Infertility: A problem that has a solution!
ΤFertility issues are common. One in six couples will face or already faces fertility issues.
There are two types of infertility:
Primary infertility consists in the difficulty in conceiving a child without having successfully conceived one in the past, whereas in secondary infertility one of the two partners has been fertile in the past.
Male infertility problems are estimated to account for 33% of infertility problems; female infertility accounts for 33%, with the remaining percentage considered infertility of unknown causes.
The couple needs to realise that infertility is a problem concerning the couple and not one of the two partners only.
Investigation of infertility
During the first visit to the infertility clinic, we will have the chance to take a detailed history from both partners. An initial assessment of the problem at hand is also made by means of a vaginal ultrasound, so as to probe the pelvic anatomy. Lab and imaging tests are also carried out, as well as a hormone screen and hysterosalpingography, so that the female partner can be fully assessed by the specialist gynaecologist.
The male partner will need to undergo semen analysis so as to reveal any problems related to male infertility. If it turns out to be pathological, clinical assessment by a specialist surgeon urologist-andrologist is then carried out, as well as special tests, such as cultures, scrotal US and hormone tests.
On the second visit, having the tests’ results available, the problem’s cause can be determined. If deemed necessary, the female partner can be further examined using diagnostic hysteroscopy and laparoscopy, so as to study the pelvic anatomy and the interior of the uterus.
Causes of female infertility may be associated with ovulation (39% of cases), damage in the fallopian tubes (30%), cervical or intercourse-related problems (18%) and endometriosis (13%).
Male infertility causes include varicocoele (32%), inflammation and other problems (23%), unknown causes (idiopathic – 23%), obstruction (14%) and female-derived factors (8%).
There are basically four treatment options with which the doctor can help the couple: