It is necessary to clarify the nuances of vocabulary that can be used at times in the current language about the problems linked to conception. To understand more clearly: - Infertility (infertility)), is the difficulty for a couple to have a child. -Sterility, , is itself, the inability of a couple to have a child. Unlike infertility, it is irreversible. A couple can only be categorized as sterile at the end of their reproductive life!
Who is affected? Answers figures:
The difficulty to conceive is a problem faced by each couple of childbearing age, from near or far. In fact 1 couple out of 7 consults a doctor about it! In the general population, 4% of couples are sterile, and 15% infertile. It should be noted that the average time to conceive is 4-6 months. A fertile couple with regular sexual activity, have about 25% chance of having a child at each cycle. Given these figures, we can understand why the first medical investigations concerning these problems will only be undertaken after a minimum period of 12 months of regular sexual activity without contraception.
What are the causes and risk factors for infertility?
-Time: Couples often impatient do not give enough time to conceive naturally. -The frequency of sexual intercourse: logically fecundability rate increases with the frequency of activity-1 activity per week: 15% chance of conceiving at each cycle -1 activity per day: 68% chance of conceiving at each cycle Male causes : -Semen quality (direct link to fertility) -Other: tobacco, alcohol, drugs, exposure to toxic chemicals (lead), ionizing radiation, age Female causes: -Maternal age: reduced fertility from 38 years on-Endocrine causes: ovulation problems -Mechanical causes: -Bilateral tubal blockage, usually scar post salpingitis -Adhesion of annexes (scarring, idiopathic) obstructing the transit of sperm and ova. -Other: tobacco, alcohol, drugs, exposure to toxic chemicals (lead), ionizing radiation -Causes not found ... called idiopathic
What will be the process undertaken for the infertile couple?
-Stage 1: examination of the couple (frequency of intercourse, date at which they started to want children, contraception earlier ...) -Stage 2 Female assesment: -complete clinical examination -temperature curve for 3 months (early morning before getting up): sudden increase in temperature of 0.3 to 0.4 ° C marking ovulation. -Specialized laboratory tests (hormonal, infectious) -Morphological examination: -Pelvic ultrasound (anatomical lesions may correspond to a mechanical obstacle to a possible pregnancy) -Hysterosalpingography (verification of tubal patency, and absence of -Post coital test Huhner -Invasive proceedures from 2nd proceedure - Hysteroscopy diagnostic -Laparoscopy diagnostic Male assesment: -Complete clinical examination -Semen analysis -Post coital test -Laboratory tests (infectious) -2nd proceedure: spermoculture, karyotype, hormonal assesment, ultrasound urogenital ... Post coital test (from Huhner) : generally made the 12th day of the ovulatory cycle, it takes place 8 to 12 hours after sex, without vaginal lwashing after intercourse, after 2-3 days of abstinence. It will allow:-the analysis of cervical mucus and to determine its quality on a local sample,at the level of the endocervix. -The microscopic analysis of the behaviour of the sperm in cervical mucus
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Victor Hugo