Factors Affecting Infertility
Infertility in medicine, colloquially defined as infertility, is the inability to conceive during one year of sexual intercourse by the World Health Organization (WHO), although the couple is not protected.
What is Infertility?
It is expected that pregnancy will occur with regular and unprotected sexual intercourse for one year. The waiting period required to be able to talk about infertility in couples aged 35 and over is 6 months. Infertility, which is seen at a rate of approximately 15-20% all over the world, can develop depending on the woman or the man. In other words, about a third of infertility problems can be caused by men and a third by women, and the rest can be caused by both couples. Sometimes, pregnancy may not be achieved even though there is no significant problem in both. This group of patients, called infertility of unknown origin, constitutes 10-15 percent of couples.
If healthy couples have regular and unprotected sexual intercourse, the monthly pregnancy rate is approximately 25%. At the end of one year, this rate is around 80%, and at the end of the second year it is around 90%.
Therefore, if pregnancy cannot be achieved despite being sexually active for one year and not using any birth control method, it is recommended that couples consult a physician together.
In infertility, advancing age is among the most common causes of infertility. Therefore, couples who want to have a child after the age of 35 are recommended to consult a doctor if they cannot have a baby despite having sexual intercourse for 6 months.
Physiopathology of Pregnancy:
For pregnancy, the brain, endocrine and reproductive systems must work healthy and in harmony with each other. Endocrine glands in the brain, such as the hypothalamus and pituitary, need to function properly.
For pregnancy, the hypothalamus stimulates the pituitary gland located at the base of the brain. As a result, the pituitary gland secretes LH (Luteinizing hormone) and FSH (Follicle stimulating hormone) hormones. The ovaries are stimulated by the hormones that reach the ovaries through the blood circulation.
Thus, some of the follicles containing the eggs begin to mature. The maturation process, which starts on the 6th day after the first menstrual bleeding, lasts until the 14th day. Of the 3 to 30 mature eggs, healthy ones hatch at the end of this process. These eggs are released into the fallopian tubes, which is a channel between the uterus and ovaries. Also known as the ovulation period, this period coincides with the middle of the menstrual cycle, which occurs on average every 28 days. After the egg is released into the fallopian tubes, the follicle from which the egg comes out secretes estrogen against the possibility of pregnancy and the endometrium, known as the intrauterine wall, matures. The egg that needs to be fertilized in the fallopian tubes can remain alive in the female body for about 24 hours. The sperm, which is a male reproductive cell, can remain alive in the female body for 4 or 5 days. Therefore, fertilization can occur with sexual intercourse in a few days before ovulation or on the day of ovulation. A single cell that occurs with fertilization multiplies rapidly by dividing. During this period, it is called the zygote. The zygote attaches to the uterus through the fallopian tubes and forms the embryo after the 3rd week. Thus, pregnancy begins.
Primary infertility if no pregnancy has occurred before; If at least one pregnancy has occurred, whether or not it results in a live birth, it is called secondary infertility.
What are the factors that trigger infertility?
Many health problems in men or women can lead to infertility. The number of infertile couples is increasing nowadays. The most important reasons for this are; stressful living conditions, unnatural diet, smoking habits. Today, one out of every 6-8 married couples does not have a child and has to seek medical help. In addition, there are many factors that can lead to infertility. These can be caused by anatomical disorder, genetic background or hormonal irregularity. Some of the factors that trigger infertility are: Obesity, vaginismus, closed cervix, drug use, chemotherapy or radiotherapy.
Infertility in RTM
Being able to have a child is a major miracle. But basically, this event develops on 3 fictions.
1-The man must have quality sperm.
2-The quality of the eggs in the woman, the active tubes and the uterus being suitable for this action.
3- Having the ability to complete the process until the birth when the fetus is placed in the uterus.
When we have the above 3 scenarios, we do not have any health barriers to have a child.
While evaluating the patient in the RTM system, we guide the diagnosis and treatment through these 3 constructs. In line with this purpose, the treatment protocol is tailored to the individual by evaluating the 3 body structures together, considering the Source-Cause-Result relationship, and considering the circulation, hormonal and genetic structure.
infertility; Since it is caused by multifactorial reasons, it should be treated with a multidisciplinary approach.