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Couple, who have regular sexual intercourse and not using contraception was infertile for 12 months if it does not come up pregnant ..
It is then necessary to seek medical help. It is important during this time period to identify the fertile days. In the event that it is a woman who has more than 35 years, it would be desirable but after six months to start treatment of infertility.
What to do and where to go first? Husband should contact a specialist in general medicine to search for sperm (Spermiogram). The wife should contact the relevant primary gynecologist. Often patients report to private health institutions to quickly look obrade.Kako first coming to the doctor? First doctors visit is significant. It is important to take a detailed history of a spouse and make a search plan for infertility treatment. Tests must be simple, noninvasive and inexpensive. They give us whether it is possible to come naturally to pregnancy. Thus, the existence of a sufficient number of progressively motile sperm morphology neat, regular ovulation, patent fallopian tubes and normal uterus where it should come up ugnježdenja embrija.Koje methods used for determining infertility? Men need to make Spermiogram and urological examination that includes an overview of the scrotum (the size testis, epididymis, prostate, and blood vessels). The seed is best given in a period of three to six days of abstinence from sexual intercourse. The conventional wisdom is that it is five days. The woman, in addition to gynecological exam and Pap test, a need to examine the breast, thyroid and ultrasound examination of the uterus, fallopian tubes and ovaries. Verification of ovulation can be done by measuring basal temperature, transvaginal ultrasound and by determination of progesterone levels 21st day cycle. Sometimes the hormonal status of women tested in the blood, and the most ideal time for this is the third day of the cycle (between the second and fifth day of menstruation). Deformations of the uterus, ovaries and jajovodaMoguci problems spermatozoidimaMikrobiološka processing of both spouses is also important. A sample is taken swab of the urethra in men and cervix in women. The following results were checking patent fallopian tubes. This is possible by means of hysterosalpingography, which can be done under ultrasound or x-ray with contrast medium which is applied through the vagina and cervix. These results are made ambulantno.U case impracticability or lack of viable pregnancy with tubes, after six months it takes to make a diagnostic laparoscopy, which is done under general anesthesia. Often find the foci of the endometrium and on the surface of the pelvis and ovaries, which is called endometriosis. View the interior of the uterus in order with the help of diagnostic hysteroscopy in which we can find polyps mucosa, adhesions, myomas or submukozni pregrade.Koje methods of treatment? Most methods treat the name of a method of assisted reproduction. Ovulation is encouraged tablets clomiphene, tamoxifen, or letrazola. If it fails to achieve ovulation, using a gonadotropin hormone injections. In patients with ovarian syndrome policistickih often give tablets metformina.U case of a small number of progressively motile sperm (10 to 20 million) and passable fallopian tubes, using the method of disposal of sperm into the uterus (IUI - intrauterine insemination, AIH - artfitial insemination by husband). Taking oocitaKod spouses who have no sperm (azoospermia) it is in the uterus insemination with donor sperm (AID - artifitial donation by donor). At a somewhat lower number of sperm in some centers used in the insemination and fallopian tubes (ITI - intratubarna insemination). Often patients stimulates ovulation, which increases the chances of pregnancy. Not recommended for more than six unsuccessful pokušaja.Kod couples in which the impassable fallopian tubes can be designed microsurgical correction with the formation of new mouths fallopian tubes, adhesions resolution that can be made via laparoscopy or classical laparotomijski (in the open abdomen). Endometriosis is also treated in this case nacin.U fewer than 10 million sperm or impassable oviduct and let us make vitro fertilization (IVF - In vitro fertilization). In a very small number of regular and or motile sperm needed to make the intracytoplasmic sperm injection (ICSI - intra cytoplasmatic sperm injection). Fertilization outside the body to be in couples where there has been no successful insemination into the uterus or fallopian tubes. In infertile couples where the cause immune, then the pairs for which we do not know the cause, it is also a method of treatment and fertilization outside tijela.EmbriotransferInvitrofertilizacija intracitoplazmicka injekcijaKod patients who continue to produce sperm in the testicles, not found in the semen, the sperm the biopsy comes epididymis or testis (MESA, TESA) and then injected into the egg stanice.U recent donation of oocytes has proved very successful in women who have more mature oocytes. These are women who have entered into early menopause before the 40th age of unknown reasons, then women who have ovaries removed because of an illness, and also damaged the ovaries during chemotherapy of malignant disease organizma.Kolika the success of each method? success of various methods of assisted reproduction is different. Also depends on the cause of infertility, age of spouses. AIH in appropriate selected patients is about 20 percent cumulatively over the three procedures. Vitro fertilization, which has a greater success in young women may reach 40-50 percent uspješnosti.O performance is much better to talk to some married couples, but for various methods of assisted reproduction. Generally the success of infertility treatment should be around 80 to 90 percent. In other words, 80 to 90 couples a hundred should have their own offspring. Success is always higher in young women and young people aged 35 years. Woman is most fertile period between the 20th and 25 years of age. It is therefore important to plan pregnancy at an early age. Success in business and career development can be achieved at any time during life, but not parenting.