound examination
A pelvic examination is an examination that is performed on the examination table in the gynecological examination room. Your doctor will actually feel your uterus and ovaries to see if they are swollen or painful when pressed.
Transvaginal ultrasonography is also performed on the examination table, and an ultrasound probe with a diameter of about 1.5 to 2 cm is inserted into the vagina. Almost no pain.
Transvaginal ultrasonography displays images of the inside of the body in real time, so it is possible to diagnose whether there are any abnormalities in the uterus or ovaries. The size of the follicle can also be confirmed, and it is also characterized by being able to predict the ovulation date almost accurately .
Blood test
A blood sample is taken in the same way as a general blood sample, and it is examined whether various hormones, such as female hormones, male hormones, and hormones that stimulate follicles, are secreted normally.
By examining the amount of hormones secreted, it is determined whether the uterus and ovaries are functioning properly and ovulation is occurring normally .
In addition to the hormone test, it is common to check for systemic diseases such as diabetes at the same time.
Since the amount of hormones in the body fluctuates before and after ovulation, examinations are performed separately for the menstrual phase (before ovulation) and the luteal phase (after ovulation).
hysterosalpingography
A contrast medium is injected into the uterus during the period from the end of menstruation to the day of ovulation. Using X-rays used in X-rays, it is possible to check whether the fallopian tubes, which are passageways for sperm, are clogged due to adhesion, the shape of the uterus, the shape and thickness of the fallopian tubes, etc.
Since a sticky contrast agent is injected into the fallopian tubes, which are as thin as about 1 mm, the examination is slightly painful, although there are individual differences.
However, it is possible to get pregnant naturally after having a hysterosalpingography.
Hooner test
The Huner test, also known as the sperm cervical mucus compatibility test, examines how compatible the female cervical mucus, which is the gateway for fertilization, and the male sperm .
The test is done during ovulation, and the day after normal intercourse, the doctor collects mucus from the cervix. How many swimming sperm are there in a woman's cervix? How far can the sperm move forward? You can see that.
The Hooner test can give bad results even if there are no problems in both men and women, so if the results are bad, it is common to retest the next month during the ovulation period.
semen test
A semen analysis is a test to determine the cause of infertility on the male side . The following items are inspected against the normal reference values stipulated by WHO.
- semen volume
- total sperm count
- sperm concentration
- forward momentum
- Total rate of motion
It is necessary to submit semen, and semen is collected manually (masturbation method) after abstinence period (period without ejaculation) for about 2-7 days.
Ideally, the semen should be collected at a hospital because the properties of semen are sensitive to temperature. However, some hospitals allow samples to be kept at 20°C to 30°C or less and brought to the hospital for testing within 2 hours of collection.
How to treat infertility
A typical treatment for infertility is a three-step treatment. Let's take a closer look at how it can be treated.
Depending on the cause of infertility, there are cases where you start from step 2 or step 3 instead of step 1. It is important to proceed with infertility treatment while consulting with your family doctor.
Step 1: Timing method
The timing method is the basis of infertility treatment, and it is a treatment method that accurately predicts the ovulation date and receives guidance on the timing of married life .
There are methods for predicting the ovulation date, such as measurement of basal body temperature, transvaginal ultrasound, blood test and urine test to measure hormones.
Although it is a method aiming for natural conception, ovulation inducers may be used if there is no ovulation or the ovulation condition is not good. Ovulation inducers can be used to prepare ovulation for pregnancy.
It is said that the pregnancy rate of couples living with the timing method is about 18%. It is believed that the pregnancy rate is higher if the timing method is used than if a healthy man and woman with no particular problems live a married life.
As a guideline, if pregnancy does not occur even with the timing method of 5 to 6 cycles, it is recommended to step up to step 2 artificial insemination.
Also read the following articles
The first stage of infertility treatment, what kind of treatment is the timing method? What is the cost and probability of pregnancy?
Step 2: Artificial Insemination
Artificial insemination is performed if the timing method in Step 1 fails to conceive or if the results of the Huner test, which determines the compatibility of cervical mucus and sperm, are unsatisfactory.
Although it is called "artificial", the process from artificially injecting sperm into the uterus to the establishment of pregnancy is the same as natural pregnancy .
Like the timing method, artificial insemination accurately predicts the ovulation date and then collects semen according to the ovulation date. Instead of injecting semen as it is, it is washed with a special method to remove excess cells and concentrate only healthy sperm, and then injected into the uterus with a special instrument.
There is a 10% chance of conceiving after one artificial insemination. However, about 80% of couples who conceived by artificial insemination are successful in the first three artificial inseminations. Approximately 90% of couples successfully conceive by the fifth artificial insemination.
The next step of artificial insemination is not ``if pregnancy is not successful even with the fifth artificial insemination'', but it is decided while consulting with the doctor based on the couple's age and sperm findings.
Step 3: Assisted Reproductive Medicine
Assisted reproductive technology is a treatment method that is performed not only when pregnancy is not achieved by the timing method of step 1 and artificial insemination in step 2, but also when it is expected that it will be difficult to achieve pregnancy without assisted reproductive technology.
Assisted reproductive medicine includes in vitro fertilization, and one type of in vitro fertilization is microinsemination. In vitro fertilization is performed when there is some kind of trouble with the fallopian tubes, and microinsemination is performed when in vitro fertilization fails or there are problems with the number or movement of sperm.
Both in vitro fertilization and micro-insemination are performed in the same way up to the collection of eggs and sperm. First, ovulation inducers are used to nurture follicles that are the source of eggs, and eggs and semen are collected at the time of ovulation.
In in vitro fertilization, the eggs and sperm are placed in the same culture medium after the eggs and semen are collected.
After raising the fertilized egg (embryo) in the culture solution for 2 to 5 days, the fertilized egg is returned to the uterus, supplemented with progesterone to make the uterus ready for implantation, and the establishment of pregnancy is monitored.
Depending on the age and cause of infertility, the probability of pregnancy with assisted reproductive technology is about 30-50% or more.
summary
There are many different causes of infertility. There are cases where one of the couple has a clear cause, and there are cases where there is no specific cause but it is difficult to conceive.
Before continuing to worry that "I can't get it easily", I recommend that you visit a hospital and examine the cause of infertility. In particular, if one of the couples is older, or both of them are older, and you want to become pregnant, you need to see a doctor early.
There are various types of treatment for infertility, but there are many methods that can be treated in a way that is close to natural conception. First of all, it is important to identify the cause of infertility and proceed with treatment while maintaining a balance between mind and body.
Aim for pregnancy at a pace that is comfortable for you while consulting with your partner and family doctor.
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