INFERTILITY

WHY DO WE SPEAK OF INFERTILE COUPLES AND NOT OF INFERTILE INDIVIDUALS?

Throughout history, we see that fecundity is a female characteristic, therefore, when pregnancy was not achieved, the woman was held responsible for being infertile. In modern society, with the scientific advances in this field, we refer to the couple as unit with reproductive capacity. 

When is a couple infertile?
A couple is considered infertile when pregnancy is not achieved after two years of regular intercourse without contraception. 

How do we know if we are a fertile couple?
The gynaecologist will study the female reproductive organs, the regularity of the menstrual cycles and other parameters reflect the woman’s capacity to get pregnant. The urologist-andrologist does the same procedure in men. Routine check ups, semen analysis and hormonal studies can determine whether it is necessary to begin a treatment.

If we are an infertile couple, what are the chances to have children?
Nowadays, we have two possibilities:

  • If it is deemed appropriate, medical treatment is initiated by the gynaecologist if the infertile individual is the woman or by the urologist-andrologist if man is the infertile one.
  • When the cause of the infertility requires another type of treatment, there are other possibilities, such as ARTIFICIAL INSEMINATION, INSEMINATION OF CAPABLE SEMEN, IN VITRO FERTILISATION (IVF) or INTRA-CITOPLASMATIC SPERM INJECTION (ICSI).

What is artificial insemination?
It is the insertion of semen in the uterus with medical instrumentation. This procedure is painless. The semen, kept at a temperature of 196 Celsius degrees (Dador’s Artificial Insemination), may be obtained from the partner or from an anonymous donor.

What is motile semen insemination?
It is a new process, very useful for men with a low sperm count in their semen. It consists of filtering the semen’s impurities, isolating the spermatozoids of the seminal plasma and concentrating them by centrifugation ready for insertion in the uterine cavity.

What does in vitro fertilisation consist of?
It is a technique to fertilise a female ovum under laboratory conditions. This fertilised egg, called egg cell or zygote, is implanted in the woman’s uterus to continue the pregnancy normally.

What does intra-cytoplasmatic sperm injection (icsi) consist of?
It consists of isolating an ovum and a single spermatozoid under microscopic vision with a very sophisticated device and to perforate the ovum and then insert the single spermatozoid in it. If it is fertilised, the embryo is then transferred.

Can psycological factors cause infertility?
Of course. Psychological factors and emotions can influence on a very important way on the fecundation capability. It has been proved that there are couples who facing the inability to create offspring of their own, turn to adoption and then later on in life they are able to achieve pregnancy. This is probably due to a more relaxed state of mind, induced by the relief they experience when they receive the adopted child.

Who should be teste first , the man or the woman?
In an infertile couple both men and women should be tested at the same time. There are cases where infertility is diagnosed in one partner and therefore the fertility test of the remaining one is not carried out. This could lead to a false diagnosis, it is recommended both are tested.

Conclusion
The future is very promising on this field, new techniques and procedures to help to understand the reproductive mechanisms are constantly evolving. 

 

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