Contents
A little-known notion: fertility
A woman’s fertility (i.e. the probability of birth) decreases after age 30 and the decline increases after age 35
It is the probability that the egg that is “laid” will be fertile. However, this probability decreases with age. Fertility is stable up to age 30, then decreases slightly after age 30 to drop sharply after age 35.
The younger you are, the more regular intercourse you have, and the more it takes place during the fertile period, that is to say before ovulation, the more chances of pregnancy. It is considered that in the absence of medical intervention, the majority of women under the age of 30 will have the desired pregnancy within one year. After 35 years, it will be less easy.
And yet the number of women wishing to have a child over the age of 30 is steadily increasing. They are then confronted with the force, almost with the urgency of their desire and the difficulty to realize it. To you who are in your XNUMXs and want to get pregnant, we say don’t wait and idealize the best time to have a child: “ It will be better later, we will be better installed. “” My professional situation will be better. We will really feel ready to welcome our baby. The figures are there: the older the age, the more fertility decreases.
Uterus and tubes must be functional
In the absence of a previous pregnancy, this is more difficult to know without a complete gynecological examination, followed by additional examinations aimed at assessing the good condition of the uterus and tubes.
• Among these examinations, hysterosalpingography occupies an important place, at least as much as the ultrasound often requested first. It consists of injecting through the cervix a product that will make the uterine cavity and then the tubes opaque and allow their permeability to be assessed – that is to say the possibility of allowing sperm to enter. If these are blocked or poorly permeable, for example as a result of gynecological infections or an infection with peritonitis, such as appendicitis, the pregnancy will be delayed.
Laparioscopy
This test may be followed by others, such as hysteroscopy (to get a view of the uterine cavity), or laparoscopy (which requires hospitalization and is performed under general anesthesia). Laparoscopy gives a complete view of the entire maternal pelvis. In the event of anomalies on the tubes, for example adhesions, laparoscopy can make the diagnosis and at the same time remove them. This examination is only justified if infertility does not fall under the two concepts we spoke about previously (sexual intercourse and ovulation); and, above all, this laparoscopy will be indicated if the sperm does not present anomalies.
What if it was endometriosis?
Finally, only laparoscopy can reveal endometriosis, which increasingly seems to be responsible for infertility. Endometriosis is caused by the migration of fragments of the uterine lining that can settle in the maternal pelvis, especially in the ovaries. Each cycle then develops nodules, sometimes adhesions, which cause persistent pain that is not that of ovulation, especially at the time of menstruation, and difficulty becoming pregnant. In the event of proven endometriosis and fertility disturbance, it will often be preferable to consult a gynecologist specializing in reproductive disorders.
What is quality sperm?
This is not always the case and it is today one of the leading causes of infertility for couples, hence the need to consult together. Indeed, all the studies devoted to sperm are consistent and show that the number of spermatozoa and their quality have deteriorated for 50 years. Probably due to a set of factors: tobacco, alcohol, drugs, environment (industrial pollution, endocrine disruptors, pesticides…), etc. For these reasons, the assessment of infertility must begin with a spermogram, well before subjecting the woman to unpleasant additional examinations such as those mentioned above. In the event of sperm abnormalities, there is unfortunately no effective treatment and it will be necessary to seek help from a specialist in reproduction.
The conditions for pregnancy to occur are met.
Did the full assessment show that everything was normal? But the pregnancy continues to be delayed (2 years, even 3 years) and the age advances … Some couples then choose to turn to the AMP (Medically Assisted Procreation), knowing that recourse to medicine to expect a child is a long journey.