Infertility is diagnosed when couples who have a desire for pregnancy do not achieve pregnancy for one year despite regular unprotected intercourse. This period is limited to 6 months if the age of the expectant mother is over 35. Firstly, 3 tests are recommended. These are; sperm analysis, hysterosalpingography (uterine x-ray test) and hormonal tests of the expectant mother. Male factor infertility, i.e. a problem in the sperm test, changes the treatment plan. If there is no sperm (azoospermia) and no functional sperm is found in the testicular biopsy, sperm donation can be performed. The hormone levels of the expectant mother are evaluated and the ovarian reserve is assessed with the AMH result. Thyroid hormones and prolactin hormone disorders are treated. HSG (hysterosalpingography), i.e. uterine x-ray, is a highly reliable test. With this simple imaging method, intrauterine adhesions, structural anomalies of the uterus, adhesions in the tubes or hydrosalpinx (fluid accumulation in the tubes) can be easily detected. Unexplained infertility is diagnosed if the expectant mother has regular periods and all tests are normal. Mild disorders in sperm motility can be treated within a few months with smoking cessation and antioxidant supplements. Severe sperm disorders require direct in vitro fertilisation. If there is a severe bilateral obstruction in the tubes, IVF treatment is necessary. Adhesions in the uterus can be removed by hysteroscopy. Pathological conditions such as fibroids or polyps in the uterus can also be operated by hysteroscopy. If there is a severe decrease in ovarian reserve, it is also recommended to start in vitro fertilisation treatment as soon as possible. It is important to note that the number of eggs decreases with each passing month. In case of completely depleted ovarian reserve or menopause, egg donation would be the right option. In addition to these infertility tests and treatments, pre-pregnancy tests should also be performed. Systemic diseases that may cause problems in pregnancy should also be taken under control. If there are any vitamins deficiencies, they should be supplemented before treatment, and folic acid and vitamin B12 should be taken. In IVF treatment, each couple is evaluated and treated individually.
