Diagnosis and Treatment of Infertility

Infertility assessment

Infertility is a growing diagnosis worldwide, including in Croatia, affecting 10-15% of couples. Its prevalence is influenced by numerous factors, which can generally be categorized into male, female, combined, and unknown or idiopathic causes. In developed countries, delayed motherhood is a significant issue, with many women deciding to conceive after the age of 35, and even after 40 . Biologically, a woman’s body is most suited for pregnancy around 26 . Therefore, advanced maternal age and the decision to become a mother later in life are among the more challenging causes of infertility. Additionally, modern lifestyles combined with unhealthy diets and high exposure to toxins impact male fertility more than female fertility. Fortunately, due to advancements in diagnostic and therapeutic methods, infertility is now a treatable condition.

Infertility is defined as a couple’s inability to conceive after one year of trying if the woman is under 35 years old. If the woman is over 35, this period is reduced to 6 months due to the decline in egg quality with age.

• Primary infertility: Diagnosed when a woman has never had a completed pregnancy.
• Secondary Infertility: Refers to the inability to achieve pregnancy after at least one previous successful pregnancy.
• Subfertility: Indicates reduced fertility, meaning the couple can achieve pregnancy after a prolonged period.

In 30-40% of cases, the cause of infertility is related to the female partner, and in another 30-40% of cases, it is related to the male partner. The diagnostic process includes a detailed medical history, which involves a discussion with the woman, followed by a gynecological examination with ultrasound, microbiological analysis, hormonal status, sonohysterography (SIS) or hysterosalpingography (HSG), and occasionally hysteroscopy (HSC) or laparoscopy (LPSC). For the male partner, a semen analysis is required.

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