DEFINITION OF INFERTILIITY

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• Conception rate of couples in reproductiveage group is 18-20% monthly and 85-90% at the end of 12 months. The remaining 10-15% is described as infertile.

• In 35% of infertile couples, the problem is in women, 35% in men and 20% in both. In 10% of couples it is not possible to identify any problem with current diagnostic methods. This situation is called Unexplained Infertility.

• The following structures and processes should be expected to be normal for pregnancy;

• Normal male and female anatomy (Vagina, cervix, fallopian tubes  and  uterus)

• Regular vaginal sexual intercourse

• Female and male germ cells in normal function (Gamet)
  This is how the system works; Sperm in the semen pools in the vagina, they move  through endocervical canal, endometrium and reach the fallopian tubes with the facilitating effect of secretions in the cervix. In the meantime, ovulation occurs from the ovary and oocyte is captured by mobile distal portion of the fallopian tube. If there are appropriate conditions and communication, oocyte is fertilized by a single sperm in the region of the fallopian tube called ampulla and embryo is formed. The embryo, which is formed by the process of division and maturation in itself, reaches into the uterus after a journey of about 5-7 days and attaches to the inner membrane of the uterus prepared with hormonal effects and begins to develop.
  
  Female Factors:

• Problems with  Ovulation: Ovulation disorders with irregular menstruation or absence of ovulation are the most common problems.

• Congenital or Acquaired abnormalities of Female Genital Tract
    *  Abnormalities related to shape and structure of the uterus.
       - Septum witin the uterus ( Septate Uterus)
       - Double-horned uterus ( Bicornuate)
       - Two seperate uterus and seperate cervix ( Didelphys)
       - T Shaped Uterus
    * Obstruction of Fallopian Tubes
    * Dilatation and fluid collection within the fallopian tubes
    * Deformation of endometrial cavity due to a mass ( Fibroid, Polyp)
    * Adhesion of uterine walls, usually after a curretage or operation
  
  Male Factors
   * Problems related to hormones secreted by the Central Nervous System regulating testicular functions.  
   * Problems related to sperm production in testis.
   * Problems related to passage of sperm cells from testis 
  
  Factors Affecting Both Sexes:
  * Environmental and work-related factors
  * Chronic Alcoholism
  * Toxic effects due to smoking, cannabis and drugs
  * Excessive exercise
  * Improper diet resulting in excessive weight gain or loss
  * Advanced age          

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