Most people create expectations for the future that pass by parenting. However, not all couples can do it, coming to the infertility.
The prevalence of infertility is very difficult to assess, and there are studies that refer to the possibility of 1 in every 4 women can have difficulties getting pregnant throughout your life. However, this estimate may have geographical variations.
The reality is that the prevalence is higher in more developed countries than in developing countries.
In Portugal, it is estimated that 9.8% of women aged between 25 and 69 years had a problem of infertility over the life course.
For women between 25 and 44 years, the value of this rate was 8.2%, the data of the Division of Reproductive Health of the Directorate‐General of Health.
HOW IS IT DEFINED INFERTILITY?
The World Health Organization defines infertility as “a disease of the reproductive system, manifested in inability to achieve a pregnancy after 12 months or more of sexual relations regular and no use of contraception”.
Infertility is considered primary when there was a pregnancy prior and secondary in other situations, even if the pregnancy results in a miscarriage or ectopic pregnancy (when the egg fertilized implants itself outside the uterus).
WHAT ARE THE CAUSES BEHIND INFERTILITY?
The reality is that the more later on if you want to get pregnant, the more difficult it is. And the lifestyle of today encourages this same delay. But why, why should this happen?
From 28 years, there is a progressive loss of responsiveness of primordial follicles to the hormone levels. In this way, the ovary tends to leave to form follicles mature, giving rise with increasing frequency, the follicles containing oocytes immature or follicles with oocytes abnormal (morphology and genetic structure), and may not even be ovulating. The menstrual cycles remain generally rhythmic, regardless of the cycle ovarian.
These anomalies are due to the fact that the oocytes are stopped for several years, which allows the aging. As a result, for example, the rate of trisomy 21 increases to 1/500 newborns to 34 years of age, and 1/100 newborn to 39 years.
Taking into account the biological risks associated with pregnancy, the pre‐concecionais, considered to be an integral part of primary care in reproductive health, have as their main target group women of childbearing age.
However, it will be necessary to contemplate, also, the participation of men in issues of sexual and reproductive health, not only as interlocutors of those, but as a true partner in these areas and, as such, subject to the same intervention.
In the query pre‐concecional should obtain the clinical information of the women /couple, and to propose the measures to minimize or eliminate this risk.
In this sense, it is essential to consider the impact that factors such as the woman’s age, background, genetic, habits, chronic diseases, infections, various drugs and pollutants, can come to represent.
So, this query is crucial since it provides an excellent time to discuss issues related to sexuality and reproduction.
It is also an opportunity to extend the preventive care by assessing the nutritional state and the adequacy of the weight. Both obesity such as low weight may have negative impacts on fertility.
This step should not be passed to the front at the time you decide to try to become pregnant. So, if something fails, you know that there was no error in this process pre-concetivo and before the inability to conceive and the desire to have a child remains, it is fundamental to seek medical help. The couple should start by to make an appointment and talk with the doctor about this situation.