Meet Dr. Yavor Vladimirov, an expert in obstetrics-gynecology and reproductive endocrinology. Dr. Vladimirov honed his skills in reproductive endocrinology at Vooburg Hospital in The Hague, Netherlands, and the Medical University in Tel Aviv, Israel. With over 30 scientific reports and publications, including in esteemed journals like “Fertility and Sterility” and “Assisted Reproduction and Genetics,” he’s recognized internationally. He’s also a member of the European Society of Human Reproduction and Embryology (ESHRE) and serves as an honorary lecturer at Sofia University “St. Kliment Ohridski.”

Wondering when to address infertility in a couple? According to Dr. Vladimirov, it’s when they’ve been trying to conceive for about a year, roughly 13 menstrual cycles, without success. At this point, consulting a specialist is advisable to identify the reasons and explore treatment options.

As for the initial investigations, standard tests are conducted for both partners. For men, this typically involves a sperm analysis to assess sperm quality. For women, it includes monitoring ovulation, checking hormonal balance, ovarian capacity, and fallopian tube patency. These tests provide essential insights, but additional ones may be required based on the specific case.

In Bulgaria, like in many European countries, reproductive issues affect a significant portion of couples—around 10-15%. These problems can stem from various factors, including issues with the woman, the man, or both.

So, what are the most common causes of fertility problems in women? Previously, sexually transmitted diseases like gonorrhea were often blamed, but now chlamydial infections are more prominent, leading to conditions like tubal factor infertility and endometriosis. Another growing concern is the early depletion of ovarian reserve, affecting around 10% of women who experience menopause before 45. This depletion can start as early as age 32 for those who hit menopause at 45.

In about 20% of cases, couples face unexplained infertility where medical tests show no abnormalities yet pregnancy doesn’t occur. It’s a puzzling situation that Dr. Vladimirov and his team are working to understand better.

Stay tuned for more insights from Dr. Vladimirov, including details about male infertility factors and the innovative in vitro maturation (IVM) method.