Treatment Methods in Infertility

Ovulation Induction

The process of monitoring the ovarian follicles through ultrasound examinations until they grow to the required size and their rupture to release the ovum, sometimes without drugs, sometimes with the help of some pills or hormone needles. After the follicle has reached the rupturing position, sometimes without drugs and sometimes with the aid of a rupturing needle, it is recommended for the husband and wife to perform intercourse 36 hours later.

Intra Uterine Insemination (IUI)

IUI is the process of giving the sperm from the male into the uterus during the ovulation period of the woman. Some couples may have problems with fertilizing the egg cell by passing the sperm cells through the uterus into the tubes. In this case, IUI is recommended among the treatment options.

IUI for Whom and When?

- Infertility states (idiopathic infertility)

-In cases where sperm number and motility are partially inadequate (Oligoasthenozoospermia)

 

Disorders of the penis (hardening of the penis):

-Retrograde ejaculation (instead of semen fluid coming out of the penis, it goes backward into the bladder in the opposite direction): In this case, the sperm cell is obtained from the urine after ejaculation.

-The presence of antibodies that cause destruction of sperm cells in women.

Endometriosis

In the case of unexplained infertility cases, at least one of the tubes must be open so that the IUI can be applied. In addition, the number, movement and morphology of the sperm cells (structural state) must be within the limits of vaccination. In the preparation period for the IUI various drugs can be given to stimulate the ovaries. By giving these drugs, it is aimed to provide a healthy follicle in the ovary (the structure containing the egg cell). Monitoring of egg development is done by ultrasonography and hormone analysis. The size of the egg cell is monitored on ultrasonography (USG). Follicle size should be 18–20 mm where it becomes ready to rupture. In hormone analysis, Estrogen and LH hormones are measured. The increase in estrogen hormone shows the development of a healthy follicle. LH is a hormone that causes a sudden increase in ovulation and a rupturing of the follicle and the release of the egg cell. The liberated egg cell passes into the tubes and is fertilized by the sperm cell from below. An unexpected rise in LH hormone during treatment may lead to premature fracture of the follicle and inability to perform the IUI process. Therefore, hormones and USG measurements are important in follow-up. The use of drugs is started on the 3rd day of menstruation. 8-9 days after that, the first USG dose adjustment is made. After that, monitoring is continued on a day to day basis. How to determine egg time? When the follicle size reaches 18-20 mm in USG, an external needle is injected, and the follicle is fractured. HCG hormone is used for this. This hormone allows the follicle to crack and release the egg cell. Many painkillers may adversely affect ovulation, so they should not be used until very close to ovulation. If there is a medication that is used continuously, you should notify the physician at the beginning of the treatment. In this process, radiation should be avoided. (X-ray film, etc.). On the day of IUI, the sperm is taken from the sperm sample. This sample goes through a series of processes to obtain the sperm cells that are most active and have high chance of fertilizing the egg cell. The catheter is entered into the uterus with via a plastic canula. IUI is painless and does not require anesthesia. The average processing time is 5 minutes. You can go home or work immediately after the process is completed. There is no restriction on sexual life after the procedure.

Drugs used for the IUI procedure may cause multiple follicles to develop in the ovaries, which may result in a multiple-pregnancy risk.

The ovaries can give insufficient response to the drugs used, although not very often. In this case, IUI cannot be performed that month. Sometimes, follicular fracture may be premature due to an unexpected elevation of the LH hormone. In this case, IUI may not be possible.

The success rate of IUI is between 10-15% per treatment. However, if the male's sperm count is within normal limits and the female's tubes are open, after a few attempts within a year, this ratio can reach up to 50% in total. Average 2-3 times IUI can be tried, if unsuccessful, IVF is recommended.

Test Tube (IVF)

In cases where pregnancy cannot be achieved by ovulation follow-up and IUI treatment, the next stage of IVF treatment is started. In addition, in the presence of negative factors present in men, women or both, IVF treatment may sometimes be the first treatment option.

For detailed information about IVF treatment, please see IVF.