Infertility: a relationship problem
Are children having fewer and fewer children in Italy? It would seem so, judging by the numbers: between 10 and 20% of couples looking for a pregnancy experience difficulties, and of these around 500,000 each year resort to the consultation of a specialist. But what exactly is the problem and what is the correct way to deal with it? First of all, we must not confuse infertility and sterility: the two terms are by no means synonymous, although they are commonly used as such.
Infertility vs Sterility
Infertility consists in the impossibility of carrying the pregnancy to term, while sterility refers to the inability for a couple to conceive. In particular, one can speak of a real sterility problem only after one year of frequent and unprotected intercourse without obtaining conception. At the end of this period it is certainly advisable to carry out further investigations. However, the waiting time before turning to a specialist consultation may be reduced in the case of a woman over 35 years of age or of previous gynecological or andrological problems.
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Male or female infertility?
Specialists underline that speaking of male and female infertility means facing the issue incorrectly: Prof. Marco Filicori, Specialist in Gynecology and international expert in sterility and Medically Assisted Procreation (MAP), reiterates that the infertility is a couple problem, in which the impossibility of conception is determined in a practically identical percentage by male and female factors. Statistically, the picture is completed by about 10% of couples who, even after thorough investigations, are unable to obtain a precise diagnosis due to their inability to conceive: in that case we speak of "unexplained sterility".
The male factor
According to statistics, this is a growing phenomenon, but if it is true that infertile couples due to male factors are more numerous than a few decades ago, it does not mean that this is a growing problem: in fact, we must consider that today the diagnostic techniques are more sophisticated and allow to accurately identify a greater number of cases. The main cause of male factor infertility, however, consists in an alteration of the seminal fluid, determined in turn by a problem of another kind (eg inflammation, varicocele or genetic anomalies), which must be precisely identified in order to be able to adopt the right treatment .
The female factor
When it comes to female infertility, we must first of all consider age, which represents a crucial factor and one of the first elements to be taken into consideration. Especially for Italian women, Prof. Filicori remembers who, for various cultural and on average, they give birth to their first child at the age of 30, much later than all other European women. Genetic aging is the worst enemy for a couple looking for a child: just think that already at 30 1/3 of the oocyte patrimony is altered and many eggs have lost the ability to be fertilized. Female factor sterility can in any case originate from causes of different nature, such as malformations of the fallopian tubes and uterus or irregularities in ovulation.
What to do?
When sterility problems are encountered, it becomes essential to act promptly: the specialist proceeds with checks in parallel in the woman and in the man, starting with the analysis of the seminal fluid, to continue with hormonal and mechanical investigations of the woman (presence of the ovulation, premature menopause, uterus evaluation, tubal patency). For both factors, many problems can be avoided with prevention and solved thanks to adequate therapies, but when infertility is judged permanent by the doctor, to obtain a pregnancy it becomes necessary to resort to Medically Assisted Reproduction (MAP) techniques.
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