Pregnancy counseling before marriage

**About 15 to 20% of young couples suffer from infertility** About 15 to 20 percent of young couples suffer from infertility. Among these, 40% of the problem is for men, and between 40 and 45% of women are facing problems. About 15% of infertility is unexplained. Now, medical science has reached effective methods in the treatment of infertility. From in vitro fertilization to egg and embryo freezing. What follows is a conversation with Dr. Amina Lahoti Ashkouri, a specialist in obstetrics and gynecology. **Should girls be under the supervision of a gynecologist before marriage?** All girls should be under the supervision of a specialist doctor from the time they become mature and menstruate. If signs of precocious puberty or abnormal secretions are seen in them before puberty, it is necessary to see a doctor immediately. For girls to go to the doctor, there is no law to say how long they should be under the doctor's supervision, but it is better to go to the gynecologist annually; He should be aware of his body with annual check-ups. But it is necessary for women to go to the doctor every six months after three years of marriage and repeat the pap smear test every three years. **What symptoms are associated with female diseases?** Women's diseases do not always have symptoms. Some infections have no symptoms and may spread from the lower part of the genital tract to the top, which causes infertility and adhesions of the fallopian tube. Infertility without a cause is also caused by strong adhesion of the tubes; For this reason, we emphasize that it is better for people to see a doctor regularly. **Can infertility be diagnosed and treated before marriage?** If a couple does not have a child after one year of marriage and without preventing pregnancy, it is said that they are infertile and should be under the supervision of a specialist doctor. Therefore, it is not possible to be 100% sure whether a person is infertile before marriage or not. But in some cases, by diagnosing diseases such as ovarian cysts, it is possible to determine that infertility will occur in the patient. Endometriosis is also a common disease. There is a tissue inside the uterus called the endometrium, which sheds and causes monthly bleeding. Sometimes this tissue, which should be inside the uterus, goes to other spaces and causes symptoms such as adhesions of the uterus, which causes infertility. If girls suffer from these diseases, their infertility can be diagnosed, but in most cases, infertility cannot be noticed until the relationship is established and one year from its beginning. Infertility does not always have symptoms, but the most common symptoms of female problems are severe menstrual pains. These pains may continue before and after menstruation. There are no definitive signs in the investigation of infertility, and the person should perform related tests. **When are menstrual cramps a concern?** As long as the menstrual pain is mild and can be resolved with regular pain relievers, it is not a concern. The pain that cannot be resolved with the usual painkillers, and is severe enough to stop the woman from work and life, should be treated seriously. 40% of infertility problems are for men, and between 40 and 45% of women have problems Do you recommend taking painkillers during menstruation? What else can be done to reduce menstrual pain? In traditional medicine, treatments such as heating the position or fennel and cumin infusion are recommended, which are also effective. Regarding chemical treatments, it should be said that a woman who is involved in menstruation for several days in a month, if one or two days in a month, the pain reliever recommended by a specialist doctor should be used in a certain dose, there will be no problem. Menstrual pain has many psychological effects, so taking these types of pills before the pain starts can help a lot in stopping the pain. **Are ovarian cysts related to obesity in women?** Notice how many models there are. Some of them have nothing to do with obesity. Some cysts called functional cysts occur during pregnancy, and this type is not related to obesity. But in ovarian laziness, when the ovary becomes polycystic, it has a wide spectrum. This type of cysts may lead to diabetes and as a result, it will lead to obesity in women. If these women want to lose weight, they should change their lifestyle and take nutrition and physical activity seriously. **In your opinion, how long after marriage is the most suitable time for bardrai?** For pregnancy, special attention should be paid to the age of the woman. Pregnancy at the beginning of puberty and at the end of the spectrum, i.e. before menopause, is risky. It is especially troublesome for the mother and child around the age of fourteen to sixteen when women's bones have not yet formed. But pregnancy at an old age has a lower risk than at a young age; Because with the help of technology, the risks caused by it can be controlled to some extent. In general, between the ages of 25 and 30 are the best fertile years. Pregnancy does not cause any problems in women from the age of 20, when their body bones are complete, to around the age of 35; Because both the physical condition and the state of ovulation are in favorable conditions. But the quality of the egg drops after the age of 40. As a result, the age of the woman is more important for having children than the years of marriage of the couple. Women should try not to postpone pregnancy after marriage, because there are infertility cases that a person is not aware of, and when she takes treatment, the woman's golden age has passed and the work becomes difficult. However, everything is based on probabilities. But consider that if a 30-year-old woman and a 40-year-old woman have five problems in common, the probability of treating the 30-year-old woman and having children is higher because women's eggs are present in their bodies from the time they are born, and like men who produce sperm every three months; Eggs are not produced. Therefore, the egg quality is better in 30-year-old women and their treatment is more successful. **Has technology not reduced the risk of infertility at different ages?** Undoubtedly, technology has had a great effect on reducing infertility; In addition, new methods have helped us to diagnose fetal abnormalities and problems caused by pregnancy early. Currently, with increasing awareness and improving nutritional conditions, we have seen a better situation than in the past. **How many years should the interval between pregnancies be suitable for women's physical condition?** First of all, it should be seen whether in the past, a natural birth was performed or a cesarean section! A woman who has had a cesarean section is at risk of an ectopic pregnancy, and the minimum interval for a woman who has had a cesarean section is about 18 months. But first, it should be taken into account that the previous child has passed the full breastfeeding period, and then the couple should try to have another child. Lactating women are also deficient in calcium, and if they become pregnant while breastfeeding, they will suffer from osteoporosis. At least three years should be given to the mother and the previous child, and the age of the mother is very important. If a couple does not have a child after one year without contraception, it is said that they are infertile Is it not possible to reduce the problem of marriage age and fertility by freezing eggs? Today, both egg freezing and ovarian freezing are performed. that ovarian freezing will be a better way to reduce the risk of infertility. In ovarian freezing, a part of the ovary is removed in the shape of a triangle and several thin slices are given from it to freeze the appropriate follicle for the future. This way is not always suitable to reduce the possibility of infertility; It should be noted in what conditions we freeze the egg or ovary. A forty-year-old woman's ovary is not suitable for this, and it is like keeping a piece of rotten ear in the freezer. This meat is not used. Eggs and ovaries of women under 35 years of age are suitable for this work, but Farad must take hormone tests to know if the woman's hormone level is suitable for this work or not. If this work is done in a good center and in good conditions, it will be about 85% successful. When the egg is removed for the freezer, they judge its quality by its appearance, but not everything is checked at the micro level. The egg may have lost its ability to be fertilized when it comes out of the freezer; Therefore, this method does not eliminate 100% of the anxiety caused by infertility. In what circumstances is egg freezing recommended? A woman who has to have her ovaries removed. Before that, we have to freeze the egg so that there is a possibility of fertility for this woman; A woman who is getting older and does not want children or who is not yet married is also advised to freeze her eggs so that there is hope in the future.