The increasing incidence of infertility is related to a variety of factors, many of which are attributed to the modern way of life. The chance of conception in healthy couples is about 20 – 25% per reproductive cycle. Infertility affects both men and women and can be diagnosed with a variety of tests and therefore the investigation of the couple should begin at the same time.
A couple should seek help when they have free sexual intercourse and have not been conceived after a year of trying or one of the couple has a history or signs of infertility. The couple can consult a specialist, even before the attempt.
Infertility must first be established (definition, causes). The initial investigation of the couple includes, after obtaining a detailed history, the complete clinical examination of both the woman and the man. The couple’s initial examinations include a woman’s transvaginal ultrasound to check the uterus and ovaries, haematological hormonal tests, and a hysterosalpingography is usually recommended to check the fallopian tubes. Sperm chart and blood tests, to control the partner’s hormones, are considered necessary.
Exams for women
• Blood tests, on the 2nd to 4th day of the cycle, to check the levels of the hormones FSH, LH, TSH, estradiol, progesterone and prolactin.
• Blood tests to check for sexually transmitted diseases such as Hepatitis B and C and HIV.
• Transvaginal ultrasound to check the uterus and ovaries.
• Hysterosalpingography which is mainly recommended for the control of the fallopian tubes. A small amount of this fluid passes through the vagina and ends up in the uterus, revealing any obstructions in the fallopian tubes.
Exams for men
• Sperm diagram to control all sperm parameters (volume, acidity, concentration, motility, morphology). If the first semen analysis is abnormal then the test is repeated, as it is the only way to diagnose male infertility.
• Blood tests to check for FSH, LH, estradiol, and progesterone.
• Blood tests to check for sexually transmitted diseases such as Hepatitis B and C and HIV.
A clear diagnosis needs to be made before any treatment. The diagnosis of infertility is made by a specialized doctor and is extremely important, because it guides the choice of treatment strategy. The tendency for individualized treatment is now apparent internationally, depending on the particularities of each couple.
There is no infertility treatment but depending on the case, simple drug treatment, intrauterine insemination (with or without the use of stimulation), laparoscopy, hysteroscopy, in vitro fertilization, etc. can be recommended.
The solution to couple infertility can be short and inexpensive and not as time consuming as an IVF cycle. IVF is a solution that we respect and lead infertile couples to there but we do not consider it an easy solution, especially for young couples.
Writes:
Stefanos Chandakas Obstetrician – Gynecologist
Assisted Reproduction Specialist
HEALTH Unit IVF EMBRYOGENESIS
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