En Sterility Causes and Treatments, we are going to study sterility, which is defined as the inability to get pregnant. It is estimated that it occurs in 10% of couples.
In other English-speaking countries, when this occurs they speak of infertility.
In our culture we speak of infertility when repeated miscarriages occur once the pregnancy is achieved. That is, in infertility the pregnancy does not end as expected. And it is not a limitation to get pregnant.
The vision and the sterility study It must be shared with the couple, whether the cause is masculine, feminine or mixed.
It is highly recommended that the people involved always attend medical visits.
The study and infertility treatment It is usually a long and detailed process that must be understood as such.
In these cases, it can take months to achieve the desired result and many times several specialists will intervene.
Today this topic has evolved in such a way that specialized centers in Infertility and Sterility, endocrinology and reproduction as the Institute of Gynecology of Barcelona Dra. Gómez Roig.
Our medical services offer personalized attention to find out the causes of the sterility and la infertility.
La Integrative Gynecology, which we also offer at our center, can help address this concern from a global, emotional and physical point of view.
How can I know the cause of sterility?
To know the causes of female infertility it is necessary to go to the specialist in reproduction.
When a couple seeks an unsuccessful pregnancy, for a period of more than one year, it is recommended that they start a study of fertility or infertility.
However, when there are factors with greater risk of sterility it is recommended that the study be started at around 6 months.
The factors that justify advancing the consultation before the year are:
- Age of the woman greater than 35 years.
- Obese or underweight women with rule disorders.
- background of genital infections, pelvic or testicular diseases.
Because pregnancy requires good fertility in both men and women. The specialists will carry out the study of both people involved to know about the sterility causes and treatments.
Study of male sterility
The study of male sterility includes the study of various factors involved in the process.
In these cases it is necessary to know:
- The normal functioning of some areas of the brain responsible for the correct release of hormones. These areas are glands called the hypothalamus and the pituitary gland.
- The anatomy and function of the testicles.
To rule out that man intervenes in the cause, we must perform:
- An good medical history asking for antecedents that influence fertility.
- complete physical exam: special attention is paid to the characteristics associated with defects in testosterone such as: loss of facial and body hair, and decreased testicular size.
- semen study or seminogram: the sperm count is studied. This analysis provides information about the amount of semen and the number, mobility and shape of the sperm.
- Blood Tests: Provides information about the hormones that play a role in male fertility. This test is requested if the seminogram is not normal.
- Genetic testing: they are only studied if the existence of genetic or chromosomal alterations is suspected.
In less frequent cases, it may be necessary to request other tests:
- transrectal ultrasound: if an obstruction of a tube in the male reproductive system called the epididymis or vas deferens is suspected.
- An post ejaculation urine sample: if retrograde ejaculation (movement of semen into the bladder) is suspected.
- Testicular biopsy: in men without spermatozoa in semen analysis.
Study of female sterility
For study of female sterility we have plenty of evidence. Despite this, it may not be necessary to perform all of them.
According to the results of the tests, the specialists will decide what causes and treatments should be studied in sterility. Initially, the medical history, a complete physical examination and some preliminary tests are carried out.
The examinations that are requested are the following:
- Medical history: A woman's health and medical history can provide some clues as to the cause of infertility. Menstrual history is also important. Women who do not have their period generally do not ovulate, and it can be the cause of infertility.
- Physical exam: This is done with special attention to any signs associated with hormone deficiency or excess, such as facial hair. As well as signs of other conditions that may affect fertility. The usual gynecological examination should also be performed.
- Blood test: the levels of various hormones that play a role in female fertility are studied.
- Basal temperature of the body: this test that was carried out in the past, but today it is no longer requested. Temperature patterns can be difficult to interpret and are generally not recommended.
- Study of the uterus and fallopian tubes.
How do you know that the uterus and tubes are normal?
In sterility causes and treatments, with the analysis of the uterus and tubes are discarded:
- uterine abnormalities: uterine partitions, fibroids or fibroids, and polyps among others.
- Scarring and blockage of the fallopian tubes: This can occur as a result of pelvic inflammatory disease, endometriosis, or pelvic adhesions (scar tissue) from infection or abdominal surgery.
To study the uterus and tubes we have:
- Hysterosalpingography: involves inserting a small catheter through the cervix and into the uterus. After injecting a liquid contrast, an x-ray is performed to see the outline of the uterus and tubes.
- Hysteroscopy: This test allows, through a thin tube with a camera at its end, to visualize the uterus inside and the holes of the fallopian tubes in their union with it.
- Gynecological ultrasound: provides a very clear image of the uterus and ovaries. It is used to measure the size and shape of the uterus and ovaries. It allows us to know if there is a pathology such as the presence of fibroids or ovarian cysts.
- Laparoscopy: it can detect damaged or blocked tubes, endometriosis, and other pelvic abnormalities. It is the best existing test for the endometriosis diagnosis or pelvic adhesions such as scarring. Additionally, endometriosis can be treated during laparoscopy, which may help improve pregnancy rates in infertile women who have this condition. However, laparoscopy is not routinely performed in the study of infertility. It is an operation, so the benefits and risks have been assessed.
- Genetic tests: they may be recommended if there is a suspicion that genetic or chromosomal abnormalities contribute to infertility. These tests generally require a small blood sample, which is sent to a laboratory for evaluation.
Sterility Treatments?
The sterility treatments both in men and women, they always have to be treated with a specialist. At the Dra. Gómez Roig Institute of Gynecology we care about your health and well-being, do not hesitate to contact us.
The existing sterility treatments to solve these problems are listed below:
- Ovulation stimulation: it is about giving a hormone that helps the ovary to ovulate in the middle of the menstrual cycle. With ultrasound controls, it is verified if the medication is taking effect. The hormone can be given orally, but in cases that do not respond correctly, injections are used with the medication. These injections are administered by the same woman, being easy to learn from her. It is not usually a problem.
- Artificial insemination: In this procedure, semen is placed directly inside the woman's uterus. The semen is previously prepared by selecting good quality sperm. It is a test that is performed in one query and is not complex. Anesthesia is not required for this.
- In vitro fertilization, Also called IVF, which is carried out in different phases:
- Ovulation stimulation with hormone injections.
- Removal of the oocytes of the ovaries by means of a transvaginal puncture using ultrasound of the follicles. Follicles are the natural cysts that appear before ovulation in the ovaries. This phase requires sedation or general anesthesia.
- Embryo transfer inside the uterus. It is performed in the office without the need for anesthesia.
On Gynecology Institute of Dr. Gómez Roig, in Barcelona, we will assist you if you have doubts or problems sterility causes and treatments.
Our professionals will take care of you and help you in moments of doubt and concern.
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- About the Author
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Head of the Obstetrics and Gynecology Service at the Sant Joan de Déu Hospital in Barcelona. Associate Professor of Obstetrics and Gynecology and Coordinator of the Sixth Course of Medicine at the University of Barcelona, UB. Director of the Dra. Gómez Roig Institute and Coordinator of Obstetric and Gynecological Processes at the Corachan Clinic in Barcelona.