For many couples dreaming of having a child, this journey can sometimes be longer and more challenging than expected. Infertility can become a physically and emotionally draining process. However, thanks to advancements in modern medicine, there are many promising treatment options available today for couples struggling with infertility. The important thing is to meet with a specialist doctor like Prof. Dr. Kubilay Vicdan at the right time and determine a personalized roadmap for you. So, what are the symptoms of infertility and when should you consult a specialist?
Definition and Prevalence of Infertility
Infertility, or medically speaking, infertilite, is defined as the inability to achieve pregnancy after one year (or six months for women over 35) of regular, unprotected sexual intercourse. These durations are considered thresholds for couples to seek expert advice. Infertility is not solely a problem belonging to either the woman or the man; it is a common condition affecting approximately 15% of couples. Infertility can be categorized into two main types: primary (never having achieved a pregnancy) and secondary (having achieved pregnancy before but being unable to conceive again). In both cases, accurately diagnosing the underlying causes and creating a personalized treatment plan are of great importance.
Warning Signs in Women
In women, infertility symptoms often manifest as irregularities in the menstrual cycle or through past health issues. These signs can be important indicators requiring a visit to a specialist:
- Irregular or Painful Menstrual Periods: Menstrual cycles that are too short (less than 21 days) or too long (more than 35 days), excessively heavy or very light bleeding, severe menstrual pain (dysmenorrhea), or absence of periods (amenorrhea) can indicate ovulation problems or conditions like endometriosis. Irregular ovulation, in particular, directly impacts the chances of pregnancy.
- PCOS (Polycystic Ovary Syndrome) Symptoms: Irregular menstrual cycles, excessive hair growth (hirsutism), acne, weight gain, and polycystic appearance of ovaries on ultrasound are typical symptoms of PCOS. PCOS is one of the most common causes of infertility in women.
- History of Pelvic Infections or Sexually Transmitted Diseases: Past pelvic inflammatory diseases (PID) or sexually transmitted infections like chlamydia and gonorrhea can lead to blockages or damage in the fallopian tubes, causing infertility.
- Previous Abdominal or Pelvic Surgeries: Abdominal surgeries such as myomectomy, ovarian cyst removal, appendectomy, or bowel surgeries can cause intra-abdominal adhesions, impairing the function of the fallopian tubes.
- Recurrent Miscarriages: Two or more consecutive pregnancy losses can indicate underlying genetic, hormonal, or structural problems and require a detailed evaluation.
- Age Factor: As women age, the number and quality of their eggs decrease. Fertility potential significantly declines after the age of 35, and this decline accelerates after 40. Therefore, it is recommended that older women consult a specialist sooner.
Warning Signs in Men
In men, infertility symptoms may not be as obvious as in women and are often related to sexual function or physical examination findings. However, the following conditions are important signs that warrant a consultation with a specialist:
- Sexual Dysfunction: Erectile dysfunction, ejaculation problems (premature ejaculation, delayed ejaculation, or inability to ejaculate), or decreased sexual desire (low libido) can contribute to infertility.
- Pain, Swelling, or Lumps in the Testicles: A palpable lump, pain, or swelling in the testicles could be a symptom of varicocele (enlargement of veins in the scrotum) or another issue. Varicocele is a common condition that can negatively affect sperm quality. Methods such as TESA / TESE / Micro TESE can play an important role in male factor infertility treatment for sperm retrieval.
- History of Undescended Testicles or Testicular Trauma/Infection: A history of undescended testicles in childhood, testicular trauma, or infections like mumps can have lasting effects on sperm production.
- Symptoms of Hormonal Imbalance: Symptoms such as decreased body hair, loss of muscle mass, or gynecomastia (enlargement of breast tissue in men) can indicate hormonal imbalances.
- Previous Cancer Treatments: Sperm production can be permanently affected in men who have undergone chemotherapy or radiotherapy in the past.
When to Seek Medical Help
Seeking medical help at the right time is one of the keys to success in infertility treatment. Generally accepted timelines for consultation are as follows:
- For Couples Under 35: If pregnancy is not achieved within one year of regular, unprotected sexual intercourse, a specialist should be consulted.
