THEInfertility in Italy affects approximately 15% of couples while, in the world, approximately 10-12% (Source ISS). This pathology can affect men, women or both (couple infertility). However, it can also happen that there is an impossibility for that particular union between individuals to conceive life. Human reproduction is an area that gathers curiosities and false myths, among these the fact that reproducing is obvious and simple. But fertilization can often become impossible or very difficult for some couples, while for others it can be a longer process than expected.
Starting from the assumption that fertility depends on the two variables (female and male) together, the problems related to reproduction are therefore considered as a couple. However, when faced with a reproductive obstacle, investigations will be carried out to evaluate the reproductive capabilities of both, combining the results towards the end of the couple. We talked about it with doctor Elisabetta Colonese, specialist in Gynecology and obstetrics at Fertility Clinic of Milan.
Infertility: when to contact a gynecologist who specializes in fertility?
«Above 35 years is recommended wait 6 months of trying failed before seeking help from your fertility specialist. While under 35 years of age the wait is 12 months. But that’s not always the case. In case of problems such as endometriosis, previous ovarian surgery, polycystic ovary, early menopause, genetic or male health problems, you should contact your gynecologist when deciding to reproduce. In this way you can carry out a complete check-in of gynecological and andrological health and well-being”, recommends the gynecologist.
Medically assisted procreation techniques
In these cases it is necessary to contact a gynecologist expert in fertility – continues the specialist – to understand, thanks to specific tests prescribed to the couple, whether this can be helped through first level solutions (targeted intercourse with monitoring of ovulation or artificial insemination) with or without the help of hormonal drugs, or second level solutions (IVF and ICSI).
What is IVF
«It is the acronym of In Vitro Fertilization with Embryo Transfer. It consists of a level II PMA technique (outside the body, in the laboratory) in which the sperm are brought into contact with the oocytes that is, the egg cells obtained in various numbers based on the ovarian reserve, the type of stimulation and following pick up, the aspiration of the follicles given by the hormonal stimulation. In IVF, fertilization occurs in a more “natural” way than ICSI, without direct manipulation.
The ICSI
ICSI is the acronym for Intracytoplasmic Sperm Injection. The sperm is individually selected in the laboratory on the basis of morphology and motility so that it is inserted into the cytoplasm of the egg cell, facilitating fertilization. This technique is very useful in case of seminal problems.
Infertility can be well managed thanks to Assisted Reproduction techniques (Getty Images)
Embryo transfer
Both after IVF and after ICSI theembryo is grown in the laboratory for days 2 to 5 until he comes transferred to the uterus through the second step of PMA following the pick upor the embryo transfer. The transfer uses a thin catheter which is inserted into the uterus, a short distance from its bottom, by the gynecologist who deals with Pma, with ultrasound guidance. At the end of the PMA we will wait a few days depending on the age of the embryo at the transfer to then take a blood sample (BetaHcg) which will give a positive outcome if the pregnancy has been established”, continues the gynecologist.
Infertility: the importance of the preconception visit
«The preconception visit to be carried out at least 3 months before conceiving is always fundamental – underlines the expert – which allows you to have a 360-degree health check of the patient and her gynecological health. After anamnesis, gynecological examination, transvaginal ultrasound and possible Pap test, a personalized supplement is prescribed to the patient.
This certainly includes folic acid 400 mcg daily for at least three months before conception, to avoid the risk of spina bifida. In some patients this dosage will also be personalized, for example in some cases of haematological problems. An explanation of reproductive physiology and the prescription of preconception tests for the couple are given. The preconception visit is a real filter that saves unknowns and surprises, allowing you to know in time if there are hormonal, anatomical and other problems that need to be known”, recommends the expert.
iO Donna © ALL RIGHTS RESERVED