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Infertility is the inability to conceive; it may be remedied.
However, should the conditions persist, it is referred to
as sterility.
In the United States, one out of every 8 to 10 couples are
childless because of infertility; it is a major medical and
social problem. Both husband and wife are urged to seek medical
attention for complete examinations and evaluation, since
almost as many men as women cause a sterile marriage.
It is usually recommended that the male be evaluated first,
because tests for the female are more expensive and time-consuming.
Such tests may require the services of a urologist, gynecologist,
endocrinologist, and internist.
In the female, the organs of reproduction and the glands
influencing them are evaluated. Among the causative factors
may be displacement and tumors of the uterus, genital infantilism,
and inflammation. To allow fertilization of an ovum, it is
necessary that the vagina, cervix, and uterus to be patent
and have mucosal secretions receptive to the sperm. Semen
is alkaline, as is cervical secretion; normal vaginal secretion
is acid.
Treatment is directed towards correcting the deficiencies
encountered in the individual patient. The following tests
assist the gynecologist in delimiting the problem.
1. Rubin test
This procedure is to determine the potency of the fallopian
tubes by introducing carbon dioxide through a sterile canula
into the uterus, into the tubes, and into the peritoneal cavity.
By listening with a stethoscope on the abdomen, the physician
may hear the gas swishing into the abdomen. If the pressure
gauge reaches 200 mm. of a mercury, an occlusion may be suspected.
2. Salpinogram; Hysterosalpingogram
A radiopaque substance is often used to determine the site
of tubal obstruction; an x-ray picture then shows the outline
of the tubal lumen.
3. Hubner test
Within an hour or two after intercourse, the physician aspirates
cervical secretions with a long cannula. The woman is to be
instructed not to void, bathe, or douche between coitus and
the examination; a perineal pad is worn until she is placed
in ?lithotomy position? in the examining room. Aspirated material
is placed on a slide and examined under microscope for presence
and viability of sperm cells.
Treatment
The treatment of sterility is a difficult matter, because
it may be caused by a combination of several factors. Efforts
are made to build up the general health of the patient, supplying
lacking glandular hormones as indicated.
Operative treatments include removal of obstructions and plastic
operations to restore tubal potency. Unfortunately, these
are not too successful; in addition, there is a high incidence
of tubal pregnancy following such operations.
The psychic and social factors of infertility must not be
overlooked. Among some religious groups and nationalities,
it is important to have blood descendants; adopting children
is not acceptable in these families.
In other family groups, the man?s virility, or woman?s femininity
are suspected when a couple fails to have children. Many pregnancies
have occurred after an infertile couple has adopted a child,
moved to another location, or the husband had a change of
jobs.
All of these things indicate that the concepts behind infertility
are not absolute and concrete. There are instances that the
information about this particular problem may have underlying
causes that should not be blamed on the inability of the person
to conceive.
Boiled down, the problem on infertility is more of a social
problem than a biological problem. It is not the aspect of
not being able to conceive that persons involved are hesitant
to disclose the matter.
If it is more than just biological malady, then, it requires
tough solutions.
About
the Author:
Robert Thatcher is a freelance publisher based in Cupertino,
California. He publishes articles and reports in various ezines
and provides infertility resources on www.your-infertility-resource.info.
Fertility
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