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More and more young couples have infertility problems: they represent up to 30 percent of the total number of couples covered by the WTO program. What is also concerning, ovarian reserves in women under 30 are getting poorer, doctors warn.
Gynecology specialists claim that the fertility problem is increasingly visible in Serbia, and based on research that showed that only 26 percent of patients under the age of 30 have been diagnosed with a suitable finding, they suggest that it is emphasize this problem at the primary health care level.
According to Dr. Bozana Stepanov, specialist in gynecology and obstetrics and subspecialist in sterility and fertility, within the annual gynecological check-ups provided by the Health Insurance Fund and in addition to the annual Pap smear, patients must receive AMH control ( antimilerian hormone) and ultrasound examination. with a focus on ovarian activity (AFC).
In this way, as he himself says, it would be possible for patients with an established reduced ovarian reserve, that is, the richness of the ovaries, to be immediately referred to institutions that deal with fertility and sterility for further diagnosis and therapy.
– In the current trend of delaying pregnancies and childbirth as much as possible, it is the duty of doctors who deal with fertility and sterility to show girls and young women how to control their fertility and plan for motherhood in a timely manner. More and more patients visit us who before the age of 40 have great problems in the sense that they cannot get pregnant, that we cannot obtain a quality egg from them, and in fact the problem begins at an earlier age. Many young women are surprised when we tell them in the regular gynecological examination that their ovaries work correctly on ultrasound, but poorly, explains our interlocutor.
It points out that special emphasis should be placed on healthy young women between the ages of 25 and 35 who delay pregnancy and childbirth, most often due to their career and training, as well as those who have had any of the following situations: frequent X-rays of pelvis in childhood or puberty (due to hip dislocation, fractures, injuries), abdominal surgery, appendicitis, and especially ovarian surgery, then suffered some autoimmune diseases (thyroid gland, type I diabetes, lupus), that had tumors, chemotherapy, patients in the family There is the occurrence of some of the genetic diseases, as well as patients who have information that their mothers entered menopause before or around 40 years of age.
He also advises that women should test their fertility, that is, the evaluation of the ovarian reserve (ovarian richness), which includes the determination of blood hormones (AMH – antimilerian hormone) and ultrasound examination, and that in patients with reduced ovarian reserve, additional examinations are performed and based on that, doctors can advise them on how and in what way they can help preserve reproduction.
– Last year we did a series of free checkups for young women under 30. 65 patients were examined and 26 percent were diagnosed with a normal finding, that is, we do not expect a fertility problem in them in later years. In others, with reduced ovarian reserve, in 26% of the cases it was determined that it was hereditary, that is, patients whose mothers entered menopause prematurely. Then, in 12%, we determined the existence of certain diseases (most of the time autoimmune diseases, and the same percentage of patients underwent some of the gynecological operations). In 13.6 percent of patients, the cause of reduced ovarian reserve is unknown, 12 percent of respondents had a diagnosis of polycystic ovaries, and only in 0.4 percent of cases, the cause of reduced ovarian reserve was previously identified using X-rays, says Dr. Stepanov, noting that it would be best for patients between the ages of 25 and 35 to test and monitor their ovarian reserves at least once every two years.
A revolutionary discovery
Dr. Stepanov claims that after the contraceptive pill, preventive control of ovarian wealth in women is a revolutionary discovery in the world of gynecology.
– In America, young women are still testing their fertility while studying. Large companies encourage their employees to take these tests, even paying them to freeze eggs. In Serbia, nobody has yet dealt with the evaluation of the ovarian reserve in this way, except for women who have appeared due to infertility or who started the IVF procedure, says Dr. Stepanov, who believes that this should change.
Reasons for reduced reserves
- 26% hereditary
- 12% of autoimmune diseases
- 12% polycystic ovaries
- 0.4% X-ray
- 13.6% unknown cause
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