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There are many, rightly or wrongly recognized, obstacles to procreation, such as amenorrhea, abnormal hair, and serological conflict. Therefore, it should be immediately clarified that menstruation is not always necessary to become pregnant, and women with excessive hair can not only give birth, but also become pregnant sometimes more easily than people with only slight hair changes. Finding differences in blood groups and the so-called Rh factor in a very small percentage of cases is the real cause of the inability to terminate pregnancy and is becoming less and less in the era of widely used prophylaxis. The most important thing is to free yourself from your own complexes and to become immune to false views or unjustified curiosity of the environment.
The easiest way is to advise getting pregnant, it is much more difficult to implement it, but fortunately the hardest thing is to forbid motherhood.
From a biological point of view, satisfying the sex drive is second only to the need to sleep and eat, and yet a person may consciously voluntarily give up sexual intercourse altogether for a short or even very long, long-term period. But voluntary intercourse, its frequency, place, time and manner is governed by only one, purely human concept: fantasy! There are no scientific standards for sexual intercourse other than mutual acceptance.
Everyone faces sexual problems in life, and at least half of all marriages suffer from sexual dysfunction of varying severity and time!
Therefore, these are not only matters of infertile marriages, so often deeply convinced of it, but – and above all – of fertile people, who, however, do not always pay attention to it. Precisely because there can be sexual problems in infertility – patients are required to have a general knowledge of proper intercourse. However, they should use popular science sources, developed by responsible authors, preferably after consulting the treating physician, and be interested primarily, if not exclusively, in natural, physiological, and not disease-related matters. The latter, after all, happen disproportionately less than normal states, and only more strongly appeal to our imagination. It is about freeing oneself from complexes or prejudices, understanding the harmlessness of, for example, masturbation in youth, the importance of first sexual contact, learning about the sexual reactivity of a partner, and above all, about making men aware that the strength of women’s sexual needs and their ability to experience orgasm can be developed in various ways. degree, but they are not a prerequisite for pregnancy!
On the other hand, the ability of men to have sexual intercourse does not imply the ability to fertilize, which is the only male factor determining fertility.
Sometimes an obstacle in the pursuit of the desired pregnancy is the lack of basic knowledge in the field of procreation, a negative attitude towards the treatment of both partners or one, improper adherence to medical recommendations, errors in taking medications. In the last place, there are actually existing disease obstacles.
For example, treating childlessness caused by the inability to report pregnancy and give birth to a healthy child too often provides an opportunity to observe women who, for many years, endure suffering, sometimes difficult to imagine, just because no one asked them to test their husband’s sperm. This applies not only to men who refuse such a test (not knowing or not wanting to know that their low-value semen may be the cause of the drama), but also those who are very willing to cooperate during the treatment of their wife – before and during pregnancy – and simply not. even suspecting any fertility disorders. Therefore, in each case of a miscarriage, premature delivery, stillbirth, newborns with malformations or their death, the father must be examined in order to exclude the cause of the failure on his part and in connection with the need to treat him before the next pregnancy.
The examination of a man includes an interview regarding the period of appearance of pubic, axillary and facial hair, the occurrence of mutations, the first erections and nocturnal blemishes (the so-called polution, i.e. spontaneous sperm production), the appearance of sexual needs, the first intercourse and subsequent intercourse, their course and the level of sexual awareness. From past and possibly coexisting diseases, the doctor pays attention to venereal diseases, tuberculosis, inflammation of the salivary glands (mumps), testes, epididymis, prostate and urinary organs, chronic diseases of other systems (hypertension, diabetes, antihistamines, steroids, etc.), past injuries the lower abdomen and surgery (abdominal, genital). It is also important to know about working and living conditions (e.g. too hot baths, sauna – they can lead to a high percentage of dead sperm), clothing (e.g. too tight shorts are harmful due to overheating of the testicles), alcohol abuse, drugs (especially heroin and morphine).
The set of specialist tests that a man should undergo is incomparably small compared to those that a woman must undergo, whose cyclical fertility creates many more opportunities for disorders. Therefore, the examination of a man should always precede the examination and possible treatment of the woman.
