PREVENTION OF STERILITY IN THE COUPLE AND FAMILY PLANNING
Darina Davidova and Valentin Irmov
ABSTRACT: Infertility is a medical problem that affects the physical and especially the mental state of men and women. Worldwide, there are between 48 million couples and 186 million people suffering from infertility. "Barrenness (infertility)" is a term that unites three conditions: inability to conceive (sterility) and/or inability to carry the pregnancy to term until the fetus becomes viable (prematurity) and/or inviability of the newborn.
There are two main types of sterility: Primary sterility – non-occurrence of pregnancy in the absence of a previous pregnancy; Secondary sterility – non-occurrence of pregnancy in previous births, abortion or ectopic pregnancy. We differentiate the causes of sterility into male factor, female factor and unexplained sterility. In almost 40% of childless couples, infertility is due to problems in the man - the so-called "male factor".
The assessment of the male factor is carried out by sperm analysis (spermogram). The examination is performed after several days (3-5) of sexual abstinence. The spermogram gives information about the quantity and quality of the sperm.
The most common cause of infertility in women is ovarian pathology. It covers about 35-40% of infertility cases, followed by fallopian tube pathology (30%), cervical (5-10%) and vaginal (5-10%), uterine body diseases. Of the disorders of ovarian function, polycystic ovary syndrome (PCOS) is common. The main one is always the increased production of androgens mainly by the ovaries; disturbed ovulatory process, the maturation of the follicles does not reach the release of an egg; endocrine infertility is present. Premature ovarian failure is a manifestation of another type of ovulation disorder – hypergonadotropic anovulation. It manifests with a lack of ovarian function before the age of 40.
The treatment of infertility depends on the age of the patient, the duration of the sterility and, of course, the cause leading to its occurrence. ART methods are a major helper in the treatment of infertility in modern medicine.
Keywords: sterility, prevention, family planning