INFERTILITY

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DETERMINING THE CAUSES AND THE PROGNOSIS

Infertility is a condition when pregnancy is not occurring during 1 year period of regular unprotected sexual life of a couple.

According to data in Georgia, in 40% of cases causes of infertility are females, in 40% – males and in 20% – both. Foreign data are slightly different (see the attached diagram).

Causes of infertility – female factor:

1. Ovarian factors

  • Polycystic ovary syndrome (chronic anovulation)   
  • Premature ovary exhaustion
  • Hypothalamic amenorrhea

2. Tubo-peritoneal factors

  • Pelvic adhesions 
  • Endometriosis 
  • Tube obstruction

3. Cervical factors

  • Cervical stenosis 
  • Cervicitis 
  • Sperm block (immunological factors)

4. Interruption of sperm penetration into vagina (vaginismus)

Causes of infertility – male factor:

1. Pathospermia

  • Idiopathic oligozoospermia (most frequent cause)
  • Azoospermia
  • Necrospermia
  • Spermatozoids agglutination, lysis and capacitation disorder

2. Varicocele

3. Other

  • Duct obstruction (Post-infectious epididymitis, post-vasectomy obstruction)   
  • Interruption of sperm penetration into vagina (hypospadia, erectile dysfunctions)

In order to determine the causes of infertility the Center for Reproductive Medicine “Universe” has implemented and effectively uses all advanced highly informative methods – hormonal, immunological, genetic, ultrasound (4D) investigations, X-ray hysterosalpingography in dynamics, hysteroscopy, laparoscopy, sperm quantitative and qualitative study, determination of DNA fragmentation index, etc. 

SELECTION OF MANAGEMENT TACTICS AND TREATMENT

High efficiency of treatment of infertility at the Center for Reproductive Medicine “Universe” is due to the complex, intensive assessment of the couple, possibility to adequately manage all types of detected pathologies (conservative and surgical treatment, assisted reproductive technologies, etc).

In selecting the infertility management tactics, specialists of the clinic consider so-called “golden standard” – in-vitro fertilization is not offered to infertile couple as the first choice, however, neither the unsuccessful conservative treatment lasts for years! If 2-year conservative and/or surgical treatment does not give a positive result, clinic team starts selection of appropriate method of assisted reproductive technology for the couple (intra-uterine insemination, in-vitro fertilization, donation, surrogacy). However, in some cases, when particular investigations predict “bad prognosis” – fertility incompatible and irreversible pathologies (primary ovarian failure or premature exhaustion syndrome, aplasia of the uterus, azoospermia in males, severe oligozoospermia, etc), selection of appropriate method of assisted reproductive technology for the couple is started on the very initial stage. It should be mentioned here that the clinic is paying great attention to the preparation for in-vitro fertilization, which involves conservative and sometimes surgical treatment stages.

The CRM “Universe” gives a special significance to the special antenatal surveillance of women treated for infertility in case their pregnancy occurs.