The essence of fertilization is the interconnection of the sperm with the egg. Then the so-called zygote, in which the personal characteristics of both parents are transferred to each other. Under normal conditions, the egg is fertilized in the fallopian tube. An egg comes out of the ovary during ovulation, also known as ovulation (ovum). Ovulation occurs once in the menstrual cycle, usually on the 14th day before your period. This means that a woman can only be impregnated once in the period between her periods.
The fertilizing sperm is one of the tens of millions of sperm contained in one ejaculation. These sperm are only fully fertilized in the female genitalia, but only one out of the multitude of millions is fertilized. The fertilizing capacity of sperm in the sexual organs of a woman lasts for several days. This means that a man can fertilize a woman by depositing his semen in the vagina a few days before and within several hours after ovulation occurs.
The fertilizing intercourse can therefore be much ahead of ovulation. In a woman who regularly menstruates every 28–30 days, sexual intercourse may lead to pregnancy in the period from day 11 to 12 to 16 of the cycle, which is determined by the optimal fertilization period. It covers the most probable days of ovulation (14–16) and the preceding 2–3 days, which fall within the period of sperm viability in the woman’s reproductive tract. During this 2-3-day period, sperm are waiting for ovulation to occur. Thus, for women who have regular periods, every 28–30 days, an important practical tip to note is that you have intercourse to fertilize on day 12 or 13 of the cycle. This optimal period should be accelerated by an appropriate number of days in shorter cycles or delayed in extended cycles, while in cycles of alternating shorter (23–28) and longer (30–35) cycles it remains unchanged, ie covers day 12–13 of the cycle.
In women who are amenorrhoeic or show significant deviations (even several months) in the course of menstrual cycles, it is practically possible to become pregnant at any time, regardless of vaginal bleeding, even during their duration. It may be due to ovulation bleeding.
Menstruation is not always necessary to become pregnant because ovulation is important, not menstruation.
The use of methods that clarify the date of ovulation significantly increases the chance of fertilization, as does regular, daily intercourse during the optimal days for fertilization. Men treated for infertility are advised not to intercourse before this period.
Treatment of infertility mainly consists in triggering ovulation in the recognized, optimal for fertilization intermenstrual period and at the same time recommending sexual intercourse and ensuring the proper condition of sperm. In second place is allowing the sperm and egg to come into contact in the woman’s reproductive tract.
Treatment of secondary infertility consists in the same procedure, starting with the diagnosis of the health and reproductive capacity of both spouses, as in the case of primary infertility, with the difference that doctors more often deal with the elderly and with their own experience in the field of procreation.
The causes are as complex as those of not being able to get pregnant, e.g. not all vaginal discharge requires treatment but always requires medical consultation. Above all, abnormal habits and complexes are combated, and the data from the past of patients are only intended to facilitate treatment without constantly returning to things that have passed.
In reproductive biology, the current time is more important than the past time, the existing pregnancy than the re-pregnancy, the preservation of fertility than the self-confidence that it will not be useful in the future.
An important aspect in understanding the reasons for the lack of pregnancy development during infertility treatment, with the confirmation of ovulation and indirect signs of fertilization (graph of morning temperature measured in the mouth, positive, very sensitive pregnancy test) is the fact that approx. 60-70% of the embryos are not implanted (nated) in the uterine cavity. Therefore, it is advisable to continue this treatment regimen for at least 6 menstrual cycles and then to consider alternative treatments. The best criterion for the effectiveness of infertility treatment is when the child arrives at home.
In the last ten years, the greatest progress has been made in diagnostics consisting in looking or indirectly viewing the body cavities with optical devices and special imaging. Improved optical fibers (optical fibers), excellent quality optics and new light sources or video technology have opened up new diagnostic and therapeutic possibilities in the field of surgery of the human reproductive system.
Nevertheless, each operation in modern medicine is still an important element of the entire course of treatment, distinguished only by a special methodology.
