Female and Male Infertility Treatments in Iran
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15% of couples in the world are facing the problem of infertility, and this statistic in Iran with 22% of infertility is higher than the world average. This problem has caused Iranian doctors to use the latest methods in the world in cooperation with advanced clinics to solve this problem and to become a leading country in the region.
In this article, after the initial examination of the concepts of female infertility and male infertility, we have examined the causes of infertility. And finally, we have explained the most common ways to treat male and female infertility in Iran.
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Our packages include:
- Infertility Treatment
Depending on the type of problem you or your spouse has, the most appropriate treatment process will begin for you.
Clinic and doctor visits, laboratory tests, Ultrasound, endoscopy, Infertility Treatment in hospital/clinic, post-operative care, medicines, recovery, and follow-up - Treatment Visa
After sending the required documents, all the process of obtaining a visa will be done by us and the visa code will be announced to you. - Medical Interpreter
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Three-star to five-star hotel offered which is preferably near the clinic or hospital
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During your stay and treatment in Iran, you will not have any worries about accommodation, transportation, translator and anything else. Depending on your taste and needs, VIP or economic services and hotels will be provided for you. Further details will be announced during the application process.
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Female and Male Infertility Treatments in Iran all you need to know
Pregnancy process
Fertilization occurs when an egg is fertilized by a sperm. Ovulation occurs about fourteen days before the start of the menstrual cycle, when an egg is released from one of the ovaries.
The egg moves to the fallopian tubes and the uterus. If the egg is fertilized by the sperm, it will be replaced in the layers of the uterus called the endometrium, which will lead to the beginning of pregnancy.
What is infertility?
Infertility does not mean permanent inability to have children. There may be disorders in the body that cause problems for pregnancy in women or men. By solving these disorders, problems related to pregnancy can be solved for sure.
In general, infertility means one year of regular sexual intercourse without prevention for a woman under 35 years of age that did not lead to pregnancy.
For women aged 35 and older, the inability to conceive after 6 months is considered infertility.
Initial visit in infertility and questions that are asked
The doctor must first know the medical, surgical and gynecological history of the woman. The history of any pelvic inflammatory disease, use of intrauterine devices, etc. should be checked.
In men, the history of genital surgery, the presence of undescended testicles, the use of drugs and infections related to the reproductive system, etc. should be investigated.
Frequency of sexual intercourse, and sexual dysfunction are asked. The patient is asked about these problems:
Having a family history of infertility, premature ovarian failure, congenital or developmental defects, mental retardation, hereditary disorders that require planning before conception, such as thalassemia.
In the first visit, the doctor evaluates the impact of infertility on the couple’s feelings. Women’s physical examinations include weight measurement, body shape examination, hair distribution, thyroid gland examination, and pelvic examination.
Evaluations before starting infertility treatment in women
A blood test is usually done in the first three to five days of your menstruation cycle to assess hormone levels. This test provides a rough estimate of ovarian reserve (ie, the number of eggs remaining in the ovary). In some hospitals, a test measuring anti-Müllerian hormone in the blood can be used as an indicator of ovarian reserve. Another method of measuring ovarian reserve is ovarian ultrasound during the first few days of the menstruation cycle.
A blood test is also performed on the 21st day of the menstrual cycle, which shows the occurrence of the release of eggs (ovulation). Also, tests are performed to detect chlamydial infection and rubella test.
To check whether the fallopian tubes are open or blocked, different methods can be used depending on the symptoms, personal preferences and possible risks for each patient.
Evaluations before starting infertility treatment in men
At the beginning of male infertility treatment, usually one or more semen tests will be done to check the amount, movement and shape of sperms.
The spermogram test is the first test in which the man is asked to provide a semen sample in a sterile container. In this test, a lot of information is checked about the quantity and quality of semen and sperm. including: semen volume, total sperm count, sperm count per milliliter, moving sperm count, normal sperm count. This test can also show an infection in the reproductive system.
To perform this test, it is necessary not to ejaculate for 2 to 7 days.
The doctor may perform a scrotal exam or ultrasound through the anus. This test is performed to observe the condition of the vessels around the testicles, tumors or blocked vas deferens.
A doctor may order a hormone blood test for an infertile man to check the level of these hormones in the body.
If the semen analysis test results are abnormal, additional tests may be needed. These tests include:
- Sperm staining test: to check for live sperm in a semen sample
- Testing of anti-sperm antibodies: in cases where sperm motility is severely impaired.
- Semen culture: if there is an infection in the sperm.
- Sperm DNA test
Causes of female infertility
Hormonal and ovarian disorders, uterine and fallopian tube problems, and underlying diseases lead to infertility in women.
