Definition and causes
Infertility is with the WHO (World Health Organization) classified as a disease and is usually defined by the fact that after a couple of 1-year trial was not pregnant. Completely rigorous Monday differentiate between infertility and infertility, as for example, couples who already have a child may subsequently be infertile, but obviously not childless.
Typically, approximately. 50% of couples who are trying to achieve pregnancy, become pregnant after six months, while approx. 90% were pregnant after one year.
There may be several reasons why a couple can not achieve pregnancy. The reasons are around. just as frequently in women as in men.
In women the cause may be that shedo not form egg. This may be due to congenital absence of the precursor to the eggs, for example. at Turners syndrome, where the woman lacks an X chromosome. Deusuden it may be because she hasEarly the menopauseThat she hashormonal disordersor dysfunctions which as polycystic ovariesyndrom (PCO).
There may bestructuralcauses in women, reducing fertility, for example. after a chlamydia infection, the egg-heads can be damaged by arvæv. Other causes of egg-heads may be that following surgical procedures might be together waxing which prevents passage of the eggs, or they can be operated enddog away. Structural causes in the womb, for example. fibromer the uterus, may reduce the possibility that the b
Reduced semen quality in male or total absence of sperm in ejaculation (release) can lead to infertility. Impaired semen quality may include due to environmental impact. The semen quality measured both in the number of sperm in ejakulatet, but also in individual spermatozoa movement and appearance. Lack of sperm by ejakuluation may be due to previous infections in man.
Often, a combination of several factors that make the couple is infertilt, and sometimes can cause does not exist. For some couples, where both parties have each had a child with another partner, may also cause infertility. This could be because some antibodies in the woman's mucous membrane, which reacts to her new partner's sperm, but not the former partners.
Precautions and diagnosis
The diagnosis is made usually by a lack of pregnancy after 1 year, and studies usually start until after 2 years unless there are quite obvious, which prevents natural pregnancy.
The determination of infertility begins with the practitioner, who will interview for a particular previous infections and operations. Also questioned in particular to eating habits, and advises on eating disorders or obesity, because both reduce fertility. In addition study, with gynecological examination, this will usually also involve the grafting of a particular chlamydia.
The woman may also be provided by her measure its temperature during the menstrual cycle, since it rises just after ovulation. She can recognize a urinstix, ie. a piece of filter paper with the indicator box on that show growth in one of the hormones before ovulation (the luteinizing hormone). Death can take blood samples for the hormone progesterone.
The anatomical relationship can be provided by reference to a røngtenklinik where you can make an x-ray production of egg-heads and visualize any aflukninger.
The man also examined, and examined testes size, and whether they are in the purse.
His semen quality can be examined by microscopy at a specialized laboratory.
Further explanation can proceed specialklinik. Here the woman include ultrasound scanned for any. polycystic ovary syndrome (PCO) and there could be more specific blood tests.
Treatment of infertility
If infertiliteten due to lack of development of eggs caused by lack of hormonal stimulation or inadequate response to female hormones, hormonal stiumlation try. Primarily with a hormone (klomifen), which binds to receptors in the brain, where it increases the release of FSH (folikelstimulerende hormone) which stimulates the ovaries to produce multiple eggs. If this has no effect, ovaries s
If infertiliteten due to an anatomical defect, such as. enclosed egg leaders, there is often no need for further explanation. There is need to initiate artificial fertilization, where eggs are harvested from the woman after stimulation with hormones. This is done by ultrasound guided punktur which introduced a needle in an ovary, in one of the mature folikler, and the egg is sucked out. This is done through the vagina.
There are different types of artificial insemination:
Intrauterine insemination (IUI):In the normal passage of egg-heads, and the man has moderately impaired fertility (more than 2 million. Spermatozoa per normal. Ml), artificial insemination can be attempted. Here is injected purified spermatozoa in the uterus through a catheter, very close to indmundingen of egg heads, just before ovulation. This may not be necessary. prior gåes of hormonal stimulation, as described above. If this does not result in pregnancy after 6 times (figure may vary
Micro Insemination:In highly reduced sperm quality (below 2 million. Spermatozoa per. Ml) can be used micro insemination (ICSI: intracytoplasmic sperm injection). Her eggs are harvested as described above, then under a microscope inject a single sperm into the egg with a very thin needle. After the display of the fertilized egg in the womb. Often set up more than one, since the risk that the egg does not grow fast and become an embryo,
IVF ( "test tubes" method):If a woman's egg-heads are closed but the man has normal sperm quality, we can apply the method, which popularly known as "test tube" method (IVF: in vitro fertilization). Her eggs are harvested as described above, then in a test tube, add sperm. Then set the highest two fertilized eggs in the uterus. This is because the risk of multiple pregnancy are substantial.
FER:Often, when the harvest of eggs, have more usable eggs, than to be put up. They can, after fertilization, frozen and used for subsequent configuration where the first configuration does not result. This is called FER (frozen embryo replacement).
Donoræg:If the woman does not produce eggs, which can display a fertilized egg from a donor. Her eggs are harvested as previously described by another woman, and this can be set up after fertilization of the woman seeking pregnancy.
Select and complications
The risk of multiple pregnancies (mostly twins) is significantly increased by artificial insemination, with a rule set more than one fertilized egg.
Artificial insemination in figures
In 2004, in Denmark referred 2,927 women for artificial insemination by one of the above methods. All were first referred. There was performed a total of 9,173 treatments. Of the 9173 treatment, several treatments have booted on the same woman, each woman may have several treatments, if failed first time. There were 1,525 single births and 408 multiple births, highlighting the frequency of flerfo
(Source: the number of births and infertility treatment positions for: Health Board IVF Register).