During, for example, videolaparoscopy, it is possible not only to precisely determine the cause of infertility, but also to remove, for example, adhesions and cysts, take samples from suspected tumors, check the patency of the fallopian tubes with contrast agents, perform various types of repair and reconstruction operations, and finally collect eggs and transfer the sperm or embryos to the fallopian tubes using assisted reproductive techniques. There is always a purely human alternative to infertility, when good professional and living conditions, willingness to take care of the child, and strong parental needs encourage the spouses to adopt. People also adopt adoptions in the hope of repairing a difficult marriage situation (as a binder of a failing marriage, in order to fill the void and boredom), as a showcase of personal sense of full social worth, or a desire to raise a child regardless of their age or marital status. The vast majority of the adoption result is favorable (approx. 80%). In the unfavorable cases, sometimes even tragic consequences of noble motives for adoption, it is not easy to decide whether to blame the excessive sensitivity of foster parents, the disinterested malice of the environment pointing out the child’s origin, or finally the child itself.
Modern extracorporeal techniques, however, concern the level of reproduction, i.e. infertility understood only in biological terms.
Therefore, the World Organization of Perinatal and Prenatal Psychology and Medicine draws attention to the necessity of treating patients subjectively, which only determines the level of modern medicine, some representatives of which still only try to treat patients in a general sense. In accordance with the sovereignty of psychology over medicine, the medical obligation is to provide full pre-therapeutic information, which cannot be limited to only diagnostic and therapeutic issues. This issue is best illustrated in the process of conception of a human by the mechanical connection of an egg cell with a sperm extracorporeally. This undoubted triumph of medical practice fulfills the wish of parents unable to have children by other means. Unfortunately, this is the only unequivocally positive aspect of this issue, taking into account the general medical responsibility that does not allow harm. The paradox lies in the fact that by fulfilling the wishes of individual patients, not only the family created in this mechanical way is exposed to the risk of the emergence and, unfortunately, consolidation of new human characteristics.
From a biological point of view, the process of fertilization in humans (!) Is preceded by an enormous, because it covers several million cells, selection for the natural selection of a zygote, with its unique identity. Psychoemotional barriers begin this selection at the level of selecting the most generally understood sexual partners to undergo a purely biological selection in the body of the future mother. In in vitro fertilization, this psycho-emotional-biological side is neglected by the isolation of material, the possible sources of which further complicate the psychological assessment, no longer of a natural phenomenon, but of a therapeutic procedure. Ultimately, the enormous vitality of the reproductive cells makes it possible to form a zygote, not because of, but against the artificial environment! This is what doctors should inform their patients about, if they properly appreciate the dignity of a human being. This is a requirement for the purely biological doctor-patient relationship in assisted procreation.
It is also known that with today’s technical level of medicine, spontaneous abortion is the last “biological filter” to eliminate defective fetuses. Hence, caution is recommended both in assessing the development of pregnancy and in maintaining it in each case. The very fact of the need to stimulate spermatogenesis on the one hand, and ovulation on the other hand, means that each pregnancy after infertility treatment is a subject of special obstetric concern.
Alongside religious positions that condemn sin rather than the sinner, and accept children born even through unrecognized methods, there are less tolerant legal regulations. Once again, the old principle of hope only works in a doctor who is more helpful than anyone else in meeting human psycho-medical needs.
In conclusion, the question remains: if infertility is 50% curable, why do so relatively many people who are very desirous of offspring are looking forward to or have not lived to see their hottest dreams come true? The answer in each case, unfortunately, can only be individual. That is why the problems related to infertility have been described so that the most interested people can reflect on their own situation and, armed with a modest but sufficient amount of knowledge, can seek more detailed information from doctors. These 50% of successes reflect, above all, the possibilities of modern medicine to instill the confidence in it that is so much needed. If medicine could not or could not help, consider whether it is not primarily negligent or simple ignorance on the part of the most concerned people. Anyway, in human affairs it is possible to divide into those receiving and providing medical aid at all? For this purpose, it is enough to read, and perhaps – while supplementing your own knowledge – also provide the therapist with the detailed scheme of infertility management recommended by us, where many things prove the need for joint actions and behaviors. In such a humanly conditioned problem, any factor, even if it is apparently the least important, but properly used or eliminated, can make it possible to fulfill maternal desires.