What are infertility and sterility?

Primary sterility: When a couple, after one year of unprotected sexual intercourse, has not reached pregnancy.

Secondary sterility: When a couple, after having a child, cannot achieve another pregnancy after two or more years of trying.

Primary infertility: When a couple achieves a pregnancy that does not reach term with a normal newly-born child.

Secondary infertility: When, after a normal pregnancy and birth, they do not achieve a new pregnancy to term with a normal newly-born child

Does it affect many couples?

Approximately 9 out of 10 couples of fertile age who have regular sexual relations achieve a pregnancy during the first year. The figures handled by specialists calculate that 15-17% of couples cannot have a child.

What are the causes of infertility?

They are of a social or medical nature. The first type includes the delay in trying to have children and the stress that both men and women undergo in their everyday lives. Among the general medical causes we have extreme obesity, anorexia nervosa, serious illnesses, thyroid problems, drug abuse and medication, alcohol and tobacco, as well as chemotherapy. 20% of cases have no explanation.

Can mental factors be the cause of infertility?

The influence that emotional disorders may have on reproduction is not known. Stress associated with reproduction must be treated as it leads to a decline in the couple′s quality of life.

To what extent does age affect female infertility?

A woman′s physical and mental maturity means that the perfect age to have children is between 25 and 30. But nowadays couples decide to have children at a later age, greatly due to women′s incorporation to working life. After 35 years of age, fertility levels drop significantly and after 45 the possibility of a pregnancy is exceptional.

Who are usually responsible for infertility, men or women?

40% would be due to male causes:

  • alterations in the testicular area
  • obstruction of ducts
  • prostate pathologies
  • alterations in ejaculation or erection
  • alterations in semen

A further 40% would be due to female causes:

  • such as early menopause
  • endometriosis
  • obstructions or lesions of the Fallopian tubes
  • uterine and cervical anomalies
  • ovulatory problems

The remaining 20% corresponds to mixed or combined causes, in which both are responsible. We always prefer to talk about the couple's causes or reasons because, whatever the problem, the collaboration of the couple is essential.

Has a current reduction in fertility been established?

Male fertility has worsened due to a reduction in the count and motility of sperm. Cases of older women who decide to commence maternity at older ages are also common, and they attempt spontaneous pregnancy when their fertility levels are reduced. Cases of men who, having had a vasectomy and on finding a new wife, wish to become fertile again, are also common.

Is infertility in some way related to the sharp decrease in the birth rate in some countries?

Only in the sense that nowadays in developed countries factors exist which can have a negative impact on the production of spermatozoa such as alcohol or tobacco. Environmental contamination is also important, as well as substances and additives contained in food, such as hormones for fattening up livestock. In agriculturalcommunities, particularly in places where there are greenhouses, the use of pesticides which have certainhormonal activity can have an impact on male infertility. Other aspects related to changes in lifestyle: incorporation of women into the workplace, delay in the age of the first pregnancy, consanguinity, etc. contribute to the reduction in birth rates.

How can you know which days you are ovulating?

A woman?s ovulation or fertile period occurs towards the middle of each cycle, around the 14th day in the case of a 28-day cycle. 24 hours after ovulation the basal temperature is raised by 4 to 6 tenths. This sign is the basis of the control method to determine on which days you ovulate.

How often should you have sexual relations in order to get pregnant?

Once the egg has left the ovary it survives for approximately 48 hours and it is only during this time that it can be fertilised by the spermatozoa, which have a fertilising power of a maximum of 72 hours. In any case, it is better not to become obsessed with controlling ovulation, as anxiety to achieve pregnancy is counterproductive, and can even be detrimental to the couple?s relationship.

Up to what age can men and women have children?

There is no legal limit which prevents a couple from seeking fertility. It is a difficult issue to judge, because it greatly depends on each couple′s situation, on their health and physical condition, and on other matters. In the case of women, 45 would be a reasonable limit after which we do not advise undergoing this type of treatment.

When do you need to turn to a gynaecologist specializing in reproduction?

After a year of regular, unprotected sexual intercourse with no pregnancy, you can start to suspect the presence of a problem.

What is an assisted reproductive clinic?

It is a medical centre specializing in diagnostic methods and reproductive techniques, which has specifically trained highly-qualified staff and the latest technologies to help you conceive. In the case of fertility problems you should visit a specialized gynaecologist as the infertility investigations are complex and include tests which are not performed in regular gynecological examinations.

What is hysteroscopy?

<p>Hysteroscopy is a procedure that allows the doctor to look inside the womb (uterus). It is performed to assess a woman with infertility, recurrent miscarriage or abnormal uterine bleeding. Hysteroscopy can be either diagnostic or operative.</p>

How is hysteroscopy done?

For this procedure a thin telescope-like instrument – the so called hysteroscope – is inserted through the vagina and cervix into the cavity of the womb (endometrial cavity). Skin incision is not required for hysteroscopy. After the hysteroscope is inserted through the cervix and into the uterus, sterile saline solution is injected into the uterus through the hysteroscope. This fluid expands the uterine cavity and enables the physician to directly view the inside structure of the uterus. In most cases, this procedure can be done without anaesthesia or sedation. There might be some slight cramping like period pain. Of course this procedure could be done also with anaesthesia, if required.

In case, hysteroscopy will be recommended, you will receive more detailed information and explanation by your IVF doctor.

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