Synonyms
Sterility, Infertility
Definition
Infertility can be described more precisely with the terms sterility or infertility. Infertility describes the inability to conceive despite existing sexual intercourse with the intention of producing a child. The attempt to become pregnant should last more than 2 years.
Depending on whether a pregnancy has already taken place, the term primary or secondary infertility is used. Infertility must be considered from a gender perspective. In the case of the woman, it says something about the ability to carry the child out.
Although the woman can become pregnant, she is not able to maintain the pregnancy without complications (e.g. risk of abortion). In men, infertility must be seen in the context of sperm quality. This can be determined with a spermiogram. In addition, infertility can also occur if sexual intercourse cannot take place due to certain barriers (e.g. anatomical ones).
Epidemiology
10-15% of couples of reproductive age have infertility. The number of unreported cases of infertility is probably much higher. a) Basal body temperature curve to measure infertility :The woman measures her temperature every day early in the morning before getting up, which is then plotted against time.
The curve should normally be divided into two halves of the cycle, which can be distinguished by a rise in temperature in the second phase. The increase in body temperature provides a reliable indication of whether ovulation has occurred and whether the progesterone responsible for the 0.5 degree change in temperature is effective. If the second phase of the female cycle does not show such an increase in temperature, there may be a disturbance in follicle maturation (without FSH no ovulation of the dominant follicle).
Another reason for the absence of temperature increase is a functional disorder of the corpus luteum, which produces progesterone. b) Hysterosalpingography to determine infertility:In this procedure, the patient is given a contrast agent into the uterine cavity, which spreads through the fallopian tubes to the free abdominal cavity. X-rays can be taken to detect obstructions and dilatation of the fallopian tubes.
In addition, fibroids can be made visible in the uterus. c) Hysterosalpingo contrast sonography to determine infertility:The difference to the hysterosalpingography shown above is the gentler contrast medium. This can be detected by ultrasound and does not require X-rays.
d) Laparoscopy to determine infertility:This is a minimally invasive procedure in the form of a laparoscopy. This gives a direct view of the tubes. In contrast to hysterosalpingography, the mobility of the tubes can be checked and adhesions with the surrounding pelvis can be detected.
Blue instillation can also be used here to examine the patency of the tubes. The great advantage of laparoscopy is that interventions can be performed on the tube itself, such as dissolving adhesions. e) Ferns test to determine infertility:This test can be used to determine the spinnability of the zevix mucus. If the fern test is positive, which is expressed by the formation of crystals in the cervical mucus, the sperm find optimal conditions for passage from the cervix to the uterus. f) Gynaecological smear for infertility: A smear of cells in the cervical area is taken on a cotton swab This smear can be checked for changes in the cervical mucosa and for possible bacterial infections.
