The reasons may be different; in some cases even unknown, and for this they are called “idiopathic“, in others they are attributed to a “incompatibilità” between the partners (causes cervical and immunological).
The sterilità idiopathic, and this is inexplicable, affecting about 15-20% of the total of the sterilità.
You get to make this diagnosis when the couple after two years of unprotected and regular intercourse has not had a conception, when the history and physical examination the objective of the partners have highlighted alterations, when the laboratory and instrumental exams performed both on humans and on the woman have shown no problems.
Often, it is well to remember that, when you delve into the exams and when you are running investigations più reliable and targeted (for example, laparoscopy instead of a hysterosalpingogram) some sterilità the so-called “idiopathic” find their explanation.
regarding the treatment of sterilità idiopathic – if the diagnosis is confirmed in any way – the roads are many and vary from couple to couple: if the età of the partner allows, the first attempt is to wait and see if the nature of the system from the sé things.
sometimes they are useful drugs, “placebo”, drugs absolutely harmless, which, however, the “comfort” of the couple. If at the end of this waiting period – provided that the età, the feel – you è had a pregnancy è well go to a street più determined as the assisted fertilization or techniques “minors”.
techniques For “minor” means a preliminary treatment in which it is a demand for the development of a number of follicles and cause aovulation multiple.
Keeping under control the follicles può to establish the time at which the follicle itself is “ready” and then decide whether to use a timed-intercourse and targeted (sarà the doctor thanks to the examinations of the laboratory in rio to establish the moment) or assisted insemination.
The advantages of the techniques in the “minors” are related to the easeà of these interventions, which do not require né centers especially equipped, né and the use of anesthesia (local or general). However, on the other hand, have a reduced effectiveness, and a limit of application: not all couples can have recourse.
then There are the sterilità immunological. Several years ago, it is found that some women produce antibodies capable of immobilizing the sperm, preventing the ascent in the channel cervica. The diagnosis is obtained with a search for antibodies in the blood of both partners, however, is still a high percentage of error.
C’è then the examination post-coital: we study the motilità of sperm in the cervical mucus of the period periovulatorio a few hours after sexual intercourse but also in this case the results are not always reliable.
If the causes of sterilità immunological &is comparable to the production of the antibodies anti-sperm, especially if it is a limited production, you get good therapeutic results simply by preceding sexual intercourse (usually “targeted”) or insemination intrauterine washings of the genital tract with solutions of hydrocortisone.
And finally the sterilità cervical. In a certain percentage of cases, the sperm of the man, perfectly normal, go back into the cervical canal of the woman to reach the uterus and fallopian tubes ready for them yet pregnancy does not occur: it is those cases in which there is an incompatibilità between partners to prevent conception. The same woman and the same man may have children but not among them.
There are also cases in which the sterilità cervical, instead, is due to mucus that does not allow the ascent of the spermatozoa into the cervical canal: at the base of the ciò there may be the results of a diathermocoagulation bad run or a cervicitis chronic.
The therapy of choice is intrauterine insemination.
La sterilità secondaria
Usually occurs after a previous pregnancy, carried to term or terminated with an abortion. Typically is related to problems of a mechanical nature, the insurgents, on the occasion of the previous pregnancy.
Even in these cases the woman will haveà to submit to laboratory tests, colposcopy, echography, pelvic, and test sterilità of the tubes, while the man followà the analysis and the spermioculture (repeat after 60 days). Depending of the causes highlighted are percorrerà the way of a therapeutic drug, or that of the artificial insemination.
Ettore Cittadidini, Carlo Flamigni, A Child, wanting to be able to have – And. The New Italy Scientific
page updated on December 27, 2007