- Ovulation and egg disorders
Absence of menstrual cycle or disorder in cycle can be a sign of ovulation disorder.
- Hormonal problems
The functioning of the menstrual cycle is controlled by glands and hormones. In order to ovulate, a part of the brain called the hypothalamus sends an order to release hormones that stimulate the release of eggs from the ovaries. Dysfunction of the hypothalamus can be one of the causes of hormonal disorders and ovulation.
- Ovarian laziness
The important function of the ovaries is to produce mature eggs and secrete estrogen and progesterone hormones. In addition to creating feminine features, these hormones prepare the tissue of the uterine wall (endometrium) for implantation and growth of the fetus.
Polycystic ovary syndrome (ovarian laziness) is one of the most common causes of disorders in the maturation process of eggs and the secretion of reproductive hormones in women. Symptoms of this syndrome include irregular menstruation, excess hair growth, pimples, and obesity, and it can lead to serious problems such as insulin resistance and diabetes.
ovarian laziness; This means that mature eggs are not released regularly. To treat ovarian laziness, you should use drugs that restore the ovulation process to its normal course.
- Cyst inside the ovary
Sometimes the presence of a cyst in the ovary disrupts the process of ovulation. To eliminate this problem, it is enough to take drugs to eliminate cysts for a certain period of time.
In cases where the cysts cannot be removed with drugs, it is necessary to remove the cysts by laparoscopic method. In this way, a tube is sent into the uterus through the vagina, and then these cysts are removed with small incisions.
- Ovarian storage disorder
Disruption of ovarian reserve occurs due to genetic problems, radiation and some drugs, and the ovaries stop working early and no longer ovulate, and as a result, there are no eggs for fertilization.
- age increasing
With increasing age, the quality and number of eggs produced by the ovary drops dramatically. It is possible to fertilize a low-quality egg, but the fertilized egg may not implant properly in the uterus or develop sufficiently.
- Primary ovarian failure (premature menopause)
Primary ovarian failure occurs when the ovaries stop working and menstruation stops before the age of 40. Although its cause is often unknown, certain factors can cause premature menopause, including immune system diseases and some genetic conditions.
- The inability of the fertilized egg to implant in the uterus
Another cause of infertility in women is the egg’s inability to implant in the uterine wall, which can be easily solved with infertility treatment methods.
- Cancer and its treatment
Some cancers (especially cancers of the reproductive organs) often affect women’s fertility. Radiation and chemotherapy may also affect fertility.
- Uterine problems
- Uterine abnormalities
Uterine abnormalities include cervical abnormalities, polyps in the uterus or the shape of the uterus, or problems related to the uterus that have been present since birth.
Benign tumors in the uterine wall, such as uterine fibroids, may cause infertility by blocking the fallopian tubes or preventing implantation.
- Obstruction or disorder in the fallopian tubes
Obstruction in one or both of the uterine tubes is one of the causes of female infertility and is very important. because the sperm reaches the egg through these tubes; Fallopian tube damage or blockage is often caused by fallopian tube inflammation.
It can be caused by congenital problems, pelvic inflammatory disease, usually caused by a sexually transmitted infection, recurrent pelvic infections, abdominal or pelvic surgery and ectopic pregnancy, endometriosis, or surgical adhesions.
Endometriosis means that the tissue that normally grows in the uterus begins to grow in places outside the uterus. which may affect the functioning of the ovaries, uterus and fallopian tubes.
Symptoms of endometriosis include painful menstruation, pain during intercourse, heavy bleeding or abnormal spotting, and pain in the genital area. Even surgical removal of this excess tissue can cause scarring, which can block the fallopian tubes.
- Weakness of the uterus
In some women, the uterus is very weak and cannot carry out fertilization properly.
- polyp
Large or multiple uterine polyps and fibroids that put pressure on the uterine cavity disrupt the ability of the embryo to attach and implant and affect fertility.
- Immunological or systemic diseases
Immunological diseases such as kidney failure and hypothyroidism, in addition to disabling other body systems, cause dysfunction of the reproductive system and infertility.
- Infertility without cause
In some cases, the cause of infertility is never found, and a combination of several minor factors on both sides of the couple can cause infertility problems.
Causes of male infertility
Many health and physical problems cause male infertility. In about 30 to 40 percent of cases, the problem is the testicles, the glands that produce sperm and testosterone (the male sex hormone).
In 30 to 40% of infertile men, they have abnormal sperm (for example, sperm that move slowly, are incomplete, or are low in number), which causes the sperm to be unable to penetrate the egg membrane and fertilize the egg.
