What is Infertility?

Infertility is the inability of a couple to achieve pregnancy within at least 1 year of regular, unprotected sexual intercourse. If the woman is over 35 years old, this period decreases to 6 months. Both female and male factors can equally contribute to infertility. In some cases, the cause remains unexplained.

Types of Infertility

• Primary Infertility: Seen in individuals who have never experienced pregnancy before.
• Secondary Infertility: Seen in individuals who have previously been pregnant but are unable to conceive again.

Causes of Infertility

1. Female-Related Causes

1.1 Ovulation Disorders

• ✔ Polycystic Ovary Syndrome (PCOS)
• ✔ Premature Ovarian Failure
• ✔ Hyperprolactinemia
• ✔ Thyroid Disorders

1.2 Fallopian Tube Blockage

• ✔ Pelvic infections (PID)
• ✔ Endometriosis
• ✔ Adhesions after surgery

1.3 Uterine Problems

• ✔ Fibroids, polyps
• ✔ Asherman’s Syndrome (intrauterine adhesions)
• ✔ Congenital anomalies (double uterus, uterine septum, etc.)

1.4 Age Factor

Fertility declines after age 35. The chances of pregnancy drop further after age 40.

2. Male-Related Causes

2.1 Sperm Quality and Count

• ✔ Oligospermia
• ✔ Azoospermia
• ✔ Teratospermia
• ✔ Asthenospermia

2.2 Hormonal Disorders

• ✔ Testosterone deficiency
• ✔ Pituitary disorders

2.3 Varicocele

Enlargement of testicular veins, which can negatively affect sperm production.

2.4 Infections and Genetic Factors

• ✔ Infections such as mumps, chlamydia, gonorrhea
• ✔ Genetic conditions such as Klinefelter syndrome

3. Other Factors and Unexplained Infertility

• ✔ Immune system problems
• ✔ Sexual dysfunction
• ✔ Pregnancy failure without any identifiable cause

Diagnosis Methods for Infertility

For Women

• ✔ Hormone tests (FSH, LH, AMH, TSH, prolactin)
• ✔ Ultrasonography
• ✔ Hysterosalpingography (HSG)
• ✔ Laparoscopy (if needed)

For Men

• ✔ Semen analysis
• ✔ Hormone tests
• ✔ Genetic testing if necessary

Treatment Options for Infertility

1. Lifestyle Changes

• ✔ Healthy and balanced diet
• ✔ Regular exercise
• ✔ Quitting smoking and alcohol
• ✔ Stress management

2. Medication Therapy

• ✔ Clomiphene citrate, letrozole, and other ovulation-stimulating drugs
• ✔ Hormone support (progesterone, thyroid hormones, etc.)

3. Surgical Treatments

• ✔ Opening blocked fallopian tubes
• ✔ Endometriosis surgery
• ✔ Varicocele repair

4. Assisted Reproductive Techniques

4.1 Intrauterine Insemination (IUI)

Prepared sperm is placed directly into the uterus. Often used for ovulation problems.

4.2 In Vitro Fertilization (IVF)

Embryos fertilized in the laboratory are transferred into the uterus. Applied in more advanced cases.

4.3 Intracytoplasmic Sperm Injection (ICSI)

A single sperm is injected directly into the egg. Used in severe male infertility cases.

Conclusion

Infertility is a multifactorial condition that can arise from both male and female factors. Thanks to advances in modern medicine, high success rates can be achieved in infertility treatment. If pregnancy does not occur within 6–12 months, couples should consult an obstetrician to begin the appropriate diagnostic and treatment process.