Treatment of infertility.

Infertility. The description of disease.

Infertility � Disability of faces of genital age to reproduction of posterity owing to disturbance of a fertilization or implantation of the fertilized ootid.

Marriage consider infertility, if pregnancy at the woman does not come within one year of a regular sexual life (the sexual relations not less often than 1 time a week) without use of agents and methods of contraception.

The quantity infertility married couples reaches 15 %. The reason of infertility marriage can be disturbances in genesial system of one or both spouses. At the woman the diagnosis infertility can be established only after exception of infertility of the man, and also at the positive assays confirming compatibility of a semen and slime of a neck of a uterus.

Men's infertility.

Secretory - it is caused by disturbance of a spermatogenesis - process of formation of spermatozoons in spermatic canaliculuses of testicles. Disturbance of a spermatogenesis: absence in an ejaculate of cells of a spermatogenesis and spermatozoons, absence in an ejaculate of spermatozoons at detection of cells of a spermatogenesis, an oligozoospermia (quantity of spermatozoons in 1 ml an ejaculate less than 20 million), and also depression of mobility of spermatozoons, disturbance of their structure.
Excretory it is bound, as a rule, to a bilateral, temporary or constant obstacle to promotion of spermatozoons.
Admixed - excretory-toxic, or excretory-inflammatory It is characterized by simultaneous disturbance of formation and removing of spermatozoons. Assume, that this form can arise at inflammatory diseases of a prostate, spermatic blebs and an epididymis as a result of the mediated toxic damage of a spermatogenic epithelium, disturbance of synthesis and a metabolism of sexual hormones.

Treatment of infertility at men.

Treatment of infertility at men depends on the reason and the form of infertility. With the purpose of restoration of permeability a spermatozoon of removing ways operative treatment is shown. For stimulation of a spermatogenesis in conditions of a hospital under the control of the hormonal status and structure of an ejaculate appoint preparations of gonadotrophic hormones, antiestrogens, androgens.

In out-patient conditions with this purpose biostimulators, vitamins A and E, trace substances, immunomodulators can be used. At absence of effect from treatment resort to an artificial fertilization semen of the donor or to a fertilization of an ootid with its subsequent implantation in a cavity of the uterus.

Women's infertility.

Distinguish primary and secondary (accordingly at absence or presence of pregnancy in the anamnesis), relative (the probability of pregnancy is not excluded) and absolute (in connection with absence of a uterus, ovaries, uterine pipes).

Allocate the basic groups of the reasons of infertility at women:

Disturbances of an ovulation - 40 %. infertility , caused by disturbances of an ovulation (endocrine infertility). The reasons can be absence ovulations (anovulation) or a syndrome of a luteinization not ovulations of a follicle.
Tubal factors (a pathology of uterine pipes) - 30 %. To tubal factors carry a functional and organic pathology of uterine pipes.
the Various gynecologic diseases, ovulations not accompanied by disturbance and functions of uterine pipes, - 25 %. The reasons can be an external and internal endometriosis, endometrial synechias, developmental anomalies of a neck and a body of the womb, an endometritis.
So-called inexplicable infertility (5 %) at which there are no visible reasons of disturbance of genesial function, - its frequency at use of modern methods of research constantly decreases (is found out, that at a part of women this immunologic infertility).
Immunologic infertility at women is caused by occurrence of antibodies to To spermatozoons. It is diagnosed by means of compatibility tests of a semen and cervical slime, revealing of antibodies in Serum of a blood and cervical slime.

Treatment of infertility at women.

Treatment of endocrine infertility is spent at absence at the woman of somatopathies and if her age does not exceed 35 years. At the infertility caused by an anovulation, therapy of the diseases which have caused an anovulation is necessary.

Efficiency of stimulation of an ovulation is defined by dynamic observation over size of a follicle (a ultrasonic biometry). Diameter of a follicle of 20 mm and more testifies to achievement up to an ovulatory stage, the subsequent disappearance of a follicle specifies the made ovulation.

For treatments of functional tubal infertility apply sedatives, tranquilizers, a psychotherapy, blockers of synthesis of Prostaglandinum (Naproxenum, Ibufrofenum, Indomethacinum, Acidum acetylsalicylicum - in up to the ovulatory period), ultrasound in a pulsed operation, hydrosulphuric baths, an electrical stimulation of uterine pipes.

At tubal infertility of an inflammatory genesis spend treatment of chronic inflammatory processes of appendages of a uterus. A hydrotubation at disturbance of permeability of uterine pipes in intersticial or isthmic departments not It is effective, and at presence of a sactosalpinx it is dangerous.

Absolute contraindication to operation is the genital tuberculosis. Relative contraindications: the age of the woman is more senior than 35 years, duration of tubal infertility more than 3 years, sharply expressed adherent process in a small basin, frequent exacerbations of chronic inflammatory process in appendages of a uterus and the transferred acute inflammatory process within previous year, presence of the big hydrosalpinx at which excision there will be no more than 5 sm of a uterine pipe.

Prophylaxis of tubal infertility includes the prevention and rational treatment of inflammatory diseases of genitals, well-timed diagnostics and treatment of an appendicitis, carrying out of rehabilitational actions in early terms after gynecologic operations at young women.

For preparation of given article materials of "The Medical encyclopedia" Russian Academy of Medical Science were used. Comments of the author are personal opinion and for objectivity do not apply. It is not recommended to use the given materials for independent treatment of infertility.