Infertility a problem with solutions!
The problem of infertility occurs frequently and is chronic.
The percentage is constantly growing in recent years and internationally 15% of couples face difficulty in conceiving in general, or in conceiving the desired number of children, according to estimates by the World Health Organization (WHO).
The probability of conception in a couple of reproductive age having intercourse without protection or using contraceptive methods is 20% per month.
In 12 months, the catch rate statistically reaches 93% .
The infertility rate has remained stable over the centuries.
There is a recorded study in a region of England, during the 19th century, in which it was found that 1 in 6 marriages were not productive (16%), however, in recent years this percentage has increased because the age of the woman who starts a family it is bigger and mainly because the lifestyle habits and diet for new couples have changed
By the term infertility we mean the inability to conceive after 12 months of sexual contact without protection or the use of contraceptives, while by the term sterility we mean the absolute inability to conceive.
Monthly Fertility Rate (MFR) we call the probability of conception in a menstrual cycle and it is about 20%
If we make a reference to the causes of infertility we would classify them in the following
- Sperm problems (related to sperm count, motility and morphology).
- Ovulation disorders.
- "Hostile" behavior of the cervical mucus and diseases of the cervix.
- Diseases of the uterus.
- Problems from the fallopian tubes (blockage, adhesions).
- Endometriosis.
- Increased age of the woman.
- Lifestyle factors (smoking, alcohol consumption, work environment).
- Unexplained infertility, which accounts for a significant proportion (about 15-20%) of infertility cases.
Therefore, if the couple makes a visit to the gynecologist specializing in infertility, they will undergo the following tests in order to perform the corresponding clinical and laboratory tests
- Internal genital ultrasound
- Hysterosalpingography
- Hysteroscopy – Laparoscopy
- Blood tests (e.g. to check thyroid-prolactin – hormone profile)
- Vaginal fluid cultures for ureaplasma, mycoplasma, etc
For the man
Spermogram and if necessary a check by a urologist
The infertility treatment philosophy may include;
a) a waiting phase
b) carrying out tests to investigate the causes of infertility, with the aim of choosing the appropriate treatment
c) treatment schedule (e.g. limited number of inseminations, hysteroscopy-laparoscopy, etc.)
d) direct application of in vitro fertilization.
Speaking of insemination, we refer to a method for couples whose infertility factors are not serious, then the first step in dealing with the problem is insemination.
Factors such as sperm with slightly lower quality than normal or "hostile" cervical mucus (mucus that prevents sperm from penetrating) are problems that can be treated with this method.
Insemination is a painless procedure that takes place on the day of the wife's ovulation.
On this day the husband gives a sperm sample which is properly processed in the laboratory.
After the sample is processed, the motile spermatozoa are collected and then placed in the uterus with the help of a catheter.
For insemination to be useful, the woman's fallopian tubes must be open.
There are various insemination techniques, the classic but also more innovative ones such as FSP and IUTPI
Finally, insemination can be performed with the use of sperm from a third donor (heterologous insemination).
In vitro fertilization is a slightly more special process because the woman takes medication in order to make eggs.
The reception will take place under mild anesthesia in the clinic and the fertilization will take place in the laboratory.
The transfer of the fertilized eggs will take place in the woman's uterus a few days later
However, both methods are a method of choice for successful fertilization and have their value depending on the needs of the couple.
But what is important is the continuous effort of the couple and the achievement of the goal which is none other than the birth of a healthy child or more!!!
With honor I. Kalogirou
