Today we
know that 80% of cases of infertility are predictable, therefore we thought
heading towards prevention, given that the infertility in the last decade has
increased from 20 to 24%.
It is the
duty of us educated physicians about preventing infertility and fertility
preservation and make this as routine as taking blood pressure, do a Pap smear
or teach the patient to examine your breasts. If all doctors opted for this
measure, preventing move to treatment as a strategy to solve the problem of
infertility
Recommendations
to preserve fertility and prevent infertility :
Do not delay
seeking pregnancy.
Safe Sex.
Conservative
gynecological surgery practice.
temporary
contraception.
Using the
services of human reproduction units when necessary emphasis on premarital
assessment.
Factors
affecting fertility:
Sexually
transmitted diseases and pelvic inflammatory disease.
Endometriosis
caused by the postponement of pregnancy and that ultimately produces
infertility .
Contraceptive
means: oral contraceptives, because of some exaggerated irregular ovulation and
intrauterine devices, which results in a greater likelihood of infection and
therefore of infertility .
Voluntary
termination of pregnancies.
Demographic
studies indicate that both reproductive age population as infertility are
increasing.
The first
task of prevention is information on these processes: cryptorchidism: It is the
total or partial lack of descent of one or both testicles in the scrotal sac.
When detected in childhood should be followed until the testes are in the
scrotum. Otherwise they should be treated with medication (hormones) , or
surgery to put the tests in the bag definitely before puberty. Despite these
treatments, although only one testicle, fertility can be altered irreversibly
was affected.
Varicocele:
Increased peritesticular venous plexus, most often on the left side. It can be
seen in childhood and particularly during adolescence. Different factors that
can impair fertility as increased scrotal temperature, filtration of pollutants
from these vessels, endocrine factors being considered. As in cryptorchidism
involvement of one testicle does not exempt an impairment of fertility on both
tests.
Urogenital
infectious processes via: The most known infectious involvement affecting
fertility is parotitis (mumps), but any infectious or inflammatory involvement,
especially chronically, can cause infertility. The most common cases are
orchitis, prostatitis and urethritis. It also processes near the genital area
as hemorrhoids, perianal abscesses, boils perineal or thigh root can produce
harmful effects on sperm production.
Taking
medication chronically: The effects of the use of chemotherapy or radiotherapy
on fertility are known and fortunately increasingly preventive measures are
carried out.
The
fundamental problems are common medications whose effects on fertility are not
described among its side effects, but nevertheless close roads for their
action or
even fully involved in the process of spermatogenesis may impair fertility.
The second
step of prevention for these cases would be the monitoring of semen quality as
possible. In cases such as cryptorchidism have to wait to adolescence to start
seminal controls. These controls can be every 4, 6 or 12 months depending on
the seminal quality. If the quality is good you can be spaced progressively
controls.
If the semen
quality is impaired in subsequent analyzes pass the third level of prevention
would be the sperm cryopreservation (frozen semen). Thus if the deterioration
does cause azoospermia we can always recover the preserved material.
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