Reverse movement of sperm inside the sac instead of exiting the penis also causes infertility.
10 to 20 percent of cases are blocked sperm path from the testicles to the seminal tube. Its cause is the creation of scars due to an infection, vasectomy (a type of surgery that prevents the passage of sperm by cutting the sperm tube) or cystic fibrosis (a type of genetic disease).
Infertility in men can rarely be caused by hormonal deficiencies.
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Abnormal sperm production or function
Abnormal sperm function due to small testicles, genetic defects, health problems such as diabetes or sexually transmitted infections )such as chlamydia, gonorrhea, HIV( and varicocele can also affect sperm quality.
Varicocele is the most common cause of male infertility when the veins in the scrotum are enlarged. The cause of varicocele is not known definitively.
The complications caused by varicocele can be the basis of fertility problems, in case of complications, surgery is considered.
Exposure to certain environmental factors such as pesticides , other chemicals and radiation, smoking, alcohol, marijuana, anabolic steroids, the use of medications to treat bacterial infections, high blood pressure, and depression can also affect male fertility.
Cancer treatment due to damage caused by treatments such as radiation therapy or chemotherapy can cause disruption in sperm production.
Frequent exposure to heat, such as saunas or hot tubs, can raise body temperature and may affect sperm production.
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Sperm transfer disorder
Sexual problems such as premature ejaculation and some genetic diseases such as fibrocystic, structural problems, such as obstruction in the testicle, injury or damage to the reproductive organs cause problems in sperm transfer.
The vas deferens can become blocked for a variety of reasons, including unintentional injury from surgery, previous infections, trauma, abnormal growth, and hereditary conditions.
Some surgeries may also prevent sperm from entering. These include vasectomy, scrotum or prostate surgery, and major abdominal surgeries (such as for testicular and rectal cancers).
– Some infections can interfere with sperm production or sperm health, or cause ulcers that block the passage of sperm;
– Ejaculation problems include no ejaculation and retrograde ejaculation (retrograde ejaculation occurs when semen enters the bladder during orgasm instead of coming out of the tip of the penis;)
– The presence of antibodies that attack sperm: Anti-sperm antibodies are cells of the immune system that mistakenly identify sperm as harmful invaders and try to destroy them;
– Cancer and tumors: Cancer can be one of the causes of male infertility, which can directly affect the male reproductive organs;
– Undescended testicles: in some men during the embryonic period, one or both testicles are not placed in the scrotum;
– Hormonal problems: Hormonal problems in men can be caused by disorders of the testicles themselves or abnormalities that affect other hormonal systems, including the hypothalamus, pituitary gland, thyroid and adrenal glands;
– chromosomal defects;
– Problems in sexual relations: these problems can include difficulty in maintaining an erection sufficient for sex, premature ejaculation, painful intercourse, anatomical abnormalities such as having a hole in the urethra under the penis (hypospadias), or psychological problems.
– Use of certain drugs: long-term use of anabolic steroids, cancer drugs (chemotherapy), some arthritis drugs, and some other drugs can disrupt sperm production and cause male infertility.
Many couples suffer from reduced fertility. that it is necessary to carry out treatment measures.
Ways to prevent infertility in men and women
- Avoid Substance abuse, smoking and drinking alcohol, which may lead to infertility. The success rate of IVF in women who smoke is half that of non-smokers.
- In men, avoid bathing and using hot tubs, as it can temporarily affect sperm production and motility.
- Regular exercise improves the quality of sperm and eggs and increases the chances of achieving fertility. But heavy sports have a negative effect on ovulation.
- Keeping fit: Obese men are more prone to sperm DNA damage and hypogonadism (a disease in which the gonads are unable to produce enough sex hormones).
In women, excessive obesity causes excessive production of some hormones, which can cause problems with ovulation. So that the success rate of IVF in obese women is 30% lower.
- Limit caffeine intake
Infertility Treatment Methods in Iran
Female Infertility treatment in Iran
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Drug therapy to increase ovulation
The use of fertility drugs is one of the main methods of treating infertility in women. According to the condition of the couple, drugs are prescribed to stimulate the ovaries and to produce more eggs. These drugs are used either orally or by injection. These drugs can help regulate ovulation and treat ovulation disorders.
One of the common drugs to stimulate the ovaries and the ovulation process is the oral drug clomiphene. which is an antiestrogen and directly affects the hypothalamus of the brain. Gonadotropin is also the most common injectable drug to increase ovulation.
New studies show that the simultaneous use of vitamins E and D3 increases the chances of fertility in women. This study, which was conducted on 100 women suffering from infertility due to polycystic ovary syndrome, showed that correcting vitamin D3 deficiency increases the chance of embryo implantation and also the possibility of twins.
