Infertility is defined as not conceiving after 12 months of regular unprotected intercourse, or after 6 months if the woman is 35 or older. It affects about 1 couple in 6 and is a shared problem: a male factor contributes in roughly half of cases.
Most couples who are investigated receive a clear explanation and a treatment plan. About 1 in 4 have unexplained infertility, where standard tests are normal. The woman's age is the single strongest influence on the chance of success with any treatment.
Symptome
- No pregnancy despite a year of trying
- Irregular, very infrequent or absent periods
- Very painful periods or pain during sex, which may suggest endometriosis
- A history of pelvic infection, abdominal surgery or ectopic pregnancy
- In men: previous testicular surgery, injury, mumps after puberty, or problems with erection or ejaculation
- Two or more miscarriages
- Often no symptoms at all in either partner
Ursachen und Risikofaktoren
Female causes include ovulation disorders, most often polycystic ovary syndrome, blocked or damaged fallopian tubes after infection or surgery, endometriosis, fibroids or polyps distorting the womb cavity, and declining egg number and quality with age, which falls faster after 35. Male causes include low sperm count, poor movement or shape, varicocele, blockage, hormonal and genetic conditions. Smoking, obesity, very low weight, anabolic steroids and some medicines affect both sexes.
Wie es diagnostiziert wird
- Semen analysis: The essential first test for the man, repeated after about 3 months if abnormal.
- Ovarian reserve tests: AMH blood test and an antral follicle count on ultrasound estimate egg quantity, though not quality.
- Hormone profile: FSH, LH, oestradiol, prolactin and thyroid function early in the cycle; progesterone in the second half to confirm ovulation.
- Transvaginal ultrasound: Assesses the womb, ovaries, fibroids, polyps and endometriomas.
- Tubal assessment: Hysterosalpingography or HyCoSy shows whether the tubes are open.
- Hysteroscopy or laparoscopy: Used selectively when a cavity problem, endometriosis or tubal disease is suspected.
- Genetic and specialist male tests: Karyotype, Y chromosome microdeletion and hormone tests when the sperm count is very low.
Behandlungsmöglichkeiten
- Lifestyle and timing: Stopping smoking, reaching a healthy weight and intercourse every 2 to 3 days. Worth doing, but it should not delay tests in women over 35.
- Ovulation induction: Letrozole or clomifene tablets, or injections, for women who do not ovulate, with ultrasound monitoring.
- Surgery: Removal of polyps, submucous fibroids or a septum; selected endometriosis surgery; varicocele repair in selected men.
- Intrauterine insemination: Prepared sperm placed in the womb around ovulation. Suits mild problems in younger women; success per cycle is modest.
- IVF and ICSI: Eggs are collected after stimulation, fertilised in the laboratory and an embryo transferred. ICSI injects a single sperm and is used for male factor.
- Surgical sperm retrieval: Micro-TESE or aspiration for men with no sperm in the ejaculate.
- Fertility preservation: Egg, embryo or sperm freezing before cancer treatment or for age-related reasons.
Wenn es dringend ist
If you may be pregnant and develop one-sided pelvic pain, shoulder tip pain, dizziness or bleeding, seek emergency care locally to exclude ectopic pregnancy. After ovarian stimulation, severe bloating, vomiting, breathlessness or passing little urine can mean ovarian hyperstimulation syndrome and needs same day assessment.
Reisen nach Türkiye zur Behandlung
Fertility treatment fits travel well because it is planned. A typical IVF cycle needs about 15 to 20 days in Istanbul, or two shorter visits if stimulation is started at home with local scans. Be aware of Turkish law: treatment is offered to married couples using their own eggs and sperm, and donor eggs, donor sperm and surrogacy are not permitted. Have the basic tests done at home first so the plan can be agreed before you fly.
Senden Sie Ihre Berichte, Scans und eine kurze Geschichte und eine Clinic-Y Koordinator Antworten innerhalb von 24 Stunden mit geeigneten Teams und schriftlich, All-inclusive Vorschläge nebeneinander. Die Überprüfung Ihres Falls ist kostenlos.
Häufig gestellte Fragen
What are the chances with IVF?
They depend mostly on the woman's age: highest under 35 and falling steeply after 40 with her own eggs. Ask for the clinic's live birth rate per embryo transfer in your age group, not pregnancy rates.
Is it usually the woman?
No. Male and female factors are about equally common, and in many couples both contribute, so both partners should be tested from the start.
How many cycles might we need?
Many couples need more than one. Cumulative success over 2 or 3 cycles is meaningfully higher than for a single attempt.
Does stress cause infertility?
There is no good evidence that everyday stress prevents conception, although infertility itself is undeniably stressful.
Is genetic testing of embryos useful?
It helps couples with a known genetic condition. For routine screening its benefit is debated and it does not improve the outlook for every group.