Cause of infertility in couples

Neplodnost se definira kao nemogućnost zanošenja nakon 12 mjeseci redovitih, nezaštićenih spolnih odnosa. Zahvaća između 8 i 12% parova diljem svijeta. Ovisno o uzroku neplodnosti, dijelimo je na žensku, mušku i idiopatsku neplodnost. U 35% slučajeva uzrok neplodnosti je definiran ženskim faktorom, u 30% muškim, a u 20% parova riječ je o kombiniranom uzroku. U 15% slučajeva se ne nalazi jasan uzrok neplodnosti, odnosno riječ je o idiopatskoj neplodnosti. Uzroci ženske neplodnosti dijele se na poremećaje ovulacije, abnormalnosti maternice, oštećenja jajovoda, peritonealne faktore te ostale uzroke, a uzroci muške neplodnosti na predtestikularne, testikularne, posttestikularne i ostale uzroke. Obrada neplodnog para započinje s jednostavnijim i manje invazivnim dijagnostičkim metodama, a one složenije i invazivnije se ostavljaju za kasnije. Početak svakog uspješnog dijagnostičkog postupka krije se u dobro uzetoj anamnezi i temeljito obavljenom fizikalnom pregledu. Daljnji dijagnostički postupci uključuju hormonsku i radiološku obradu. Po potrebi se vrši i genetsko testiranje ili se uvode nešto invazivnije metode, kao što su laparoskopija, histeroskopija i biopsija testisa. Liječenje neplodnosti zahtijeva pristup koji treba biti što prirodniji i manje agresivan, a temelji se prvenstveno na otklanjanju uzroka. Ukoliko je etiološko liječenje konzervativnim i operacijskim pristupom neuspješno, poseže se za metodama potpomognute oplodnje.Infertility is defined as the inability to conceive after 12 months of regular, unprotected sexual intercourse. It affects around 8 to 12% couples worldwide. Depending on the cause, infertility is divided into female, male and idiopathic infertility. In 35% of cases the cause of infertility is determined by female factors, in 30% by male and in 20% of couples it is a combined cause. In 15% of cases, there is no clear cause of infertility, therefore defined as idiopathic infertility. The causes of female infertility are divided into ovulation disorders, uterine abnormalities, fallopian tube damage, peritoneal factors and other causes, and the causes of male infertility are divided into pretesticular, testicular, posttesticular and other causes. The investigation of infertility begins with simpler and less invasive diagnostic methods, and those more complex and invasive are left for later. The beginning of any successful diagnostic procedure lies in a well-taken medical history and a thorough physical examination. Further diagnostic procedures include hormonal and radiological treatment. Genetic testing may also be performed as well as some more invasive methods, like laparoscopy, hysteroscopy and testicular biopsy. Infertility treatment requires an approach as natural and less aggressive as possible and is based primarily on eliminating the cause. If the etiological treatment with a conservative and surgical approach is unsuccessful, assisted fertilization methods are used