Research has also shown that the use of PRP can increase the ability of the uterus to maintain the fetus, or in other words, the ability to implant.
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Infertility treatment with IVF
This method is called definitive treatment of infertility. A sample of male sperm and female egg is taken and fertilization is done in a laboratory environment.
In infertility treatment with IVF, sampling of eggs is done directly from the ovary. After fertilization is done and the eggs are fertilized, one or more fertilized eggs are transferred to the woman’s uterus and placed in the uterine wall, and after a certain period of time, a pregnancy test is taken.
If the man’s healthy sperms are few. Healthy sperms are selected and injected into the egg, which greatly increases the chance of egg fertilization. This method is called microinjection or ICSI.
The chance of pregnancy in the IVF method for women who are less than 34 years old can reach 50% in each cycle.
IVF fertility is often used in women with ovulation disorders, low egg quality, endometriosis, blocked fallopian tubes.
Also in cases:
- couples using donated eggs or sperm,
- For those who, for any reason, have frozen their sperm or eggs for future childbearing,
- For those who, according to the conditions, genetic screening is necessary before implantation
- And sometimes healthy couples for whom definitive gender determination is a high priority
IVF method can be very effective.
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Infertility treatment with IUI
IUI treatment is simpler and less expensive than IVF treatment. In IUI fertilization, which is also called the sperm washing process, the male sperm are sampled and the best sperm are isolated and prepared. Then, the prepared sperms are transferred into the woman’s uterus and placed in the fallopian tubes.
This procedure is performed by a thin and soft tube and is painless. In the treatment of infertility with IUI, the sperm must be healthy and well stimulated to fertilize the eggs.
According to experiments, only 10% of male sperm enters the cervix during normal intercourse. But in the IUI method, more sperm are taken from the man and they are inserted into the woman’s uterus with better quality.
Suitable candidate for infertility treatment by IUI method
- Abnormal secretions in the cervix
- The presence of a wound in the cervix
- Feeling severe pain during sex
- Erection or ejaculation problems in men
- Woman’s sensitivity to man’s sperm or seminal fluid
- The presence of sexually transmitted diseases such as hepatitis or AIDS and immune disorders in one of the couples
- Low sperm fluid volume, low sperm motility, low sperm count, etc.
The success rate of infertility treatment with IUI method completely depends on the age and cause of infertility. If a person benefits from IUI treatment along with fertility drugs, he can increase his chances of pregnancy by 10-20% in each treatment period.
Repeating this treatment for women is an average of 3-4 cycles.
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egg donation
In women who have ovarian failure and the ovaries do not work properly, or the eggs are not of high quality but their uterus is normal, they can get pregnant through egg donation.
For this purpose, the eggs in the donor are extracted by taking oocyte-stimulating drugs and combined with male sperm by IVF method, and after fertilization in the laboratory, they are transferred to the mother’s womb.
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Surrogate uterus
This method is used when women have uterine problems and the woman’s uterus is not capable of keeping the fetus. In this method, female egg and male sperm are combined in the laboratory with the IVF method. After fertilization, the eggs are transferred to the uterus of the donor. After the child is born, it is given to its original parents.
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Laparoscopy and hysteroscopy
In women who have problems in the reproductive system and uterine tubes, the doctor uses the laparoscopic method to reconstruct and solve the problem of the reproductive organs.
Hysteroscopy of the uterus is used to solve uterine problems such as fibroid tumors and polyps or uterine tube problems.
After solving these problems, the doctor may determine that IVF is needed for pregnancy.
Treatment of Male infertility in Iran
Symptoms of Male Infertility
low volume of semen; transparent and watery semen; decrease in libido; erection problems; having a history of testicular or penile surgery; Changes in hair growth, abnormal breast growth are symptoms of male infertility.
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Surgery
If the problem is the obstruction of the sperm transfer system, it can be solved by surgery. But many men remain infertile even after the blockage is removed. In these cases, extracting sperm from the testicles and using the IVF method can help.
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Hormone Therapy
Hormone therapy takes more than a year and is an expensive treatment method. Men whose sperm count is very low due to testicular disorder, hormone injection has no effect on them. In this case, the use of IVF method along with microinjection or Donated sperm can cause fertility.
FAQ ABOUT INFERTILITY TREATMENTS IN IRAN
Infertility is not a hereditary disease. But complications that can cause infertility (such as polycystic ovary syndrome, endometriosis and premature ovarian failure, varicocele, etc.) often occur in a number of family members.
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