The birth of a baby is the most important event in the family. But not everyone is able to have children due to diseases of the reproductive system. Modern medicine has learned to overcome these problems; now doctors have a whole arsenal of means, from drug therapy to “heavy weapons” in the form of assisted reproductive technologies. IVF procedures are not only a serious test for the female body, but also a very expensive service. In pursuit of profit, many “fertility clinics” do not even try to use other treatment methods, immediately moving on to the most expensive service - IVF. Doctors at the Vitalis Clinic specialize in restoring reproductive function without in vitro fertilization. We try to use gentle methods of treating infertility and recommend that couples use ART only in cases where this is truly the only way to achieve pregnancy. Our doctors help couples cope with the diagnosis of infertility and become parents.

How widespread is the problem?

According to WHO (World Health Organization) criteria, a 15 percent rate of infertile couples of reproductive age is considered a threat to the country's national security. In Russia this figure is 17-20% and has a negative trend. This dry statistic means that every fifth family among our friends and acquaintances is faced with the problem of infertility.

When is infertility diagnosed?

The official WHO definition states: “Infertility is the failure of a sexually active, non-contraceptive couple to achieve pregnancy within one year.” Of course, there is a chance of getting pregnant later, but the highest chances of pregnancy are in the first year (provided that the couple is not protected), then the chances decrease every year. If you were unable to get pregnant in the first year, do not waste precious time and seek help from a doctor.

Although the wording of the diagnosis refers to the couple's inability to achieve pregnancy, it is a common misconception that the cause most often lies with the woman. This is not surprising, since 10 years ago even doctors did not consider the “male factor”. Medical centers often even now refer to the treatment of infertility as treating a woman, while men draw a direct connection between their “male strength” and the ability to reproduce (note, completely unfounded). According to the European Association of Urology, in 50% of cases, the absence of pregnancy is due to problems in the man. Therefore, it is better for a married couple to come to the clinic together for the first consultation. This will significantly reduce the time to find out the cause of infertility in your particular case. It is also worth considering that treatment in men is a longer process than in women, which is associated with different durations of the maturation cycles of sperm and eggs (the process of spermatogenesis takes almost three months, unlike the usual 1 month for women).

Factors influencing reproduction in men

Impaired fertility can result from smoking or drinking alcohol, taking antidepressants, or having sexually transmitted diseases. Ecology has also made its contribution: over the past half century, as a result of environmental deterioration and an unhealthy lifestyle, the concentration of sperm in men's semen has decreased by 2 times.

Spermatogenesis disorders can develop as a result of nervous stress, chronic fatigue and lack of physical activity.

Spermatogenesis occurs normally at temperatures several degrees below body temperature; excessive heat causes damage to young germ cells. A short-term increase in body temperature above 39° C can seriously inhibit spermatogenesis; normal sperm activity is restored only after 2.5 months. For this reason, overheating of the genitals caused by frequent visits to the sauna, using a heated car seat, wearing thermal underwear, etc. is harmful for men.

Well, the “scourge” of modern men is excess weight. It has been proven that excess weight in men, especially those with central obesity (pronounced “belly”), causes a decrease in the number and quality of sperm and directly leads to a decrease in the likelihood of natural conception.

Factors influencing reproduction in women

There are several classifications of female infertility, but from a practical point of view, the most important is the one based on pathological and genetic factors that lead to infertility. It is on this basis that the attending physician determines the method of treatment.

According to this classification, the following types are distinguished:

	Explanation
Uterine	This type includes various gynecological diseases with disruption of the endometrium, but with preserved patency of the fallopian tubes (internal and external endometriosis, uterine fibroids, endometrial polyps, endometrial hyperplasia, endometritis, etc.).
	It implies obstruction of the fallopian tubes as a result of adhesions (as a consequence of inflammatory processes in the pelvic organs or operations). As a result, sperm cannot reach the egg or the fertilized egg cannot descend into the uterine cavity.
Endocrine	It means an imbalance in a woman’s hormonal profile, when a deficiency or excess of various hormones makes the normal process of egg formation impossible.
Immunological	Associated with the production of antibodies in the female body to the partner’s sperm. Antibodies attack sperm and destroy them. There are no visible causes of infertility, because... the pregnancy is terminated so early that the woman does not have time to notice it.
Psychological	Caused by stress (including chronic lack of sleep and dieting) or chronic fatigue
Idiopathic	That is - unclear. This conclusion is made if, as a result of the examination, it was not possible to find the reason for the lack of pregnancy.

Hormonal imbalances are one of the most common causes of infertility. Below are the most common endocrine disorders.

