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The check-up for suspected infertility

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When you become aware that you cannot have a child, it is fundamental to go to a specialist in gynaecology, andrology , or to an Assisted Reproduction Centre: in all cases these specialists have to affront infertility in a specific way. They have to reach a correct diagnosis in the shortest possible time, at a reasonable cost.

The gathering of the anamnesis
During the first check-up for suspected infertility it is generally advisable to, go as a couple. The doctor will ask you:

  • how long you have been trying to have a baby
  • the frequency of sexual intercourse
  • to describe the menstrual cycle (regular, irregular..)
  • if there are any existing or previous genital infections
  • medical and surgical history and past and present treatments (some of which can negatively affect natural fertility)
  • contraceptive methods used in the past
  • hygiene and lifestyle: weight, physical activity, alcohol intake, smoking and the possible exposure to toxic substances…
  • therapy administered so far, to cure infertility.

During the first visit, often, the woman undergoes a gynaecological check up with a pelvic ultrasound, and the doctor will prescribe some biological analyses, instrumental and genetic which serve to understand the absence of pregnancy and give a first diagnosis. Other exams might be necessary in successive phases.

Infertility is defined as a condition whereby after a year of regular unprotected sexual intercourse a couple cannot have a child. This phenomenon seems to be on the increase, maybe because couples decide to have children later and also because of unfavourable conditions, for example pollution. Infertility depends one third exclusively on the woman, one third only on the man and another third on both of them together. This definition of infertility can be reduced by six months if the age of the woman or certain conditions are unfavourable.

The psychological aspect of infertility
The negative factors of a psychological nature are a very common condition in infertility, this being because the same desire to become parents can in itself be a stressful element. Even extreme physical activity can compromise fertility, in the same way as anxiety and the stresses of modern life. For this reason holiday periods are considered the best times in which to conceive. It is not rare among couples that conception occurs just at the time when the partners surrender themselves to the impossibility of conception and decide to adopt a child, giving up on the idea of having one of their own. In other cases, the simple fact of resorting to a specialised centre increases their hope of conception and reduces stress, tremendously improving the effective possibility of conception. In unexplained infertility there can be many psychological components.

Male causes of infertility
It seems that the masculine causes of infertility are on the increase. Both the daily lifestyle and atmospheric conditions can play a big role. Causes like varicoceles or infections can disturb the formation of spermatozoa for a very long time and cause notable and sometimes irreversible damage to the testicles. Fortunately therapies available today allow for the cure of practically all types of male infertility, even when there are no spermatozoa to be found in the seminal liquid (azoospermia), it is therefore rare today that a doctor can say to a man: “there is nothing that can be done”. Alterations of the normal values of the spermatozoa can be caused by:

(1) Varicoceles
(2) Infections
(3) Hormonal Deficit
(4) Other causes
(5) Unknown causes

Female causes of infertility
In the last decade, better hygiene conditions have reduced the infective causes of infertility, especially those caused by two types of infection: tuberculosis and gonorrhoea. These infections principally caused the blockage of the tubes, in fact the tubaric causes of infertility have diminished as a whole. Contrary to this bacterial infections such as clamydia have increased. These infections are insidious because the woman can go without noticing at all that the infection is present. In these cases antibiotic therapy is not administered immediately.

You therefore become aware of the consequences when you undergo a check up to find the causes of infertility.

(1) Ovulation abnormalities
(2) Tubaric causes
(3) Hormonal deficit
(4) Uterine causes
(5) Other causes
(6) Unexplained infertility

lunedì 2 marzo 2009

Risorse video
The first consultation
Couples already in consultation
Couples with previous failed attempts
When can we say “there is an infertility problem”?
Secondary infertility
Transforming a possibility into a success

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