Having children is the dream of every married couple, but not every couple is blessed with children quickly. For couples who have been married for more than 1 year but have not gotten pregnant, there is a possibility of experiencing fertility problems. Impaired fertility and the inability of a woman to get pregnant and have children is known as subfertility. In Indonesia, the treatment for fertility disorders is better known as the Pregnant Program.
What is fertility disorder / infertility?
Infertility is defined as the inability of a woman to get pregnant and have children after marriage and have regular intercourse with her husband for more than one year, without using contraception.
Couples of childbearing age usually check with obstetricians and gynecologists (Obstetrics & Gynecology Specialists) to undergo a pregnancy program, by identifying the causes and trying to find solutions to the problems they face.
According to the World Health Organization (WHO), one in four couples of childbearing age in developing countries experience infertility problems. WHO data even estimates that more than 186 million women of childbearing age in developing countries cannot have children.
With the progress of the medical world, there has been a method to overcome the problems of every couple who never get offspring, namely by getting pregnant.
Pregnant program as a solution to fertility disorders
The pregnant program is a method that has been proven successful in increasing pregnancy rates. This method includes comprehensive diagnosis and treatment of women and their partners. One third of infertility causes are problems in women. One third is a problem in men. And one third is a problem in the combination of the two (husband and wife) or even the cause is not found ( unexplained ).
As we know that pregnancy is the result of several processes. The process of a woman releasing an egg from the ovary is called ovulation. The egg must be able to pass through the fallopian tube to the uterus. Sperm must be able to fertilize a woman's egg. And the fertilized egg must be able to attach and grow in the uterus, which is better known as the implantation process. Infertility occurs, if problems are found in the process mentioned above.
What are the causes of infertility?
Infertility problems in women are caused by disruption of the ovulation process. The most common ovulation problem with infertility is PCOS ( Polycystic Ovary Syndrome ). Other causes such as blocked fallopian tubes, uterine abnormalities or myoma in the uterus.
Meanwhile, infertility in men is due to sperm disorders, low sperm count, impaired sperm movement or abnormal sperm shape. In men, the most common cause is varicocele.
Variety of fertility therapies
For couples who want to have children but find it difficult to get pregnant, they can try a variety of pregnancy programs that are adapted to the conditions of the couple.
Fertility therapy using drugs
The drug most often used in women for ovulation induction is clomiphene. The newest drug for fertility therapy that is currently available is letrozole. This medicine is usually taken from the second day to the sixth day of menstruation. This drug is primarily used in women with ovulation disorders, including PCOS patients. Another drug that can also be used in PCOS is metformin. Ovulation induction with clomiphene or letrozole is not recommended for use more than six times if pregnancy has not been successful. There are also other drugs in the form of injections for ovulation induction with better success rates, but at a much higher cost than the oral medication.
Intrauterine insemination?
Insemination is a method of inserting washed sperm into the uterus using a special tool. Usually the patient will receive ovulation induction drugs before insemination. And then evaluate the size of the follicles in the ovaries with Transvaginal ultrasound (ultrasound through the birth canal). In this case Transabdominal ultrasound (ultrasound on the abdominal wall) cannot be used to clearly evaluate the growth of the egg. After obtaining a sufficiently mature follicle, an egg breaking injection is usually given (36 hours before the insemination procedure).
Insemination is usually done with certain indications, for example if you haven't succeeded in getting pregnant after six times of clomiphene. Or in mild sperm disorders, uterine fluid disorders or in couples with unexplained infertility (infertility for which no cause is found).
IVF Program (IVF)?
IVF is a method of fertilizing an egg by sperm outside the body. Currently, IVF is the most effective method of fertility therapy. IVF is used in women with blocked fallopian tubes, or husbands with very low sperm counts. Medicines will be given to the mother so that the ovaries produce enough egg cells. The egg will be collected and the best quality sperm will be injected into the egg in a laboratory. Three to five days later, the best results of fertilization will be inserted into the mother's womb.
EMC has a Pregnancy Program service with insemination and IVF Center in collaboration with INDO Fertility and IVF Center by Happy Reproductive Family supported by quite the latest methods. As the best fertility service center and supported by Obstetrics and Gynecology specialists who graduated at home and abroad, has international standards (Royal College Obstetrician & Gynecologist). Do a consultation beforehand about fertility disorders you are experiencing to get the best infertility therapy.
Article written by dr. Handojo Tjandra MD, Mmed O&G (M'Sia) SpOG (Obstetrics and Gynecology Specialist at EMC Alam Sutera Hospital).