Hormone	Effect on the reproductive system
Testosterone	It is one of the factors in the development of a dominant follicle. Increased testosterone can lead to the formation of a functional cyst, since the follicle does not rupture during ovulation.
Estradiol	The hormone is responsible for the growth of the endometrium in the uterus and the attachment of the embryo directly to the functional layer. If the level of estradiol is below normal, the likelihood of becoming pregnant and carrying a child is negligible.
LH (luteinizing hormone)	Stimulates the production of estrogens by the ovaries, which contribute to the onset of ovulation. If there is a deficiency of LH, the capsule of the dominant follicle will not rupture and the egg will not be able to be released.
Prolactin	The level of prolactin increases during pregnancy, since the main task of this hormone is to prevent the onset of another pregnancy if fertilization has already occurred. Therefore, excess prolactin outside of pregnancy leads to suppression of ovulation, which makes pregnancy impossible.

Normal values ​​of hormones that affect a woman’s reproductive function

What examinations are needed?

To choose the right tactics for the upcoming treatment, it is extremely important to find out the exact cause of infertility, for which it is necessary to conduct a diagnosis. You can undergo an examination and take all the necessary tests in our clinic. If you have the results of previous examinations, take them with you.

Diagnosis of infertility in men

• appointment with a urologist-andrologist
• Ultrasound of the reproductive system (prostate, scrotal organs)
• spermogram + MAR test
• STD diagnosis
• hormonal blood test

According to the doctor's decision, additional examinations may be required:

• Genetic tests
• Sperm DNA fragmentation
• acrosomal reaction assay
• biochemistry of seminal fluid.

Diagnosis of infertility in women

Basic examination includes:

• gynecologist appointment
• Ultrasound of the pelvic organs (on days 10-16 of the cycle)
• hormonal blood test (given on the 2nd or 3rd day of menstruation)
• diagnosis of infectious diseases (smear using PCR method)
• ovulation assessment (ovulation test strip)

Additionally, the doctor may decide to perform the following diagnostic procedures:

• colposcopy
• genetic research
• postcoital test
• hysterosalpingography (HSG)
• hysteroscopy
• laparoscopy

Diagnosing infertility in women takes longer than in men, because many tests and studies need to be carried out only on certain days and phases of the cycle.

An ovulation test strip gives a result after contact with urine, namely, it shows the concentration of luteinizing hormone (LH), the level of which rises several hours before ovulation. Carry out an ovulation test every day, this will allow you not to miss the moment when LH levels reach their maximum. If you have a regular menstrual cycle, subtract 17 from your cycle length and you will get the day of your cycle on which you need to start taking ovulation tests.

Background:

Complaints about the absence of menstruation for 7 months. The desire to give birth to a child. Before this, there was a long-term unstable cycle accompanied by severe pain. Lack of pregnancy. Repeatedly took courses of hormonal therapy.

Diagnosis: Infertility

Treatment:

Treatment lasted 1 year and 2 months. The cycle was restored after 4 months, stabilized after 7 months. After 14 months there was a natural pregnancy, which proceeded without threats or complications.

Result:

After 14 months there was a natural pregnancy, which proceeded without threats or complications. Independent childbirth. Healthy daughter and happy mother.

Background:

The patient did not experience menarche (first menstruation) at the age of 14. She was diagnosed with “delayed sexual development” and prescribed hormonal medications, which she took on an ongoing basis until she was 26 years old. When the desire to have a child appeared, pregnancy did not occur. A new diagnosis was made - infertility.

Diagnosis: Infertility

Treatment:

Since the patient’s hormonal background was completely unbalanced, it was necessary to bring it back to normal, establish a healthy hormonal background and completely stop taking hormonal medications, which the patient had been taking for more than 10 years. It took six months to restore hormonal levels.

Result:

Pregnancy occurred naturally and passed without complications. The boy was born on time, the health of mother and baby is excellent.

The patient is a 43-year-old woman. (Moscow city)

Background:

The patient has a history of 2 abortions. Due to complications after the second abortion, it was recommended to undergo a course of hormone treatment. The patient refused, found another specialist and underwent an alternative course of treatment. I felt healthy. Analyzes confirmed this. However, subsequently, for more than 13 years, pregnancy did not occur.

Diagnosis: Infertility

Treatment:

During the treatment, a number of diseases were identified that directly affect the ability to get pregnant, and even more so to bear and give birth to a healthy child. The course of homeopathy took six months. After the Doctor stopped contraception, pregnancy occurred naturally in the first cycle. Throughout her pregnancy, the patient continued regular monitoring with the Doctor and, in case of a cold, was treated only with homeopathic remedies. The pregnancy was easy, the patient experienced neither toxicosis nor fatigue, and went on maternity leave 2 weeks before giving birth. The baby was born on time.