- For Women Over 35: If the woman is 35 years or older, this period is reduced to six months. As egg reserve and quality rapidly decline with age in women, time is a much more critical factor.
- For Women Over 40: Women aged 40 and above are advised to consult a specialist immediately upon starting to plan a pregnancy, or if pregnancy does not occur within a very short period (e.g., 3 months).
However, there are situations that require consulting a doctor without waiting for the above-mentioned periods:
- If there is a known history of ovulation disorder (such as PCOS), endometriosis, fallopian tube blockage, or previous pelvic surgery in the woman.
- If there is a known history of sperm problems, varicocele, undescended testicles, or previous testicular trauma/infection in the man.
- If the woman experiences irregular or excessively painful menstrual cycles.
- If either partner has a history of sexually transmitted diseases.
- If recurrent miscarriages have occurred.
In such cases, consulting a specialist without delay is critically important for early diagnosis and treatment initiation. At Ankara IVF Center, we conduct a detailed evaluation to determine when IVF or other assisted reproductive technologies might be suitable for you.
What Happens During the First Consultation?
When you visit Ankara IVF Center with suspected infertility, a comprehensive evaluation process is initiated by Prof. Dr. Kubilay Vicdan and his team. This process is crucial for making an accurate diagnosis and determining the most appropriate treatment path for you. The first consultation typically involves the following steps:
- Detailed History Taking (Anamnesis): Detailed information is gathered from both male and female partners, separately and together, regarding their medical history, sexual history, lifestyle, medications used, past surgeries, and family history. For women, menstrual regularity, pregnancy history, and miscarriages are inquired about; for men, sexual functions, previous infections, and childhood diseases are discussed.
- Physical Examination: In women, a gynecological examination and ultrasonography are performed to evaluate the uterus, ovaries, and fallopian tubes. In men, the size and consistency of the testicles and the presence of conditions like varicocele are checked.
- Tests for Women:
- Hormonal Blood Tests: Hormone levels such as FSH, LH, E2 (estradiol), Prolactin, TSH, and AMH (Anti-Müllerian Hormone) are measured on specific days of the menstrual cycle to assess ovarian reserve and hormonal balance.
- Pelvic Ultrasonography: The uterine structure (anomalies such as fibroids, polyps), the condition of the ovaries (cysts, PCO appearance), and the antral follicle count are evaluated to provide information about egg reserve.
- Hysterosalpingography (HSG): The shape of the uterine cavity and the patency of the fallopian tubes are checked. Blockages or damage in the tubes can prevent pregnancy. If necessary, advanced imaging and surgical methods such as Laparoscopy & Hysteroscopy may also be considered.
- Tests for Men:
- Semen Analysis (Sperm Test): The number, motility, morphology, and other characteristics of sperm are examined in detail. This test is the fundamental step in diagnosing male factor infertility.
- Hormonal Blood Tests (if necessary): If abnormalities are detected in the sperm test, hormone levels such as testosterone, FSH, and LH may be checked.
- Genetic Tests: In situations where deemed necessary (e.g., recurrent miscarriages or severe male factor), genetic tests may be recommended for couples. Genetic Diagnosis (PGT) can help evaluate the genetic health of embryos in some cases.
Following all these tests and evaluations, Prof. Dr. Kubilay Vicdan will create a personalized treatment plan for you based on the findings. This plan may include intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or other assisted reproductive technologies. Throughout the treatment process, it is important to communicate openly with your doctor and not hesitate to ask all your questions.
When you encounter infertility symptoms on your journey to parenthood, instead of despairing, taking professional help at the right time is the most important step. Thanks to modern medicine and experienced specialists, your chances of achieving your dreams are higher than ever. As Ankara IVF Center, founded by Prof. Dr. Kubilay Vicdan and our expert team, we are proud to stand by you during this challenging process and offer you the most up-to-date treatment methods. Remember, early diagnosis and personalized treatment planning increase your chances of success.
To take another step towards your dreams and learn about your personalized treatment options, you can schedule a free initial consultation. We look forward to meeting you and guiding you on this journey.