Sterility refers to a difficulty or inability to conceive.
There are two types: absolute, when conception is impossible, and relative, which is also called subfertility and is the condition where more time is required than it normally takes to achieve pregnancy. It should be distinguished from infertility, which applies to women who are able to conceive but not to carry a pregnancy to term, as is the case with repeated miscarriage.
Sterility can also be classified as primary (when pregnancy has NEVER been achieved) and secondary (when pregnancy was achieved in the past but cannot be achieved at present). The latter situation is very common when women grow older, because of the higher rates of gynaecological problems in women over 30 years of age and the physiological decay in fertility, which in general is more acute in women over 35 years of age and increases dramatically in women over 40.
For this reason, receiving a timely diagnosis is crucial.
If there are no sexual problems involved in the couple and no other cases in the woman’s clinical history, a one-year wait before consulting a specialist is reasonable enough if she is younger than 30. If she is between 30 and 35, the wait should be between 6 months and one year, and 6 months if she is younger than 40. If she is older than 40 and began trying to conceive at that age, she should consult a specialist immediately.
The causes are multiple and may affect any woman.
They can be congenital (in other words, women can have them from birth), as is the case with anatomical and hormonal disorders, anomalies of the genitalia and so on, or linked with toxic habits, such as drug use, genital infections (they often do not produce symptoms), pharmaceutical drugs, radiation or environmental contaminants.
Diseases such as endometriosis, adenomyosis and female genital organ tumours are further barriers to conception.
Assessing female sterility involves examining the functioning and anatomy of the ovaries, the Fallopian tubes, the uterus and the external genitalia. As a consequence, diagnosis cannot be made before considering each and every one of these factors.
It should be kept in mind at all times that sterility problems are specific to each couple. It is possible for a woman to become pregnant by one man’s sperm and not another’s, either because of male problems or because of a deficient sex life.
For this reason, a careful study of each couple is always essential.
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