Result:

The girl was born with excellent indicators, 8-9 points on the Apgar scale.

The patient is a 33-year-old woman. (Kiev City)

Background:

The first pregnancy ended in miscarriage. According to indications, cleaning was carried out. After which pregnancy did not occur. The examination revealed: 1. A significant amount of fluid in the pouch of Douglas (retrouterine). 2. In hormonal status - increased FSH levels with a significant decrease in estradiol. The case was regarded as a chronic inflammatory process, which became the cause of infertility.

Diagnosis: Infertility

Result:

Post-therapy examination showed excellent results. In the first cycle, the patient became pregnant naturally. The birth was successful, everyone was healthy.

The patient is a 37-year-old woman. (Moscow city)

Background:

The patient got married at 36 years old. Within a year, the young family was unable to get pregnant. Doctors said that the patient is healthy and pregnancy is not occurring due to her age. I turned to Doctor Grigoriev with great skepticism and mistrust in a state of depression. Also, the patient’s condition was negatively affected by the inability to do IVF (the presence of contraindications), which forced her to assess the situation as hopeless.

Diagnosis: Infertility

Treatment:

During the treatment, severe dyshormonosis and problems with the thyroid gland (autoimmune thyroiditis) were revealed. It took three months of treatment.

Result:

Soon a natural pregnancy began, which proceeded without complications. The patient no longer contacted the Doctor, and on January 27, the happy husband and father sent an SMS: “Good afternoon, Evgeny Vladimirovich! Today at 15.55 they gave birth to a girl, height 48, weight 2.9. We are working on the name :).”

Patient, woman, 42 years old (Moscow)

Background:

Complaints about the inability to bear a child. History of ectopic pregnancy, amputation of one tube. Three attempts at IVF did not produce any results.

Diagnosis: Infertility

Result:

Persistent restoration of clinical data on hormonal status. Artificial insemination in the natural cycle led to the desired pregnancy.

The patient is a 37-year-old woman. (Moscow city)

Background:

Complaints about the inability to bear a child. The patient has a history of 1 pregnancy and childbirth, followed by three spontaneous abortions in the early stages.

Diagnosis: Infertility

Treatment:

Additional clinical examination revealed a latent infection with Brucella abortus. The treatment lasted 6 months. A control study did not reveal any infectious complications. Soon the long-awaited natural pregnancy began, which proceeded without complications.

Result:

The birth was successful, the baby and mother are healthy.

The patient is a 33-year-old woman. (Saint Petersburg)

Background:

The patient has a history of a nodule and a cyst in the thyroid gland. At the time of treatment, she had been treated by a specialist for a long time, but there was no improvement. An unstable menstrual cycle and an additional clinical diagnosis of fallopian tube obstruction were identified as concomitant complaints. The patient also wanted to have a baby.

Diagnosis: Nodule and cyst of the thyroid gland. Obstruction of the fallopian tubes.

Treatment:

After 3 months of treatment with individual homeopathic medicines, ultrasound control revealed a decrease in the size of the nodule and cyst in the thyroid gland. The monthly cycle has stabilized. After 6 months, the nodule completely resolved, the cyst retained its size. After 9 months from the start of therapy, no structural abnormalities of the thyroid gland were detected. My general health has returned to normal. The patient was able to carry and give birth to a healthy child without harm or risk to herself and the baby. Artificial insemination in the natural cycle led to the desired pregnancy.

Result:

The boy was born healthy, height 54 cm and weight 3.850 kg. Mom and baby are doing well.

The patient is a 28-year-old woman. (Moscow city)

Background:

I sought help 4 years ago for ulcerative colitis. During the treatment, a stable remission was achieved, and the patient did not appear again. A new request for nonspecific ulcerative colitis, during which it turned out that the exacerbation arose against the background of 2 unsuccessful IVF attempts.

If it is impossible to conceive a child for a year in the absence of contraception, a diagnosis of “infertility” is made. It should be noted that this diagnosis is not a death sentence, since there are different forms of the disease and methods of treating it.

This disease occurs quite often. However, it is not always the woman who is to blame in this situation. To clarify the causes and select effective treatment, you should undergo a full examination.

Causes of infertility

Let's start with the fact that there is female and male infertility. In addition, there is a combined form when both partners have problems. According to statistics, 2/5 of cases are female infertility. The same number are diagnosed in men. The combined occurs in only 1/5 of all clinical cases.

In men, pathology can be caused by chronic inflammatory processes in the genitourinary area. This can be urethritis, prostatitis and even cystitis. In addition, obstruction of the vas deferens, varicocele, decreased potency, and so on are often diagnosed. Diseases associated with a violation of the psycho-emotional state are especially difficult to treat. Hormonal problems are treated today with great success.

