Fertility Specialists Tell You About Tests and Treatments for Successful PregnancyObstetricians and Gynecologists Heesun Lee, Myunghee Kim, Hyunjung Jung

Older pregnancies are increasing due to late marriages, and worries about pregnancy are increasing due to the use of hair loss medications. There are a wide variety of visits, ranging from those caused by azoospermia in men and chronic vaginismus in women, to those who have been Dinks for a long time after marriage and are now elderly. Currently, my husband's participation in fertility treatment is much higher than in the past.

 

Infertility doesn't necessarily occur due to older age, and women in their 20s may experience infertility due to low AMH, the hormone that determines whether or not they can become pregnant. Even if you have a low AMH, the quality of your eggs is good when you are young, so if you continue with fertility treatment, you can succeed in getting pregnant.

*AMH: Anti-Mullerian Hormone, secreted from the follicle, which is the sac of the egg, and a high level of AMH means that there are many follicles to ovulate in the ovary, while a low level means that there are no follicles to ovulate, which means that the person is close to menopause.

 

2. Mandatory pre-pregnancy tests

What tests are required before pregnancy?

 

There are five tests you should do before you can have a healthy baby:

 

It should be done in both men and women, and it is a blood test to check for syphilis and hepatitis B.

 

Urinalysis is performed for men and vaginismus for women to check for the detection of bacteria such as chlamydia. Sexually transmitted diseases can cause infertility, fetal infections, miscarriage, premature birth.

 

Women who are expecting a baby are tested for rubella, chickenpox, and measles antibodies. If you don't have antibodies, you should get vaccinated and plan to get pregnant after a certain period of time, because they can cause malformations in the fetus.

 

An AMH test, which measures the degree of ovarian function, and an ultrasound are performed to check for uterine fibroids and malformations.

 

Measure the amount of semen, sperm concentration/motility/straightening speed/egg fertilization. In order to improve the accuracy of the test before semen test, a period of abstinence should be taken from 3~4 days in advance.

 

3. Precautions for a Successful Pregnancy

What do I need to do to get pregnant?

 

In order to have a healthy pregnancy, you need to be careful of things that directly or indirectly affect pregnancy and childbirth.

 

First of all, you need to abstain from alcohol and quit smoking. In order to have a healthy pregnancy, you need to stay away from drinking alcohol, which causes persistent metabolic problems. It is recommended to abstain from alcohol during menstruation as much as possible. We all know that smoking also has a negative impact on pregnancy. Both women and men should quit smoking during the woman's ovulation period. Recently, a study has been published showing that secondhand smoke from the fetus caused by the father causes early menopause in the child, so it is recommended that you quit smoking.

 

You also need to take care of your BMI* index. Obesity in women can disrupt hormones, making it difficult to conceive, and high BMI in men can affect sperm, so both women and men need to keep their BMI at a moderate level for a healthy pregnancy.

*BMI: A measure of obesity that uses body mass index, height and weight to estimate the amount of fat

 

4. Fertility treatments

How is infertility treated?

 

There are three types of treatment based on the results of the screening.

 

First, the drug

If there is inflammation, it is difficult to conceive or maintain a pregnancy, so it must be treated with antibiotics. In addition, if you have difficulty getting pregnant due to irregular menstrual and ovulation cycles, you can try ovulation inducing drugs such as Letrozole/Femara/Bretra. In addition, when the thyroid secretion hormone or lactation hormone is excessively high, ovulation disorders or luteal phase defects may occur, so endocrinological drug treatment should be carried out.

 

Patients suffering from chronic vaginitis due to the poor sterilization of vaginal lactic acid bacteria can prescribe lactobacillus vaginal tablets to improve the microbial environment in the vagina.

 

If you have low levels of vitamin D, which is responsible for the release of substances that aid in the maturation and implantation of eggs, you may be able to conceive immediately if vitamin D is prescribed.

 

Second, surgery

The conditions for natural pregnancy are that sperm must be able to travel to the fallopian tubes, that there are no abnormalities in the fallopian tubes, and that there are no implantation obstructions in the uterus itself. However, if the examination results indicate that there are many bumps in the uterine lining or if the fallopian tubes are blocked due to repeated PID, surgical treatment should be carried out because fertilization itself is difficult and interferes with pregnancy.

 

Endometrial polyps, fibroids, and endometrial adhesions are treated with hysteroscopic surgery, while intra-abdominal problems are treated laparoscopically.

 

There are many negative reactions to surgical treatment, but sometimes surgery can be a shortcut to pregnancy, so if you are struggling to conceive, you may want to actively consider surgical treatment.

 

 

Third, infertility treatment

15~20% of infertility is unexplained infertility. If you have infertility of unknown cause or if you need to become pregnant in a state of ovarian insufficiency due to premature birth, you should proceed with infertility procedures such as artificial insemination or IVF from the beginning.

 

Recently, the government has increased support for infertility treatments, and the burden of patients is up to 30%, and depending on the local government, some places will support up to 2023 infertility treatments from July 22, so you can check with the public health center in your area.