Fertility - Infertility
Infertility
Infertility primarily refers to the biological inability to achieve a pregnancy and affects one in six couples. A couple is considered infertile if they have failed to conceive after one year of unprotected intercourse.
Female infertility accounts for approximately 35% of the cases, male infertility another 35%, and a combination of both male and female factors attributes to 20%. The etiology is unknown in the remaining 10% of the cases, and is termed unexplained or idiopathic infertility.
At the Gynaecology & Fertility Centre the diagnosis and specialized fertility treatment plan is adjusted to the needs of each couple and applied using cutting edge medical technology and protocols in accordance to the latest international directives.
The couple's chances of success are mainly determined by the woman's age, the causes of infertility and the medical team managing their treatment.
Head of the Gynaecology & Fertility Centre is Dr Elias G. Tsakos MD (Hons), FRCOG, DFFP, CST, trained and certified in the United Kingdom.
Causes of infertility
Female
Polycystic ovarian syndrome, fallopian tube abnormalities, endometriosis, poor quality oocytes - premature ovarian failure, polyps - fibroids, endometrial adhesions, hormonal imbalance, etc.
Male
Varicocele, prostatitis, undescended testicles, sexual dysfunction, hormonal imbalance, idiopathic oligoazoospermia, etc.
Other causes compromising fertility
Female
Gynaecological surgeries, abdominal surgery (eg appendicitis, etc).
Miscarriages (spontaneous - medical), abnormal menstrual cycle, ovarian cysts, fibroids, endometrial polyps, history of salpingitis, polycystic ovaries, hormonal imbalance, obesity - depression, etc.
Male
Unhealthy occupation (overexposure to chemicals, toxins, drivers, etc), smoking - stress, history of varicocele, prostatitis, undescended testicles, etc.
Couple
Couple's age (woman > 35 and husband > 40), unhealthy lifestyle (stress, smoking, poor nutrition, lack of exercise), sexual dysfunction, etc.
Recommendations to a couple planning a pregnancy
Female
• Folic acid
Daily supplementation with folic acid is recommended to all women. Folic acid is necessary for the normal formation of the embryonic neural tube and helps protect against malformations of the spine, skull and brain, such as spina bifida, anencephaly, etc.
• Prenatal tests
Blood type - Rhesus, thalassemia - sickle cell anemia, antibodies for Rubella, Toxo, CMV, Hepatitis B & C, VDRL, HIV I-II, etc.
• Hormonal check-up
FSH, LH, Estradiol, Prolactin, TSH, T3, T4, Testosterone.
Male
• Vitamins E and C
Daily supplementation of vitamins E and C is recommended, particularly for men with poor semen quality.
• Prenatal tests
Blood type - Rhesus, thalassemia - sickle cell anemia, antibodies for Hepatitis B & C, VDRL, HIV I-II.
Couple
A healthy diet is recommended, as well as exercise, a positive attitude, no smoking, limited consumption of alcohol, etc. Moreover, a medical assessment will determine what gynecological tests are required (according to the couple’s characteristics, such as age, medical history, existing problems, etc).
Basic fertility tests
Female
• Ultrasound of reproductive organs
• Hormonal tests
FSH, LH, Estradiol, Prolactin, TSH, T3, T4.
• Salpingography
This is carried out by a radiologist and provides a visual picture of the uterus (endometrium) and the fallopian tubes. In case of some abnormality, a laparoscopy or hysteroscopy is recommended.
Male
• Semen analysis and culture
Two samples should be examined at a time interval of 1 to 2 months.
Specialised fertility tests
Female
• Hysteroscopy
A hysteroscopy is a detailed inspection of the uterine cavity through the cervix. It allows for the simultaneous diagnosis and treatment of possible pathologies. It is recommended in cases where a problem was diagnosed during an ultrasound or salpingography, before IVF or after an unsuccessful IVF cycle.
• Laparoscopy
A laparoscopy involves an inspection of the internal reproductive organs and their treatment, if necessary. It is recommended for conditions of the fallopian tubes, ovarian cysts, endometriosis, etc, as well as in cases of unexplained infertility, particularly in young women.
• Blood tests
Hormonal tests are carried out as necessary in each case (e.g. androgen levels, glucose and insulin tests in cases of women with polycystic ovaries), thrombophilia testing, karyotype, autoimmune tests, etc.
Male
• Assessment by a Urologist - Andrologist
• Semen analysis carried out by a Biologist specializing in reproduction
Semen analysis, sperm enhancement, sperm DFI test, etc.
• Hormonal tests - karyotype
Fertility services
• Evaluation and screening of subfertile couple
• Workup and outline of individualized treatment plan
• Surgical treatment, if necessary
Laparoscopy: diagnostic salpingography, treatment for polycystic ovaries and endometriosis, treatment of ahesions in the fallopian tubes, etc.
Hysteroscopy: cervical dilation, treatment of endometrial adhesions, removal of endometrial polyps – fibroids, treatment of uterine septum, etc.
• Ovulation induction
• Intra-Uterine Insemination (IUI)
• In Vitro Fertilization (IVF) and Intra-Cytoplasmic Sperm Injection (ICSI)
• Written instructions and protocols
• Fertility Seminars every 6 months for interested couples and doctors.
• Website www.gynfert.com regularly updated with current fertility news and topics of interest.
The Gynaecology & Fertility Centre is open 9 am to 9 pm with secretarial support and 24-hour medical emergency service.