Female infertility most often occurs against the background of inflammatory and infectious processes in the pelvic organs. Blocked fallopian tubes, congenital abnormalities, hormonal disorders and endometriosis can also cause infertility.

As a rule, the examination reveals several causes at once, and only eliminating them all will allow one to restore reproductive function and successfully conceive and bear a child.

Types of infertility

As already mentioned, the following forms of infertility are distinguished:

• Female infertility, that is, there are problems on the part of the woman.
• Male infertility. In this case, the man has diseases.
• Combined, when both partners have problems.
• Incompatibility. In this case, given the absence of diseases in the partners, pregnancy does not occur for other reasons.
• Idiopathic infertility is diagnosed when both partners are healthy and there is no incompatibility.

Diagnosis of infertility

If you have problems conceiving a child within a year, you should see a doctor. Using traditional recipes rarely gives the desired effect, and you only waste your precious time.

When contacting a specialist, a full examination of both partners is prescribed. First, let's look at what kind of examinations a man should undergo. First of all, a digital examination of the prostate is prescribed to identify adenoma and other diseases. After this, an ultrasound examination of the testicles and prostate is performed. A spermogram is mandatory. It allows you to determine the number of active sperm, their concentration, condition and other characteristics. It should be especially noted that it is necessary to properly prepare for this analysis. To do this, you need, if possible, to give up smoking and alcohol, as this helps reduce the amount of sperm. It is also recommended to abstain from sexual activity for 3-4 days.

Women undergo a gynecological examination and tests for infections. The menstrual cycle is also assessed, an ultrasound and a blood test for hormones are prescribed. If necessary, hysterosalpingography and endometrial biopsy can be performed.

Based on the data obtained, effective infertility treatment is selected.

Prevention of infertility

In order to avoid infertility, you should be careful about your health. All diseases must be treated to the end. If any abnormalities occur, such as irregular menstrual cycles, a full examination should be carried out and adequate treatment should be obtained.

The optimal treatment method is selected by the doctor after a thorough diagnostic examination of the couple and determination of the type of infertility.

For infectious diseases, thorough joint antibacterial and anti-inflammatory treatment of sexual partners is carried out with mandatory control tests of cure. In case of tubal infertility and external endometriosis, obstructions in the patency of the fallopian tubes are eliminated using laparoscopy, removal of pathological foci and dissection of adhesions. During the procedure, endometrioid lesions are also eliminated. Then, drug treatment is mandatory. Various pathologies of the uterus are eliminated using reconstructive plastic surgery. Treatment of immunological infertility is carried out using various methods, incl. plasmapheresis. Injection of the husband's lymphocytes under the woman's skin is also used. In case of endocrine infertility, hormonal levels are corrected and ovarian function is stimulated, including stimulation of ovulation with various drugs: clostilbegit, recombinant gonadotropins, etc. During cycles of ovulation stimulation, folliculometry is required - a transvaginal ultrasound examination to determine the effectiveness - follicle growth and determine the fact ovulation has occurred, ovulation tests are also used.

The causes of male infertility, just as often as in women, are infectious diseases of the genitourinary organs; less often - congenital defects of the genital organs, injuries, complications after surgical operations. The treatment system for male infertility includes procedures aimed at stimulating spermatogenesis, as well as restoring the patency of the spermatic ducts using medication or surgery.

The use of unique methods of treating infertility in our clinic allows 80-85% of patients to achieve pregnancy naturally. If there is no effect from the therapy, various types of IVF are recommended to the couple. It is important to understand that its use must be truly necessary and justified. On average, no more than three percent of infertile couples need the artificial insemination procedure; for all others, conservative or surgical treatment will be sufficiently effective. Successful IVF on the first attempt occurs on average in 30% of cases. The older a woman is, the lower her chances of becoming pregnant even this way, since the quality of reproductive cells (ovarian reserve) deteriorates over the years. If many attempts have not brought the desired result, doctors recommend IVF with a donor egg. In the absence of a uterus or severe defects in the development of the uterus, you can resort to surrogacy.

Indications for IVF:

• the absence of fallopian tubes in women, as well as their obstruction that is not amenable to medical correction;
• endocrine infertility in the absence of hormonal therapy effectiveness;
• strong degree of oligozoospermia (after unsuccessful treatment of both partners);
• infertility of unknown origin.

In vitro fertilization is contraindicated for women suffering from:

• oncological diseases;
• acute inflammatory diseases;
• mental disorders;
• benign tumors of the ovaries or uterus;
• pathology of the uterus, in which the transplantation of a fertilized egg or its development is impossible.

One of the Clinic's specializations is pregnancy management and preparation for childbirth.