Infertility affects a large number of couples, but once the causes have been identified and the examinations suggested by the specialist have been carried out, various solutions can be considered. Let's find out what they are with the help of the expert
Infertility is defined by the WHO (World Health Organization) as a disease characterized by the absence of conception for a well-defined period and which varies according to the age of the couple. It can concern the man, the woman or even both partners for different reasons.
In Italy alone, about 15% of couples are unable to have children due to infertility. And although receiving this diagnosis can cause stress and tension, pregnancy should not be considered a distant dream. There are in fact different solutions that can be explored and through which there are good chances of conception.
However, it is important to take the situation in hand and contact a doctor who takes care of precisely this, that is, an infertility specialist. In fact, through the results of the various tests performed at your request, it will be possible to first identify the causes and then proceed with the appropriate therapy.
We discussed this delicate topic with Dr. Elisabetta Colonese, surgeon, specializing in Gynecology and Obstetrics, couple infertility therapy.
- What is that
- Exams to be carried out
- Possible solutions
What is that
The term "infertility" means "the reproductive inability of a couple after a limit period. We generally speak of infertility under the age of 35 when you have free, targeted intercourse for a whole year, which however does not result in conception. Instead, over the age of 35, infertility is considered already after 6 months of continuous intercourse ”, explains the doctor.
“The causes belong to the couple and can be divided into male or female causes in broad terms. Male causes are of a despermic type, therefore an anomaly in the semen that can be of different degrees of severity. Instead, as regards the woman, the causes can be:
- age first;
- hormonal (e.g. hormonal abnormalities);
- polycystic ovary syndrome;
- anatomical anomalies concerning the uterus such as fibroids, polyps, or ovaries (cysts);
- tubal problems, namely mono or bilateral tubal occlusion.
There are also some pathologies that can be attributed to infertility, such as haematological problems », continues Dr. Colonese.
When you realize that the pregnancy test continues to be negative well beyond the timing outlined, it is good to contact the specialist and perform the necessary tests to understand the causes. In this way, it will be possible to act in a targeted manner.
Exams to be carried out
"First of all, it is good to visit an infertility specialist who will go to frame the couple and ask for suitable tests to understand which of these anomalies we have mentioned may be present and if a cause is identifiable. The exams he will ask are:
- ultrasound, to evaluate the morphology and ultrasound appearance of the woman;
- the count of antral follicles, that is an ultrasound that goes to see the ultrasound ovarian reserve;
- hormonal tests, namely AMH, FSH, LH, prolactin, androgens, progesterone, thyroid function;
- examination of the tubes to see if they are open or not;
- a series of haematological tests.
During the gynecological examination, it is right to ask, if the woman has not done so, for the pap test, which I recommend to perform annually. If necessary, the specialist can also evaluate a complete vaginal-cervical swab to rule out vaginal pathogens and breast control in the form of bilateral breast ultrasound at a young age. While, in adulthood, following the more fibrous change due to age, a breast checkup in the form of bilateral mammography is recommended, possibly also associated with bilateral ultrasound if the breasts are particularly dense or in the case of fibrocystic mammoplasty. There are also tests that can possibly go to see the endo-uterine microbiota, therefore at the level of the endometrium. The man, on the other hand, is asked to perform the seminal test ", specifies the expert.
«The possible solutions can be divided into first and second level. First level means that the couple is suitable on the basis of the exams carried out, to remain at least initially, towards targeted intercourse at home or towards artificial insemination, or the introduction of a catheter with the sperm of the husband enabled at the right time. And these two things can be done on a spontaneous cycle or stimulated with a small amount of hormones, usually in tablets with a short therapy (on average 5 days).
The second level, on the other hand, involves an in vitro assisted procreation technique, therefore a technique with hormonal stimulation a little more sustained and longer over a period of about 2/3 weeks, to then go for an operation called egg retrieval that goes to take the follicles that have been stimulated by hormonal stimulation and inside which it is hoped to find the eggs to put in contact with the semen in the laboratory. After 2-5 days, embryos will be created, hopefully, to be transferred to the uterus with a catheter absolutely quickly and painlessly, without anesthesia. At that point, she waits for about two weeks to have the pregnancy test positive or not, "concludes the expert.
In general, therefore, in the case of infertility, it is possible to intervene through different techniques which aim to promote conception.
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Tag: Pregnancy Infertility