Couple's infertility
From ChildWiki.com
The couple's infertility is defined as the incapacity of a certain couple to conceive a child after 12 months of repeated, regular and unprotected sexual intercourse. According to this definition, about 15% of couples of fertile age couples are infertile. This does not necessarily mean that the two can not conceive a child with someone else, or that both of them are sterile.
The definition of the couple infertility is rigid, because it is reported to a fixed period of one year, but almost 90% of fertile couples will conceive after one year of trying. There is a possibility of conception even after that, but the rate of fecundability will decrease with every year that passes.
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[edit] Social and Emotional Problems
The failure in conceiving generates a series of social and emotional problems, including feelings as guilt, uselessness, social isolation, all resulting in a decrease of the professional and social activities and finally to couple tension. Statistics show that about 40% of the infertile couples present a feminine etiological factor, for 40% of them the factor is masculine, and for 20% it is a combination.
When the doctor is confronted with infertility, he has to approach and investigate both partners.
[edit] Approaching Couple Infertility
The approach in case of this type of infertility usually requires a team work, including a team of doctors to deal with various body problems and body parts. they will all help defining the problem, reaching a conclusion and diagnose and then conducting the treatment.
The evaluation of the infertile couple needs to take into consideration all the parts of the conception process: ovulation, the transportation of the egg from the ovarian follicle to the uterus, the production and viability of sperm, the release into the vagina at the right moment, the receptivity of the cervix mucus, conception itself and the implantation process.
[edit] Needed Investigations
Generally, the first investigation during an infertility problem is the sperm test. This is a very simple analysis, non-invasive, and the result is obtained shortly. This test will tell at once the fertile capacity of the man, expressed in number of sperm cells, their mobility and morphology.
If these results are under normal limits, the next investigation will be orientated towards the female factor. They are more complicated and even invasive at times.
If the sperm test is not normal, there will be a series of investigations that will detect the precise cause for which the sperm has suffered modifications. Hormonal tests will be performed, as well as blood tests. If the hormone levels are not normal, they will be adjusted with medication.
[edit] Masculine Infertility
The treatment of the masculine infertility is address mainly at the precise cause, if it can be shown, and in parallel there will be a treatment for the female factor as well, if she requires it.
Good results have been encountered in the following situations: glands affections, retrograde ejaculation, anatomical defects. In other situations, IVF, artificial insemination with a donor or adoption were the solution.
[edit] Feminine Infertility
While the masculine infertility is tested, so will be the feminine one, which can have many causes.
A simple test will be performed first: a test that can signal the existence of the ovulation. Hormonal determinations will follow, in various periods of the menstrual cycle.
The permeability of the uterine tromps will be tested, the shape and health of the cervix and of the inner lining of the uterus. If after complex tests that are aimed at all organs inside the female reproductive system a precise cause of infertility is not found, immune determinations can be effectuated, especially dosing anti-sperm antibodies.
Treatment can contain the causal therapy as well as other measures: ovulation inductors, artificial insemination, IVF, embryonic transfer.
