Tubal-Related Infertility (Tubal Factor)

Open and healthy fallopian tubes are necessary for pregnancy to occur. The fallopian tubes have a very delicate and complex internal structure. Any disruption in this structure may interfere with the transport of the egg and, consequently, with fertilization. If the end of the tube close to the ovary is affected, the capture of the egg and its entry into the tube may be impaired. The most severe condition, however, is complete blockage of the tube. Tubal obstruction may occur as a result of infections that reach the tubes through the genital tract, or it may develop due to other intra-abdominal infections. In addition, a patient may have lost one or both fallopian tubes as a result of an ectopic pregnancy.

Tubal factor infertility can be evaluated before starting infertility treatment by hysterosalpingography (HSG) and/or laparoscopic examination. During laparoscopy, problems involving the tubes, such as obstruction, adhesions, or damage, may be detected. Mild cases may benefit from microsurgical treatment. In cases of advanced adhesions or severely damaged tubes, the chance of pregnancy can generally be achieved only through in vitro fertilization (IVF).

Ovulation-Related Infertility (Ovulatory Factor)

A woman’s menstrual pattern provides important clues about ovulation. Irregular or abnormal ovulation is observed in approximately 25% of infertile women. Basal body temperature monitoring, special urine tests that detect LH, blood progesterone testing, ultrasonography, and endometrial biopsies taken from the inner lining of the uterus 1–3 days before the expected menstrual period for diagnostic purposes are among the tests that may be used to monitor ovulation.

Cervical-Related Infertility (Cervical Factor)

The secretion of the cervix allows sperm to pass freely only during the ovulation period. At all other times, due to changes caused by hormonal stimulation, the structure and consistency of cervical mucus do not allow free passage of sperm. In some women, antibodies against sperm may be present in this secretion. In such cases, even during ovulation, sperm may not be able to pass through the cervical canal and reach the uterus. Antibodies are substances produced by the woman’s immune system against sperm cells. These substances may impair sperm cell function and cause infertility. In this situation, performing a postcoital test may be sufficient for diagnosis.

Uterine-Related Infertility (Uterine Factor)

Abnormalities that alter the structure of the uterine cavity, where the embryo is expected to implant, are also among the possible causes of infertility. Hysterosalpingography (HSG) is one of the standard tests used to evaluate the inside of the uterus and the fallopian tubes. It should be performed shortly after the end of menstruation and before the ovulation period. Uterine problems diagnosed in this way can be planned for surgical treatment with the help of hysteroscopy. Hysteroscopy is a procedure in which the inside of the uterus, namely the endometrium where the embryo implants and develops, is directly visualized by passing a thin optical camera through the cervix. Click here to get more information about hysteroscopic surgery and to watch a sample video.

Endometriosis

Endometriosis, which is quite common among women of reproductive age, is a condition in which tissue similar to the lining of the uterus, called the endometrium, is found outside the uterus, such as on the ovaries or the inner lining of the abdomen. Since bleeding may also occur in these tissues during menstruation, the condition can cause severe pain. Endometriosis may also lead to the formation of dark brown ovarian cysts known as chocolate cysts or endometriomas. These cysts can be removed by laparoscopic surgery, and damaged tissues or endometriosis lesions can also be destroyed using thermal methods such as cautery or laser. Laparoscopic surgery provides many advantages for the patient, including a more comfortable postoperative recovery period. Click here to get more information about laparoscopic surgery and to watch a sample video.