“Reimbursement organizations must help guarantee citizens their reproductive rights” After marriage, many couples are impatient to see a newborn born. Except that as the months and years pass, patience wears thin. To overcome doubts and seek treatment, you must carry out clinical examinations. Abbad El Andaloussi Malak, obstetrician-gynecologist answers our questions.
What is the medical procedure to follow in the event of a woman’s infertility problem?
A complete clinical examination and a good history can already provide valuable help with this problem. In women, numerous steps can be taken, such as the analysis of temperature curves over two months to assess the rhythm and presence of ovulation. Hormonal measurements in the blood can also be carried out. In addition to this, an x-ray examination using a contrast product to check the absence of obstruction of the tubes, called hysterography, can also be considered. Pelvic ultrasound, which is an imaging test that evaluates the quantity of oocytes present in the ovaries and detects possible abnormalities, is also one of the different tests recommended to get an overall idea of whether a woman is late to become pregnant. .
Women are not the only ones affected by these medical tests, men can also be affected by a pathology of dysfunction of the reproductive system. What about tests recommended for male patients?
When it comes to men, practitioners generally start with the spermogram. This medical practice consists of analyzing semen to define the number, mobility and shape abnormalities of the spermatozoa. Additionally, blood tests may be done to identify hormonal disorders. Infertility in a man can, as you know, result from many dysfunctions. This is why it is also important to carry out a biopsy to detect them. But this is not enough if the patient’s metabolism has not responded to the various treatments. Further investigations may be undertaken if all of the above interventions prove unsuccessful.
Do the lifestyle and environment in which a married couple lives have an impact on fertility?
Indeed, numerous studies have established a link between exposure to certain families of pollutants and fertility disorders. On the women’s side, scientific hypotheses suggest that the increase in female infertility could be linked to environmental changes, pollution and endocrine disruptors. For men, sperm damage may be due to chronic exposure to high temperatures. For example, sitting for long hours, regularly visiting saunas, taking very hot baths or using a laptop on your lap. These are factors that could be responsible for infertility in men.
Apart from these factors, age is a variable that must also be taken into consideration. Can you tell us about it?
Quite. It is important to keep in mind that it becomes more difficult for a couple to conceive as the mother’s age increases. The problem arises more among women, because you should know that men are constantly renewing their reserve of sperm. However, eggs are in limited quantity. At birth, a little girl has 1 to 2 million eggs. Over the years, their number gradually decreases until we reach 40 years of age. At this age, women only have 3% of their ovarian reserve. In this sense, it should be emphasized that female fertility begins to decrease around the age of 35 and accelerates after 37 years. Furthermore, the number of eggs drops drastically as we age, but also the quality of them. It should also be noted that advanced maternal age leads to an increase in chromosomal abnormalities, risks of miscarriage, congenital malformations and potential complications during pregnancy.
In men, spermatogenesis undergoes changes over the years. Can you give us an overview of how this reproductive process is changing?
Even if a man produces sperm throughout his life, it is important to remember that from the age of 30, the level of testosterone, necessary for the production of sperm, decreases each year by approximately 1%. The quality of the latter is also decreasing. The sperm of a 40-year-old man can contain 3 times more genetic mutations than a 20-year-old man. Scientific studies have shown that the rate of DNA fragmentation and decondensation is higher.
If the result is negative after following the treatments prescribed by specialists. What is the outcome for giving birth to a baby?
The couple can turn to medically assisted procreation (MAP), such as artificial or “intrauterine” insemination or in vitro fertilization “IVF”. The first involves injecting sperm taken from the patient directly into the uterine cavity during the ovulation phase, in order to facilitate fertilization. While the second, which takes place in the laboratory, is a kind of embryo implantation in the uterus. However, the gametes can come either from the same couple themselves, or from a male or female donor. It mainly depends on the type of infertility involved. But in my opinion, this solution remains insufficiently funded and often inaccessible due to its high cost.
Related News :