It is considered infertility when the couple has sexual intercourse routinely, without contraceptive method, for a year, without getting pregnant. In these cases, it is necessary to seek a gynecologist and urologist to investigate the reason for the difficulty in getting pregnant and to start treatment.
There are several treatment options for infertility. Low-cost, low-invasive procedures are the first. If gestation does not occur, the treatments become progressively more sophisticated, expensive and invasive.
The treatment of infertility should whenever possible be directed to the cause. Thus, women will have to perform some laboratory tests, hormone levels, transvaginal ultrasound, to evaluate uterus and ovaries, and sometimes a test to check for tubal obstruction. The man should perform a spermogram to evaluate the quantity and quality of the spermatozoa. In the presence of changes in the spermogram, you should investigate the causes (diseases of the testicles, hormonal changes, varicocele, etc.). After treatment of changes in the reproductive tract of the couple, when found, gestation should be attempted by natural methods (there are some exceptions). When treatment is unsuccessful (does not result in pregnancy), or in cases of infertility without apparent reason, treatment is stipulated according to some relevant prognostic factors:
- age of the woman: the more advanced, the lower the probability of becoming pregnant;
- type of infertility: primary (the couple does not have previous pregnancies) or secondary (couple already got pregnant before). If it is primary, the chance of getting pregnant is lower;
- time of Infertility: the longer, the lower the chance of becoming pregnant.
Treatments for infertility with no apparent cause are as follows:
- expectant,
- ovulation induction (poliovulation);
- intrauterine insemination (IUI);
- induction of ovulation with intrauterine insemination (IUI);
- in vitro fertilization;
- intracytoplasmic sperm injection.
The chances of success for each method are variable and should be discussed with the fertility specialist.
