And whether you know...
May 4, 2012
Today infertility many people around the world have. According to medical statistics it is considered that about 14% of married couples have problems with conception of children. Every year the number of couples which are sterile increases on two million.
In medical practice allocate four different forms of infertility. This man's infertility, female infertility, combined infertility, "inexplicable" infertility. To define what form of infertility takes place at specific couple, is carried out a number of special analyses.
If to estimate the infertility reasons, then it is necessary to allocate such types of this state: uterine, endocrine, hormonal, immunological, psychological, peritoneal infertility.
Infertility at women is also allocated primary and secondary. It is possible to speak about primary infertility if the woman was not pregnant any time in life. Secondary infertility is diagnosed if earlier pregnancy came, but the conception after that following does not happen over one year.
If it is about the combined form of infertility, then in this case there is both a female, and man's factor. Such form of infertility is diagnosed approximately in a quarter of all cases of a similar state. In certain cases infertility is shown at couple in which partners are incompatible. Sometimes after implementation of careful inspection of the man and the woman no visible reasons of infertility are found. In that case inexplicable infertility (so-called infertility of not clear genesis) takes place.
Diagnosis of infertility
Infertility is diagnosed for the woman or the man if pregnancy is absent for one year of constant sex life without use of contraceptives. Such term was determined, being guided by the following statistics: about thirty percent of women become pregnant in the first three months of regular sex life. Another sixty percent of married couples learn about pregnancy for six-seven months, and at ten percent of women conception comes within one year. Therefore, one year – sufficient term for an assessment of fertility of spouses. Today the majority of cases of infertility it is possible to treat successfully by means of modern methods of reproductive medicine.
To estimate fertility of a married couple, the doctor performs inspection and studies a case history in detail, and also features of the sexual relations of partners.
Men without fail need to make the test of sperm allowing to estimate mobility and quantity of spermatozoa.
In the course of inspection of the woman existence of an ovulation at her surely is defined. Ultrasonography of ovaries, special blood test on hormones is for this purpose carried out. In the presence at the woman of a normal ovulation she appoints carrying out a gisterosalpingogramma – a X-ray analysis of fallopiyevy pipes and a uterus. Besides, also other inspections (ultrasonography, a gisterosonografiya, a lapraskopiya) which allow to reveal existence of other pathologies are appointed.
Besides, if necessary researches which are directed to an assessment of interaction of spermatozoa and an ovum are conducted. Also definition of development of antibodies to spermatozoa is made, sometimes the immune system attacks spermatozoa, perceiving them as hostile substance.
Infertility at women is an inability of the woman to conceive the child owing to any disturbances in reproductive system of its organism. So, it becomes very frequent the infertility reason at the woman an oothecoma, pathology of uterine tubes, disturbance of interaction in a slime neck of uterus with spermatozoa.
Very often conception at the woman is impossible in view of disturbance of maturing of an ovum. As a rule, the similar state provokes a hormonal imbalance which at women occurs much more more often than at men. Disturbances of hormonal character negatively influence also process of maturing of an ovum, and provokes disturbances of an ovulation, and also function of a yellow body. As a rule, problems in functioning of ovaries occurs as a result of disturbances in a thyroid gland, a hypophysis, adrenal glands. If endocrine disturbances are the reason of infertility, in the course of therapy the doctor appoints means which recover hormonal balance and stimulate maturing of an ovum.
One more reason of infertility at women — a syndrome of polycystic ovaries. Often infertility causes emergence in ovaries of a large number of small cysts in women. These cysts represent bubbles in which liquid gathers. As a rule, this illness develops against high content in blood of men's hormones. In this case infertility at women is, as a rule, shown as a result of disturbances of maturing of ova. As treatment of this disease stimulation of an ovulation with use of FSG is applied.
Among the reasons of impossibility of conception also tube infertility is often diagnosed for women. In a normality spermatozoa move ahead on uterine tubes and as a result get to an ovum. On pipes oospores move to a uterus. If there is a gluing together of uterine tubes, or they are corked otherwise, then process of the movement of ova can be at a loss or they will not be able to move at all. Impassability of uterine tubes sometimes provokes inflammatory process or endometriosis, that is growth of an endometria out of uterus limits. Today there are many methods allowing to define passability of uterine tubes. At similar pathology conception can be made by means of the EKO method.
