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Anadolu Medical Center Women's Health Department Coordinator Dr. Aydin Arici, factors affecting fertility gave information about.
How can women and men find out if they are fertile?
For men, a very simple test, the sperm test, can be performed. With this test, the volume of sperm, density, that is how much sperm in a milliliter and the morphology of the sperm can be examined. Abnormally shaped sperm are found in sperm cells. But there is a certain proportion of them. We want abnormal shapes to be less than 40 percent. In addition, we want the sperm count to be at least 60 percent by moving forward. The number of sperm in 1 ml should be at least 20 million. Sperm volume between 2 and 5 ml is within normal limits. However, it cannot be said that someone with a low sperm count cannot be a father. He has a chance to be a father, only a little less than others. For example, if a man has 15 million sperm in 1 ml, we cannot say that you cannot be a father. He may be a father, but this process may take a little longer. In addition, these kinds of sperm disorders can be treated successfully either by vaccination or in vitro fertilization.
Women need a little more detailed examination. The first is to check whether the tubes are open. However, we do not recommend doing this in an unmarried woman. We recommend this test only if couples who decide to have children do not have pregnancy. This period of time in women under the age of 35 years after 1 year of pregnancy if there is no pregnancy should be checked whether the tube is open. Women over the age of 35 can be kept slightly shorter than this period. Another test to be done in women is to determine whether there is an ovulation pattern and whether the hormones are balanced. There are two simple blood tests for this. The first is the measurement of the hormones that manage the ovary and ovary on the 3rd day of menstruation. The other is a blood test that can be performed on the 21st day of menstruation and checks whether ovulation is present. With these tests, it can be understood in general terms whether a woman has a hormonal disorder or if she has problems in ovulation.
Is It Possible to be Infertile in Women with Menstrual Irregularity?
Yes, this is more likely than regular ones. By menstrual irregularity, we mean: A woman normally has her period every 28 days. But the normal limits of this is between 25-32 days. However, for example, if a woman has menstruation once every 2 months or once every 3 months, the ovulation function is most likely not fully functioning. This person is therefore less likely to become pregnant without treatment.
What is the age limit for men?
For example, if a 70-year-old man can have sexual intercourse and ejaculation günümüzde there are many medicines that provide it today ası it is not a problem to be a father. The number of sperm also decreases slightly in men due to the decrease in hormones. But it never goes down to zero.
What is the Fertility Age Limit for Women?
In women, the situation is completely different. This is because the eggs of a girl are placed in the ovary of that girl when she was a baby in her mother's womb. It reaches the highest figure in the fourth month of pregnancy, about 2 million. But these eggs gradually decrease over time. About half of it goes when you're born. It is estimated that approximately 400 thousand eggs remain in the ovaries when it reaches the age of cloudiness. And then these eggs are constantly reduced. Roughly around the age of 45 is also very reduced. Getting pregnant after 45 is therefore very difficult but not impossible. The biological structure of course varies from person to person but is very rare. When a 50-year-old woman is a mother, we see it in the news, but when a man is a father at this age, there is no news. Because this is part of its natural function. Therefore, there is not much change in the fertility of women until age 35. 20-30 years of a woman's most fertile age. This continues until 34, then decreases after 35. If a woman has a regular relationship, her tubes are open, and there is no problem with her husband's sperm, the chances of such a couple - women under 35 years of age - have a 30-35 percent chance of getting pregnant every month. After 35 years of age, this ratio gradually decreases. First it goes down to 20 percent, then it goes down to 10 percent. When the woman is 40 years old, the chance of getting pregnant without treatment is about 10 percent every month. Consequently, women's fertility decreases gradually with increasing this birth.
Are Environmental Factors Affecting Fertility?
Of course there is. We see the effects of environmental factors mostly in men. Because egg production in women does not continue for life, the eggs that are formed are damaged due to environmental effects. For example, not only does the woman's chance of getting pregnant decrease, but the likelihood of a disabled child increases during pregnancy. It depends more on genetic problems. The eggs are placed in the woman's body while still in her mother's womb, that is, at a sensitive stage of cell division. And therefore it is sensitive to environmental factors. As time progresses, chromosome damage begins to form inside these eggs. That's why we recommend genetic screening for pregnancy after 35 years of age. In men, as I said before, sperm is constantly produced. It is even one of the most reproductive cell types in the male body. Therefore, it is more affected by environmental impacts. Sperm production takes about 3 months. The chemicals, radiation, poisons and uncontrolled hormones that are given uncontrolled to the environment affect the reproductive organs. For example, in the 1960s in the United States because of a hormone given to chickens to spawn more, reproductive disorders have occurred in children of pregnant women eating these products.
How Does Lifestyle and Smoking Affect Fertility?
Lifestyle certainly affects a person's productivity. For example, cigarette contains a lot of chemicals that reduce the blood-carrying capacity of the blood at the same time, which reduces the vessels' oxygen-carrying capacity. Therefore, it causes a decrease in the amount of oxygen to each organ. The ovary is also affected. The best proof of this is that in a woman who smokes 1 pack of cigarettes a day, while the average menopause age is 51, this occurs about 3 years earlier. So it shortens the life of the ovary 3 years. In other words, the age of menopause of a woman who smokes 1 pack of cigarettes per day decreases from 51 to 48 years. For those who drink two packages, this age can go down to 46 years. This is evidenced by many scientific research on the subject. If smoking affects the ovary so much, we are sure that it will also affect fertility. To give an example, many private health insurance companies in the United States, IVF and private health insurance companies that cover infertility treatment do not cover IVF treatment if couples smoke. First, let them quit smoking and chances of fertility and then cover the cost of treatment. Since these are based on scientific data, nobody can object.
