PROBLEM TO LEAVE PREGNANT

The first thing that it is necessary to consider is when we can speak of infertilidad and it is in the following cases:

• The couples that they have trying to have children during one year and they have not gotten it. If the woman has more than 35 years, she should go to the specialist last 6 months.
• Women with anovulación, factor tubárico, endometriosis or precocious ovarian failure, independently of the age.
• Males with alterations of the seminograma.

Their frequency is variable in diverse population nuclei and latitudes, but he/she is considered that of 10 to 12% of the couples in urban populations are affected by problems of this nature. It is spoken of sterility or primary infertilidad when there have never been viable, or secondary children when they have already existed.
The reproduction and their problems are not a matter of the women, but rather they are shared by the couple: at least 40% of the causes resides in the male and 30% in both simultaneously.

Causes of sterility in the man

General •
It tires, estrés
Excess of alcohol or tobacco
Excess of sexual activity
Sexual impotence
• Of the development
Criptorquidia
Germinal Aplasia
Hipospadias
Syndrome of Klinefelter
Endocrine •
Hipopituitarismo
Acromegalia
Hiper or hipotiroidismo
Syndromes adrenogenitales
Severe diabetes
• genital Pathology
Varicocele
Epididimitis
Prostatovesiculitis
Orquitis urliana

Causes of sterility in the woman

General •
Bad nutrition
Serious anemia
Moving ("hipotalámicas")
Frigidity
• Of the development
Absence of uterine hipoplasia
Uterine malformations
Disgenesia gonadal
Syndrome of Kallman
Endocrine •
Hipopituitarismo
Hiperprolactinemia
Hiper or hipotiroidismo
Syndromes adrenogenitales
Ovary poliquístico
• genital Pathology
Inflammation pélvica.Tuberculosis
Obstruction tubaria
Endometriosis
Miomas. Poliposis endometrial
Cervicitis. Vaginitis

Causes of mixed sterility

• emotional Desajuste
• Errors in the sexuality
• immunologic Incompatibility


I study of the sterile couple

Most of the couples that exercise the sexuality in normal form achieve a pregnancy in the first year (80%) and others in the second year (5 additional%). For this reason, he/she usually recommends not to make studies neither specific treatments in this respect before 1 year of sterile sexual relationships. Lapsed this time will be come in the following way:

Clinical history
The doctor will be interested for:

- Confirmation of the state of individual health of each one of the couple's members (diabetes, cardiopatías, nefropatías, chronic infections, toxicomanias…)
- Antecedents and current habits of the couple in the realization of their sexual activity (not very frequent coitus, precocious ejaculation, etc).

Physical exploration of the genital apparatus
The doctor will try to discover:

- Congenital malformations or obvious anatomical problems in the woman.
- Idem in the male (varicocele, hidrocele, criptorquidia…).
- Cytology of the uterine neck (exam of Papanicolaou).
- I study of the snot endocervical. Their macroscopic and microscopic characteristics indicate if there has been or non ovulation in a given moment of the menstrual cycle.
- Espermiograma. He/she informs about the capacity fecundante of the sperm.
- Espermatobioscopia poscoito (test of Sims-Huhner) to half of the cycle: he/she informs about the capacity fecundante of the sperm and also on the receptividad of the uterine neck.

Married Infertilidad
The recurrent loss of pregnancies in a viable principle can have genetic causes of anyone of the spouses or of both, immunologic, endocrine, anatomical of the uterus, toxic, infectious or parasitic whose diagnostic and treatment yes they sometimes require attention of very high specialization, for what its study should be approached from the beginning by the specialist to avoid losses of time, frustrations or worse damages in the couple's reproductive potentiality.