Quite often pregnancy at the woman does not come directly because of endometriosis, that is growth outside a uterus of its slime layer. Till today it is unknown for what reason there is this illness. If the centers of endometriosis are located in uterine tubes, then owing to manifestation of hems of a pipe lose the functions. If endometriosis is diagnosed for the woman, then such diagnosis in certain cases is the indication to carrying out EKO.
Sometimes infertility at the woman is a consequence of change of a uterus and neck of uterus. Such changes can be shown as an operation effect. Also pregnancy can not come because of immune deviations of a neck of uterus. For overcoming of a similar problem artificial insemination is used.
Besides, female infertility can turn out to be consequence of development of a hysteromyoma, a number of malformations of pipes, a uterus or ovaries, existence of disturbances of immune system of an organism. In the latter case it is about so-called biological incompatibility owing to which the immune system of the woman considers an ovum or spermatozoa as an alien body, and, respectively, destroys them.
Sometimes infertility at women arises as a result of the genetic reasons. However female infertility is shown for the genetic reasons much more less than infertility at men.
It is accepted to understand such condition of a man's organism at which conception of the child is impossible as man's infertility. Distinguish three different types of man's infertility: secretory, obturatsionny, immunological. At men it is about infertility then if at the woman of a problem are absent, and at the man disturbances of fertilizing capacity of sperm take place, or there is pathology of sexual function or function of an ejaculation.
If the secretory form of infertility is diagnosed for the man, then the problem consists that owing to the different reasons testicles are incapable to develop mobile healthy spermatozoa which concentration will be sufficient to impregnate an ovum. Similar pathology arises at the man because of disturbances of hormonal character, torsion of a small egg, the genetic reasons, a hydrocele. Chronic illnesses, diseases of generative organs, etc. Besides, among factors which can become the reason of this type of infertility at men can provoke also similar phenomenon, define avitaminosis, proteinaceous insufficiency of food, an injury of testicles, some professional factors.
At an obturatsionny form of man's infertility at a man's organism there is an obstacle which is not allowing to get freely to a spermatozoon from testicles into an urethra. Commissures after an infection or an inflammation, postoperative hems, absence or narrowing of a site of the seminiferous highway, existence of a tumor or cyst of generative organs or those bodies which are located a row can act as such obstacle.
If the immunological form of man's infertility takes place, then in this case its development is preceded, as a rule, by a small egg injury. In a man's organism there is a development of antibodies to fabric of testicles. After an injury fabric of testicles and immune system of the person adjoin owing to what there is a perception of testicles immunity as alien bodies.
In the course of diagnosis of man's infertility the doctor performs the general inspection and poll of the patient. After that by means of laboratory analyses the level of hormones is estimated at blood, the spermogram is carried out (that is the analysis of an ejaculate). Also in the course of diagnosis to the man ultrasonography of generative organs is appointed, and carrying out the MAR-test is in certain cases appointed.
The spermogram allows to define the following disturbances: low concentration of spermatozoa, lack of spermatozoa in an ejaculate, low mobility of spermatozoa or total absence of mobile spermatozoa, reduction of normal forms of spermatozoa.
Infertility of not clear genesis
This diagnosis is established if after careful and versatile inspection of partners — men and the woman — at them no pathologies and the reasons for infertility were revealed. The situation at which both partners are healthy however conception does not occur, takes place approximately at 5-7% of all sterile couples. In this case it should be noted impossibility of modern medicine to find out all reasons of problems in reproductive system of people. So, for example, today there is no opportunity to define existence of biochemical disturbances of receptors of a cover of an ovum what can be established in the course of EKO later. Sometimes diagnosing of the imaginary reasons of infertility is in that case possible. As a result, treatment is inefficient.