What advice would you give to couples who want to get pregnant naturally?
As they are under their control, they must first move away from substances that harm them. They must stop smoking first. The second element is the drink. There is no harm in drinking once in a while, but it is essential to keep drinking constantly. We recommend reducing caffeine-containing drinks such as coffee and tea. Furthermore, it should not be used too much from foods that are painted with artificial dyes, which contain a lot of chemical substances, and which contain high amounts of nitrite and sulfite as preservatives.
When should I apply for IVF treatment?
Couples younger than 35 years should try to get pregnant by natural means for at least 1 year. Saying this, of course, if there are problems immediately seen 1 year does not need to wait. For example, if a woman has a period every 3 months, it would be absurd to say wait a year and then do a test. So if there is a significant problem, they need to be treated. But it is convenient to wait 1 year in a functioning state like clockwork. Waiting for 1 year after the age of 35 may not be correct. Some tests, such as a sperm test, may be performed earlier than 6-9 months. For a person who wants to have a 40-year-old child, we advise him to take the test without wasting much time and go over it if there is a problem.
Does Abortion Have an Effect on Fertility?
Abortion Like every surgery, it carries a certain amount of risk. Risks of abortion; causes adhesions in the uterus, infection, bleeding and perforation of the uterus. These are, of course, rare risks. For example, uterine perforation is a very low risk, while infection has a slightly higher likelihood. Today, however, antibiotics can be treated. Bleeding may occur due to parts remaining inside. Adhesions can only be understood in the long run. Abortion fertility There is a certain risk. But a well-done abortion has no effect. But every time it's done, there's this risk. In other words, a woman who has an abortion 3 times faces this risk in every operation. However, increasing the number does not mean that it creates more risk than the previous ones.
What is the maximum chance of a woman's pregnancy in a year? Can special days be calculated?
In a year chance of pregnancy, roughly 80 percent of women younger than 35 years. Therefore, we recommend that couples younger than 35 years of age do not panic if pregnancy has not occurred before 1 year because 80 percent are pregnant. However, in 20 percent of those who cannot get pregnant, tests are made to determine if there is a problem and treatment is initiated. There are some measures that can be taken in the first year, especially in the days of sexual intercourse, which will increase the chances of pregnancy. If a woman is menstruating every 28 days, we would normally expect ovulation on the 14th day. The egg unfortunately can only survive 24 hours. If she meets sperm during this period, she becomes an embryo and the baby develops. If he can't meet the sperm, he'il disappear by himself. Sperm, on the other hand, lives up to 48 hours after intercourse if there are good sperm parameters. Even if there are very good sperm parameters and the environment is suitable, this period can be up to 72 hours. In other words, if an ovulation such as 14th day is expected, we count it as the first day of menstruation. This means that the 14th day after the first day of menstruation is the most anticipated ovulation day. Since he lived 48 hours of sperm. We estimate that the chances of pregnancy will reach the highest level from day to day by roughly 10 days.
Is there such a time for men?
Men don't have much restrictions. Since the production of sperm continues continuously, but the liquid part of the sperm must also be formed, it is estimated that the man will produce the most appropriate combination in a standardized relationship every other day. If a man is going to have a sperm test in the laboratory, we recommend him to give a sperm sample after 2-3 days of sexual abstinence. Because after these two days of abstinence, we can measure the optimal sperm profile. Sperm volume and number decreases in more frequent relationships. If the break is too much, the motility of the sperm decreases. Therefore, the relationship to be made every other day is most suitable for pregnancy. In a man whose sperm count is already very good, this period does not matter. This is often true for men with limited sperm counts.
Is there any chance of not getting pregnant as a result of treatment?
Of course there is. Today, about 90 percent of couples who cannot have children can have children with treatment. The remaining 10 percent cannot become pregnant for very important reasons. If there is no sperm production in a man or if there is no egg production in a woman, there is nothing to be done. Also, if there is an advanced disorder in the uterus, nothing can be done.
How many times should the IVF not be treated?
As a result, treatments are a process against both sacs, psychology and time. Couples also suffer from stress during treatment and psychological wear. Therefore, after trying for a while couples can not say that not. The previous experiment should be the guide for the next one. If everything is not appropriate on the last attempt, it should be tried again. But before we try again, we have to look back and see why he didn't. A woman under 35 years of age has a 50-60 percent chance of keeping it on the first try. However, the probability decreases slightly with each trial. There are no problems in women up to 6 attempts on average. But with today's technology, a woman under the age of 35 can get pregnant in up to three attempts, unless there's a major problem. However, if the woman is more than 40 years of age, the chance of pregnancy is lower as fertility is reduced naturally. At this age, there is a 25 percent chance of getting pregnant with IVF. So there could be more to experiment in that group.