Infertility affects 15% of the general population. In 40% of cases of infertility, the problem is associated only with the woman or both with the woman and with the man, in 30% of cases it is predominantly with the man or in combination with the woman, in 15% equally with both, while in 15% neither one of the reasons was not found.

This was mentioned by AUTH Professor of Reproductive Endocrinology Dimitris Gulis, speaking to APE-MPE on the occasion of today’s event on the theme “Infertility and Fertility Today”, organized by the Region of Central Macedonia and the Vice-Region of Health and Social Solidarity.

Mr Gulis pointed out that infertility is defined as the absence of a pregnancy after a year of trying, and also noted that the chance of conceiving during intercourse on a woman’s fertility days is about 18% for a couple without problems, which will affect fertility. .

Infertility affects the couple, not just one of the two

Speaking about the problems of fertility, as well as the new opportunities to have children that exist today, he noted that infertility is a problem that concerns a couple, not just a man or just a woman, and that a married couple should always be examined together. doctor.

“It is extremely important that the couple is examined together because, by definition, infertility affects two people, but we often forget about it.

That is, a man is observed by a urologist, endocrinologist and andrologist. Woman gynecologist. We never put it all together and end up ignoring the picture. A male can fertilize an alpha female, but not a beta, and vice versa. It rarely happens that one of the two has big problems, while the other does not at all. Most likely, some problems coexist, and therefore the child does not come. In addition to psychological reasons, going to the doctor together, supporting each other, there are also purely medical reasons.

Of course, the urologist will deal with men’s problems, ie. if there is erectile dysfunction, if a man has a varicocele, if he has low testosterone, but, on the other hand, he cannot ignore that having a wife is not the same thing. partner is 20 years old or 45 years old. If the partner is 25, she has all the time in the world, and if 45, then she has no time at all for the female factor. So the treatment in both cases will be different. That is, you can not do an operation for a varicocele and expect an improvement in sperm in the next year or two. when the woman is 43,” Mr. Gulis explained.

Why should you look for the causes of infertility?

Noting that a man has more sperm than a woman has eggs, he clarified that “a woman is not only her eggs” and that identifying a man with a sperm is also wrong. As Mr. Gulis explained, for a woman to have children other than eggs, she must have open fallopian tubes and a suitable uterus, while for a man, sperm quality can be an indication of his overall health.

In fact, he characteristically referred to a dramatic incident, saying: “The man had average quality sperm, but it was enough to be in a test tube. She had IVF, the baby was born, and the man died three months later, because the reason his sperm was of poor quality was testicular cancer, and no one examined him further to see him in full. This is an extreme example.

Unfortunately, however, these things have happened. So the quality of the sperm may be due to other issues with his general health, and this is an opportunity to seek out a man more.”

Mr Gulis added that infertility is a condition, a symptom, not a cause. “Infertility is a symptom. The ultimate goal is to continue the family, but always in medicine, the intermediate step is the diagnosis: “why can’t I have children.” Therefore, sometimes IVF and assisted reproduction methods, which have helped a lot, become an obstacle to the immediate solution of the problem, without identifying the cause. The solution is not to find a way for the child to come, but to find the reason why the child does not come. If you find the cause, you can act causally and it will help future children as well as overall health. A person may have something else, and one of its consequences is infertility,” said Mr. Gulis.

He pointed out that just because a woman has a normal cycle and a good erection in a man does not mean they are fertile. “A woman with a regular cycle of 28-30 days should not be complacent, because she can have regular periods until the age of 50, but her fertility starts to decline after 35, and by the time she reaches 40, every year counts.

Menstruation is probably the last to stop. There may be problems with the ovaries, the ovary may begin to age, grow and not show this from menstruation. So everything has its time. On the other hand, men have always confused erections with reproduction. A man may not have erection problems and may not have sperm. He has no way of knowing unless he does a cum count. The fact that a man has an erection means he has testosterone, not that he can have children,” Mr Gulis explained.

What are the main causes of infertility?

He cited hypogonadism (i.e. insufficient production of testosterone), varicocele, and infections such as prostatitis and orchitis as the main causes of male infertility.

“In about 1/3 of cases of male infertility, we do not find the cause, that is, there is a violation in the sperm, but we do not find the cause. In the remaining 2/3 we find the causes, the most common of which are infections, low testosterone, varicose veins. Rarer causes are thyroid disease, hyperthyroidism, or hypothyroidism, which can interfere with sperm function. Also genetic causes, erectile dysfunction in men and less often neurological, hematological and other causes.

Accordingly, the ovarian factor is common in women, which is associated with the age of the woman. As she gets older, the ovaries are released from the follicles and they stop when menstruation stops, which is about 50 years old, which is the average age of menopause. But a woman becomes infertile much earlier. For women, the causes of infertility are poor ovarian function, closed fallopian tubes, anomalies in the uterus, polyps, fibroids, endometriosis,” added Mr. Gulis.

Source: RES-IPE