Young should turn to family earlier and the government should create the environment which provides jobs faster and decent salaries. Modern lifestyle, stress and decision of couples to decide to be parents thirties are the main cause of infertility. Medicine has not yet won the biological clock, “supported pregnancy” gives results but it is not sufficiently efficient, one of the biggest , experts for reproductive health of women, professor and doctor Ana Mitrovic Jovanovic, says for eKapija.
We discussed with the head of daily hospital GAK Narodni front and a professor at the Faculty of Medicine in Belgrade the infertility causes necessary analysis and treatment methods in Serbia and abroad.
eKapija: Is infertility the modern society’s desease?
- Infertility is a common thing in modern society because we pay the toll for our lifestyole and a decision of a large number of couples to have children in later age in life. We still have not succeeded in beating the biological clock and every year chance for motherhood decreases. It refers to women with a problem of course. Sill, general population has 10% of women who are extremely fertile and who can get pregnant in 40s or 45.
eKapija: Do you have data on sterility in world and Serbia?
- The researches show that every sixth couple has minor or bigger problem in having reproduction which is 15 do 20% of couples in general population.
eKapija: After how much time should a couple turn to a doctor?
- If a couple is younger than 30, after a year of regular, unprotected relations and for older, after six months.
eKapija: What are the first analysis?
- Apart from the basic gynecological examination, ultrasound, papa test and colposcopy are done. It is important to test hormones because we have to know endocrine milieu of a woman. Thyroid hormons are extremely important because we have a significant decrease in hashimoto, i.e. subclinical forms of problems in inadequate thyroid function.
Then, we check oviduct patency to see whether there is a mechanical problem. If there is, we do hysteroscopy or laparoscopy, or both.
After these basic steps we decide on treatment method – stimulation, induction, insemination or in vitro fertilization.
When it comes to men, we start from sperm graph and bacteriological analysis and hormones.
eKapija: Before treated fertilization, do you recommend some alternative methods?
- If the couples do not have any of the health obstacles, we advise spas, sea, hot baths, etc.
Oxygen can also be useful with men with bad sperm graph.
I would outline this procedure must be well defined because as any medicine, it can make more damage than use if used in an inadequate way.
eKapija: You educated yourself abroad as well. How far did Serbia go in infertility fight? Why do a large number of couples opt for in vitro fertilization abroad?
- During the past five years, in vitro fertilization extremely progressed in Serbia. There is very few methods in the world which are not available here but I hope they will soon get to Serbia.
A large number of people opt for Prague and Macedonia due to donation of spermatozoids and eggs. It is governed by the law and allowed. It is possible to choose a donor, a man or a woman, depending on phenotype features.
eKapija: In our country, donors cells are not allowed. What do think about that?
- I always support new things but carefully and critically. New is not always good. Clear propositions are necessary, donors should be defined as well as procedure with donors. When the law governs it, I do not see a reason why donor should not be an option in our country as well.
eKapija: How could the state support increase in birthrate in Serbia?
-In vitro fertilization is successful at every third or fourth couple. Birthrate will not increase through in vitro fertilization. The state should motivate the young to turn to family earlier and the government should create the environment which provides jobs faster and decent salaries. This way we would stop their leave abroad. I believe everybody would stay at his own house if he had a decent life and a job. They would chose less in Serbia than more abroad. The second thing is to promote more kids, families with more members, to motivate people to have the third or fourth kid. It takes three kids minimum for simple reproduction, to rehabilitate ourselves.