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Infertility

Infertility

Getting pregnant

The very first conversation with an infertile couple needs to be focused on their education with the aim of increasing their chances of getting pregnant. If there are no absolute obstacles for conceiving, the couple is recommended to ha...
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Menstruation

Menstruation or period is a monthly bleeding from the uterus and represents the shedding of the inner lining of the uterus under the influence of hormones produced in a woman’s body. The hypothalamus begins to secrete GnRh which induces...
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Fertility

In the most normal natural circumstances fertility of women is low. Fecundability is defined as the probability of conceiving within a single menstrual cycle and in healthy couples it is around 25%. This means that if a healthy young co...
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Ovulation

Ovulation is a moment when the follicle releases an egg, which can be fertilized in the next 24 hours. The egg is alive for 24 hours, whereas the sperm can live up to three days. This means, a woman can get pregnant only during these fo...
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Coping with Psychological Issues

Most couples faced with the diagnosis of infertility are unaware of the physical, psychological and financial burden the infertility will bring on them. This provides for a specific role of counseling of the infertile couple’s road to f...
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Weight loss

The first step an obese woman needs to make if she wants to get pregnant is to lose body weight. Almost half of women with PCOS are obese. Obesity is defined as having the body mass index (BMI) above 25. A large number of authors have r...
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Infertility – Where to Begin

Around 15% of the world population has infertility problems regardless of a country's development. This makes it an important problem of public health. 85% of couples practicing unprotected sex will conceive during the first year of try...
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Basic findings for IVF

The process of diagnosing infertility begins by talking to a woman. Anamnesis of a woman (a case history established by interviewing a woman) with infertility problems, among others, includes the following: Time of first period (me...
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Checking for Ovulation

Calendar Method It is based on monitoring the duration of the menstrual cycle. If the cycles are regular, women ovulate 14 days prior to their next period so this method can be used to calculate the time of ovulation. If the cycl...
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Ultrasound

Ultrasound examination, even though quite frequently used nowadays, is not at all simple. Ultrasound of two organs, uterus and ovaries, can sometimes be rather complex and difficult to interpret. The reason is that uterus, its lining an...
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Hormonal Status

When treating infertility it is common to ask for a so-called hormonal status of a woman. Although in cases of young and healthy women with regular periods the status mostly shows no abnormalities, the simplicity of treating certain dis...
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Hysterosalpingography (HSG)

Hysterosalpingography (HSG) is a method of examining patency of Fallopian tubes. For a woman to conceive, tubes must be intact. As they are of very fine structures, if there is no damage, they are not visible by ultrasound. HSG is norma...
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Office Hysteroscopy

Histeroscopy (HSC) is a procedure done often in the process of diagnosing and treating infertility, which enables us to see inside the uterine cavity, using the small camera. The problems can be detected in up to 30% of infertile patients...
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Laparoscopy

Laparoscopy is a direct inspection of abdominal cavity, ovaries, external walls of ovarian tubes, uterus (as well as other organs in the abdominal cavity if laparoscopy is performed for non-gynecological purposes) by using laparoscope. L...
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Testing the Male Partner

The very first step in testing the male partner is to analyze semen sample. We do this following the World Health Organization (WHO) 2010 standards. These tests are controlled by an independent control done by Quality Control Programme of...
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Intercourse Frequency

Some couples are not aware of the fact that they do not have intercourse often enough or at the right time. World Health Organization recommends, in order to reduce the stress on the couples, to have intercourse every 2 or 3 days during a...
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A Woman’s Age

Today one of the most important reasons of infertility is a woman's age. A woman is born with a predetermined number of eggs / oocytes (6-7 million). From birth, the number is on the decline and new oocytes cannot be produced. A calculation...
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Low Ovarian Reserve

Ovarian reserve is an expression for the supply of egg cells or follicles. Quantity, as well as quality of egg cells, reduces with age which means that the ovarian reserve decreases. Women are born with approximately 6-7 million egg cells,...
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Anovulation and PCOS

The only time a woman can conceive is during ovulation. Some women ovulate rarely or even never, thus reducing their chances of having a child. The most common example of non-ovulating women are women with polycystic ovarian syndrome (PCOS)...
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Amenorrhea

Amenorrhea, or a complete absence of a menstrual period, is a symptom, not a disease. Many reasons may cause this symptom, and diagnosing amenorrhea is one of most difficult tasks a gynecologist can face. However, reasons are mostly simple....
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Male Factor

Even today infertility is considered to be a female problem although we are facing male factor as a growing infertility factor. Today we assume that in 30% cases of infertility the reason is a male factor, and in additional 20-30% cases b...
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Damaged Fallopian Tubes

A place where a sperm and an egg meet is the fallopian tube. If it is damaged the conception will either fail or will occur, but the fertilized egg will not reach uterus thus resulting in ectopic pregnancy. Women who are likely to have thei...
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Endometriosis – Adenomyosis

Endometriosis is a chronic gynecological condition in which cells from uterine lining are found outside uterus (mostly in the abdomen, but also in other tissues and organs). As these cells are sensitive to hormonal changes, even when in a...
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Congenital anomalies

Congenital anomalies, or malformations of female reproductive tract, are quite common. In a female fetus at its fetal stage, so-called Müllerian ducts must develop and fuse in order to grow uterus, cervix and fallopian tubes. Two paired...
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Natural Cycle

If you and your doctor decide on the procedure in a natural cycle (or as it is called in medical terminology a modified natural cycle – since one drug is given, i.e. hCG injection), the first follicle ultrasound exam should be performed bet...
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Clomiphene citrate and letrozole

If a weight loss fails or in cases of non-obese patients, the drug of choice for ovulation induction in patients with no ovulation is chlomiphene citrate (CC). It induces ovulation in 70-85% of patients, although only 40-50% of them manag...
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Mild Stimulation for IVF

In mild stimulation of ovulation clomiphene or letrozole pills are taken for five days usually starting at day 3 of the cycle, although the treatment could be started sooner or later than day 3. This is decided by the doctor, depending on...
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Standard Stimulation for IVF

Stimulation of ovulation (synonyms are superovulation or ovulation induction) for IVF comprises of using some medication which will lead to ovulation of one or several follicles, depending on the procedure that is planned in that cycle. In...
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Therapy before IVF

Contraception Pills Contraception pills are commonly used before the planned procedure of assisted fertilization, especially before planned IVF/ICSI in the long protocol. One reason is because in the long protocol treatment with GnRh agonis...
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