Sometimes "not clear" infertility arises as a result of immunological or biological incompatibility of the man and the woman. The similar situation is confirmed by the following succession of events: throughout a long span at spouses there does not come pregnancy. However as soon as they begin to live in new families, conception happens very quickly. Today the modern medicine offers carrying out different tests for determination of similar incompatibility. The so-called "Post-coital test" and Kurtsroka-Miller's test is most often used.
Incompatibility of partners is overcome by means of intrauterine insemination which is carried out after check of passability of uterine tubes was made.
Treatment of infertility
After all necessary researches were made, and the specialist has a clear picture of the reasons of infertility at the woman or the man, treatment of infertility is carried out taking into account all specific features of each separate case. The doctor appoints carrying out or conservative therapy (hormonal, antiinflammatory), or surgical intervention is required. So, at hormonal disturbances the appropriate hormonal means are applied. If at the woman the ovulation is broken, then its stimulation is reasonable. Disturbance of passability of pipes demands surgical treatment.
If both of these methods were inefficient, and conception did not come, treatment is offered to a married couple by methods of auxiliary reproductive technologies.
The simplest and often applied method of treatment of infertility is the planned intercourse. In this case it is only about easy forms of infertility. So, if the woman has a normal passability of fallopiyevy pipes, the condition of its endometria and sperm of the man is also normal, then this method can be effective. It is important to define precisely day of an ovulation, and after it to make conception attempt.
But existence of tube infertility demands use of artificial methods of treatment. Use of intrauterine insemination is reasonable if the effect of the planned intercourse is not observed, or problems with cervical slime take place.
The method of extracorporal fertilization is based that the ovum is impregnated in the conditions of laboratory then the received embryo place in the woman's uterus. Such treatment of infertility is applied at endometriosis, tube infertility, pathologies of a neck of uterus.
At treatment of infertility at men it is important to remove the infertility causes, carrying out the corresponding treatment. Antiinflammatory therapy at inflammations in generative organs can be necessary, surgical intervention at a hydrocele and the varikotsel. If the obturatsionny form of infertility takes place, then determination of level of expressiveness of impassability and the subsequent surgery is carried out. If the hormonal background is broken, to the man drugs which adjust it are appointed. The complex therapy including a plasmapheresis and reception of androgenic and fermentsoderzhashchy means is shown to men with an immunological form of infertility.
img class="alignleft size-full wp-image-14333" alt="бесплодие " src="//medicalmed.us/img/besplodie-probir1.png" tppabs="medicalmed.us/wp-content/uploads/2012/05/besplodie-probir1.png" width="280" height="200" />Also treatment of infertility at men assumes process of stimulation of a spermatogenesis (it is not made at an immunological form of infertility). For this purpose it is recommended to man to conduct a healthy way of life, to play sports, to use enough proteinaceous food, to accept the vitamins and other drugs appointed by the doctor. In the course of treatment of man's infertility it is important regular, at least, once in three months, to carry out control spermograms.
The man has to realize that therapy of a similar state is long process which assumes implementation of all recommendations of the doctor.
Prevention of infertility
Treatment of infertility – process long and labor-consuming therefore the special attention should be paid to an opportunity to prevent manifestation of this state. In the childhood parents have to care for the prevention of inflammations of generative organs at the child. Such inflammatory processes are sometimes shown against various children's infections.
It is very important to treat all inflammations of internal generative organs at women in time. They often arise as an effect of abortions, childbirth, operations. At the wrong or untimely treatment formation of commissures can break passability of pipes.
Women whenever possible should not allow carrying out abortions and venereal illnesses, it can become the infertility reason in the future.
As prevention of infertility specialists note also timely conception and the child's birth. At teenage age the woman is not ready to become a mother, and the sex life early begun can negatively influence functions of a female organism.
People who suspect impossibility of conception should not postpone visit to the doctor. What treatment process begins earlier, especially chances to achieve success are high.
Besides, for fertility preservation specialists strongly recommend not to smoke, not to abuse alcohol, to avoid work with harmful chemicals. It is not less important to have legible sex and to use a condom during accidental contact.
For representatives of both floors it is important to support normal weight not to allow emergence of a hormonal imbalance.
Section: Andrology (Man's diseases) B Gynecology