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About
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Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility affects millions of people of reproductive age worldwide – and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.
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In the male reproductive system, infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape (morphology) and movement (motility) of the sperm.
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In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others.
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Infertility can be primary or secondary. Primary infertility is when a pregnancy has never been achieved by a person, and secondary infertility is when at least one prior pregnancy has been achieved.
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Fertility care encompasses the prevention, diagnosis and treatment of infertility. Equal and equitable access to fertility care remains a challenge in most countries; particularly in low and middle-income countries. Fertility care is rarely prioritized in national universal health coverage benefit packages.
What causes infertility?
Infertility may be caused by a number of different factors, in either the male or female reproductive systems. However, it is sometimes not possible to explain the causes of infertility.
In the female reproductive system, infertility may be caused by:
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tubal disorders such as blocked fallopian tubes, which are in turn caused by untreated sexually transmitted infections (STIs) or complications of unsafe abortion, postpartum sepsis or abdominal/pelvic surgery;
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uterine disorders which could be inflammatory in nature (such as such endometriosis), congenital in nature (such as septate uterus), or benign in nature (such as fibroids);
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disorders of the ovaries, such as polycystic ovarian syndrome, and other follicular disorders; primary ovarian insufficiency (early menopause);
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disorders of the endocrine system causing imbalances of reproductive hormones;
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cancer and its treatment;
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idiopathic infertility, when there are no obvious disorders found out during the couple examination.
In the male reproductive system, infertility may be caused by:
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obstruction of the reproductive tract causing dysfunctionalities in the ejection of semen. This blockage can occur in the tubes that carry semen (such as ejaculatory ducts and seminal vesicles). Blockages are commonly due to injuries or infections of the genital tract.
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hormonal disorders leading to abnormalities in hormones produced by the pituitary gland, hypothalamus and testicles. Hormones such as testosterone regulate sperm production. Example of disorders that result in hormonal imbalance include pituitary or testicular cancers.
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testicular failure to produce sperm, for example due to varicoceles or medical treatments that impair sperm-producing cells (such as chemotherapy).
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abnormal sperm function and quality. Conditions or situations that cause abnormal shape (morphology) and movement (motility) of the sperm negatively affect fertility. For example, the use of anabolic steroids can cause abnormal semen parameters such sperm count and shape.
Environmental and lifestyle factors such as smoking, excessive alcohol intake and obesity can affect fertility. In addition, exposure to environmental pollutants and toxins can be directly toxic to gametes (eggs and sperm), resulting in their decreased numbers and poor quality, leading to infertility.
Up to date the in vitro fertilization is considered to be safe and the most effective method of infertility treatment.
Each infertility case is unique and requires individual approach. The treatment plan is to be identified only after entire examination of the couple and diagnosis verification. The effectiveness of IVF depends on numerous factors including the infertility period and the woman’s age. According to the long-term experience of using this method, it is evident that children born with the IVF do not have any increased potential risks to their health.
You can make an appointment with the fertility specialist of Scandinavia AVA-PETER clinic in Saint-Petersburg, and ask for further information.
You can make an appointment with the fertility specialist of Scandinavia AVA-PETER clinic in Saint-Petersburg, and ask for further information.
In vitro fertilization (IVF) is
In Vitro Fertilization is an assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by egg pick-up, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish in conditions close to natural ones. Once the embryo is obtained is ready to be transferred into the uterus.
Generally there are five basic steps in assisted reproductive technology program:
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With the aim to provoke multiple growth of follicles and production hormonal treatment is prescribed. The very medications are selective and safe thus providing very delicate effect. This stage lasts about 2 weeks and requires 2-4 control visit to clinic. A transvaginal ultrasound is used to monitor the ovaries, and blood test samples are taken to check hormone levels.
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Ovum retrieval is considered to be a minor surgical procedure with ultrasound imaging guidance. It’s usually performed under intravenous anesthesia to avoid any possible discomfort.
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The man is asked to produce a sample of sperm, which is prepared for following fertilization
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In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory dish to encourage fertilization. The eggs are observed to confirm that fertilization and cell division go properly. Once this occurs, the fertilized eggs are considered embryos. Thus the stage of embryo cultivation is started. This period lasts 5-6 days till the embryos reach the stage of blastocyst and are ready to be transferred into uterus of patient or surrogate mother.
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When performing transfer a special catheter is inserted into the uterus to deliver the embryos. This procedure is painless in majority of cases, although some women may experience slight discomfort.
Scandinavia AVA-PETER clinic was one of the first clinics which has used so-called the elective single-embryo transfer technology – eSET – an approved tool to minimize risk of multiple pregnancy.
ICSI (intracytoplasmic sperm injection) is one of the assisted reproductive technologies (ART) methods, used in cases of severe male factor (semen absence/deficiency, low motility or bad quality of spermatozoa). Through this procedure, a single sperm is injected directly into the oocyte in an attempt to achieve fertilization. Nowadays just a small amount of normal spermatozoa is needed to achieve good results after ICSI.
The MSOME-IMSI
(motile sperm organelle morphology examination - intracytoplasmic morphologically selected sperm injection) is an actual method which allows to assess morphological features of native spermatozoa. The semen image is enlarged in 6300 times with the use of a new electrooptical microscope. This method is used also in cases of severe male infertility and helps the doctor to make a decision, which method would be the most effective one for infertility treatment: the IVF, ICSI or IMSI. This technology facilitates better IVF outcomes, lower risk of miscarriage and fetal abnormalities.
