Infertility

Apr 15, 2012 , Veronika Fejfarová

neplodnost.jpg - kopie
neplodnost.jpg - kopie
Infertility is another term for the inability to conceive a child and is caused by various reasons. Nowadays is infertility a very debated topic since it affects around 15% of couples. In the Czech Republic is almost 30 centres which deal with infertility, i.e. the centres of assisted reproduction. Their influence reduced inability of couples to conceive the child of their own at 3-5%.

Infertility

Infertility is defined as the inability to conceive a child with regular unprotected sexual intercourse within two years. Fertility is divided into primary and secondary. It never come to pregnancy in primary infertility. In secondary, pregnancy occurs but it can be successful or unsuccessful, i.e. miscarriage or ectopic pregnancy. Infertility in men and women is approximately equal. Although in recent years the fertility of men begin to decrease even more. This is mainly due to the decreasing number of healthy sperm on which has the environment and the way of life a negative influence. In women play a role increasing age, lifestyle and various diseases that cause failure or the release of ovum.

Fertilization

For conceiving a child is a fusion of male sperm and female ovum necessary. Ovum, usually one, matures ideally every month in the ovaries and it is released during ovulation. After that, the ovum is capable of fertilization for about 24 hours. In men, the sperms originate in the testes which is stored in the scrotum, i.e. leathery pouch below the penis. Here is temperature about 2 degrees lower than in the rest of the body, this is essential for the proper function of testes and production of sperms. In healthy men is per day produced up to a hundred million of sperms. After emission or ejaculation of semen are sperms able to survive in the female body three to four days. But the ability to fertilize an ovum lasts only 48 hours. This maturation of gametes, egg cells and sperms is not random but it is strictly controlled by the higher centres. The ovaries and testes are controlled by hormones that are released by the pituitary gland. The pituitary gland is the part of brain that has just the task to produce a variety of hormones. In addition, this gland is also controlled by the higher centres in the brain. After the fertilization of ovum by sperm, complex process in which cells multiply occurs. However, it often comes to an error but organism can cope with this. Exactly this way damaged embryo is not able to catch on in the uterus and is expelled with blood during menstruation. Woman will not even know that there come to fertilization. If this natural selection did not occur, it would be up to 80% of children born disabled.

Infertility in men

As already mentioned, the infertility occurs in men and women approximately equally. The most common cause of the infertility in men is the low sperm count and its quality. The culprit may be insufficient regulation of sperm production by hormones. This deficiency can be also due to testicular malfunction caused by, for example, higher temperature in the belly when the testes did not descent into the scrotum, various infections, varicocele thus the extension of veins in the scrotum that the testicles warm and oppress, or by testicular injury. Testicles, as well as the brain, are separated from the human's immune system by barrier, since it could happen that the immune system classifies the testicles as strange and can possibly damage it. Precisely when trauma occurs it comes to disruption of the immune system's barrier and inflammation of the testicles. In the infertility is also involved dysfunction of erection and ejaculation. The penis contains erectile bodies that fills with blood during arousal and swell. Thanks to this penis hardens and erects. This is description of an erection. If erection fails, most commonly due to vascular disease or mental conditions, fulfilling sexual intercourse is not possible and thus the ovum can not be fertilized. The ejaculation is process in which comes to emission of the semen during orgasm. Ejaculation may be negatively affected by some drugs. It is also possible that an ejaculate does not contain any sperms. The man may this not even notice. The fault is clogged duct or vas deferens which transports sperms from the testicles to prostate. The prostate is the place where is the majority of ejaculate formed.

Examination

The simplest and most reliable examination of infertility in men's is sperm count. In this test is the sperm sample microscopically examined, the sperms are provided by man, mostly by masturbating on the spot in the special room or in the comfort of your home. However, it is necessary to use special sterile container to store the semen. In sperm count test are different factors evaluated, e.g. sperm density, movability, quality and shape.

Infertility in women

Within the most common causes of infertility in women belong disorder of hormones and ovaries, tubal damage, endometriosis, an anatomical variation and disturbance of the uterus, genital malformations, impaired immune function and psychological state. Due to developmental defects or diseases of the brain that releases necessary hormones, fertility disorders in which sex hormones are not released properly develop. These hormonal disorders are associated with the impairment of ovaries due to which ovum can not mature or be released from the ovary. Therefore, it does not come to ovulation. In the case of impaired fallopian tubes can be woman fertile in terms of the ovum but the sperm is not able to reach the released ovum due to the blockage of fallopian tubes, the sperm is not able to impregnate the ovum or the fertilized ovum is not able reach the uterus in which the ovum nidates and evolves. Tubal blockage occurs most frequently as a result of long-term wrong treated or untreated gynaecological inflammation. Endometriosis is also cause of infertility and tubal occlusion. Endometriosis is a condition in which the lining of uterus is located outside the uterus, most commonly in the ovaries, fallopian tubes, and bladder. These places with mucous membrane of the uterus are also influenced by hormones and during menstruation comes even here to bleeding. Affected places gradually cicatrize and adhesions that cause infertility develop. In the impaired uterus is the fertilized ovum not able to nidate and evolve. If failure of the immune system occurs, the immune infertility develops, the immune system attacks the sperms that are foreign to the body but also the body's own tissues and organs.

Examination

In women is performed hormone blood test, ultrasound examination of the uterus and ovaries. In some cases, especially if pathological finding is assumed, laparoscopic examinations is carried out. In laparoscopic examination the doctor performs a few small holes in the abdomen, through which are induced tools, source of light and camera attached to a television screen on which can the doctor view performed examination. 

Treatment of infertility

With regular unprotected intercourse within one month 30% of women get pregnant, 75% in seven months and 80% till one year. By the end of the second year, 85% of women conceive. These percentages subsequently does not grow much longer so it is necessary to begin to solve this situation. Nowadays can be infertility well treated. In the Czech Republic is almost 30 centres which currently specialize in the treatment of infertility. Almost in half of the cases we manage to solve the root cause of infertility and it comes to spontaneous pregnancy ,and the other will become pregnant using assisted reproduction. Only about 3-5% of couples are unable to have their own child.

Treatment of infertility in men

Treatment of male infertility depends on the causation. Varicocele with obstructed vas deferens is treated surgically. In case of sperm's deterioration by the immune system is the main way of treatment use of immunosuppressive drugs, i.e. medications that inhibit the function of the immune system. In other cases or if previous treatment methods have failed, the methods of assisted reproduction are performed.

Treatment of infertility in women

Treatment of female infertility depends also on the underlying cause. Hormonal imbalance is treated with drugs that affects hormones, or with medications that replace these hormones when they are missing in the body. Surgery is used to treat clogged fallopian tubes, endometriosis and adhesions. In the case of immunological fertility is the immune system inhibited with medications. If even after these treatment methods woman do not get pregnant, assisted reproduction is performed.

If you have unprotected sex and have not gotten pregnant, and yet it does not take more than a year, there is no need to be concerned. Even in healthy couples is not conception immediate. Of course, it is recommended to have a reasonable weight and live a healthy lifestyle. However, if conception is not possible for longer time, it is necessary to visit your doctor who will recommend next steps that moves you closer on your way to baby.

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