The reasons of infertility and the methods of treatment. Qnarik Alexandryan

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Obstetrician-gynecologist, reproductologist Knarik Aleksandryan represents the main ways of confronting infertility and gives useful advice.

 Please, represent the common causes of infertility in Armenia.

-According to the data provided by WHO, the rate of infertility in Armenia is 18 %.

Generally, the major cause of infertility is a sexually transmitted infection. Great number of Armenians are working abroad nowadays, and in my opinion this is the main reason of facing Sexually transmitted infections (STI) – the main cause of infertility.

Very often a week after the marriage the newly married women complain of frequent urination, (cystitis-like condition but, not cystitis) and after 5-6 days they begin to feel well. Sometimes they follow their neighbour’s advice, take medicine and the symptoms disappear, while in fact the disease becomes chronic. As a result, under this seemingly healthy conditionthey do not consult the doctor, and the fact, that pregnancy does not occur, starts to worry them in a couple of months time. After the consultation patient is being diagnosed with Ureaplasma – a sexually transmitted disease (STI).

The quality of sperm is being affected by Sexually transmitted infections, but once they managed to get rid of the infection and it no longer disturbs the patient, the sperm may be easily retrieved. STI brings about various changes. In the organism of a woman inflammatory processes start to activate. Fallopian tubes, where the sperm meets the oocyte (egg) and fertilizes it, are the main target for inflammatory processes.

E.g. Chlamydia causes adhesions in the fallopian tubes, hence the couple faces the problem of infertility. That is precisely why, I am for undergoing medical examinations before getting married. In my practice I have met couples who decided on passing medical exams beforehand. I highly appreciate their initiative and I do believe, that this is a matter of national mentality. Often girls are consistent with their exams, while men are reluctant to undergo medical exams before marriage and generally avoid it. On should break this stereotype.

Another major cause of infertility is Anovulation – an ovulation disorder, that may be caused by Polycystic ovary syndrome with its highly expressed symptoms. Let me state, that this is a widely spread disease among Armenians. Besides this, anovulation may be caused by hormone disorders alike.

Cervical mucus plug is one of the factors, that causes infertility. Generally cervix mucus must be viscous, so that the spermatozoa manage to pass through cervix and meet the oocyte (egg).

Unfortunately, the Syndrome of premature ovarian failure has tendency to grow. The Syndrome of premature ovarian failure is common among women up to 40.

Moreover, very often women become career women, and devote their life to the job. At a certain age (40 or older than 40) they determine to have a child.  Before visiting our center they usually do Folliculometry during several months and examine ovulation in their organism.

Very often, they are told that everything is within the norms, and that they have all the chances of getting pregnant. But let me state, that not all follicles contain eggs. But every problem has its way out ! Donor egg is the solution to the problem. The results of hormone tests reveal that the ovaries are already in the phase of atrophy, i.e. the eggs are no longer fertile.

Last but not least, every woman at the age of 40 or older mustn’t hesitate to consult gynecologist-reproductologist, regardless the fact she is pregnant or not.

 

When should one start to consult a gynecologist?  Do preliminary medical examinations lower the rate of infertility?

-It is worth mentioning, that the couple must get certain medical tests, preferably before marriage. Women should get infection and hormone tests, as well as Ultrasound diagnosis (USD). Men should get sperm and infection tests. The earlier the problem is diagnosed, the easier it is solved and as a result, the patients avoid further complications.

Women under 35 years are diagnosed with infertility if pregnancy does not occur during 1 year of having a regular sexual life, while women over 35 are diagnosed with infertility if  pregnancy does not occur until 6 months of regular sexual life.

What kind of lifestyle should the couple lead in order to avoid fertility problems?

-They should not commit adultery, and should have monogamous marriage.

– Is the way of pregnancy management dependant on the type of fertilization? Are there certain indications and contraindications that are given to a woman?

– There is no difference between pregnancy, which occurred with the application of assisted reproductive technologies and pregnancy, which occurred naturally – without using assisted reproductive technologies, but in the first case the risk of complications of pregnancy is even greater, as these patients have a comprehensive obstetric-gynecological history. After the completion of IVF (In Vitro Fertilization) there are various specific features of pregnancy management.

For example, the rate of spontaneous miscarriage risk during the first trimester of pregnancy is 30-70%.