Pregnancy / Childbirth

What factors affect fertility?


The questions are answered by dr Dariusz Mercik - specialist in women's diseases and obstetrics, endocrinologist
Medical Director of the GYNCENTRUM Clinic, Katowice

Are you having trouble conceiving a child today?

Dr. Dariusz Mercik: Yes and the scale of the problem is growing every year. Already every fourth couple in Poland has problems getting pregnant. 70% of the problem concerns a woman or a man. In 30% the cause of infertility cannot be determined or it concerns both partners.

When can you talk about fertility problems?

We refer to infertility when there is no fertilization, despite regular intercourse 3 to 4 times a week, without using protection against pregnancy, for a year or two - with less regular intercourse.

When should a couple see a doctor?

If, after a year of regular sex without any protection, the couple cannot get pregnant, it is a sign that they should see a specialist. Of course, this is not a fixed period, some couples should not wait that long. Consider, inter alia, the age of the woman. After the age of 35, a woman's natural ability to fertilize is reduced. Therefore, it is not worth postponing the appointment of a doctor.

How is infertility diagnosed?

Diagnosis of infertility should be started simultaneously with both partners. The man is examined for semen and, if indicated, for hormonal tests and urological consultation.

A woman should have a gynecological examination with bacterial and chlamydia trachomatis swabs, ultrasound examination with an accurate assessment of the number of antral follicles in the ovaries. The next step is to perform hormonal tests: assessment of prolactin (pituitary), AMH (ovarian reserve), TSH (thyroid function assessment), on day 2-3 of the test cycle: FSH, LH, E2 (ovarian assessment).

Next, the patency of the fallopian tubes should be checked by sonohysterosalpingography. Performing these tests will help determine the cause of infertility and propose a treatment method.

How important from a fertility point of view is the attitude of the couple?

Many couples do not realize that it is the psyche that hinders conceiving a child, and the source of problems can be even in early childhood. At a conscious level, a man or a woman may crave a child very much, at a subconscious level, for some hidden reasons, the mind does not give consent.

The psychological basis for unsuccessful efforts for a child can be very different: fear of pregnancy, miscarriage, birth of a sick child or its loss (this problem most often affects women who have traumatic experiences associated with a previous pregnancy). Also fear of change, marital conflicts, depression, neurosis, traumatic childhood experiences, incorrect parental patterns, women's fear of becoming unattractive. In addition, there are everyday problems - prolonged stress, fear of losing a job. That is why in our Clinic we offer couples consultation with a psychologist before or during treatment.

What are the causes of infertility?

Among the many causes that can affect a woman's fertility, it is worth mentioning those that occur most often: ovulation disorders, past infections, fallopian tube obstruction, postoperative adhesions, endometriosis, congenital abnormalities in the structure of the reproductive organ, uterine fibroids, age, which plays a very important role because The fertility of a woman is decreasing every year, and we notice a significant decline after the age of 35. This is mainly due to a decrease in the number and quality of ova and an increase in miscarriages at a very early stage of embryo development.