What is infertility

Difficult situation to have children (INFERTILITY).
Lt. Col. Dr. Theerapong free.
Labour is not difficult disease to have children, but married couples with children difficult. Often feel that they have a deep defects responsible for maintaining strains of lineage and heritage acculturation unique spirit and heritage of ancestors to continue this.
The couple married and living more than a year ago to have children is called a "difficult people to have children" because the research surveys 100 married couples in the same pair of 1 year to have sex regularly. To have children or are pregnant to 90 pairs or 90% to 10% of the children of these people are not treated as "children who have difficulty" category first (Primary infertile).
But there are some people who never have children then their children grow as children die or are widowed. One fine day remarry wanted to have children and tried to look on for more than a year, it also failed. These people have children is considered difficult as well, but as "children who have difficult second type" (Secondary infertile) called simply "types of repentance."
Whether it is children who are difficult from the beginning (Primary infertile) or repentance would like to have a few times (Secondary infertile), it is not difficult. Only to find the cause and correct treatment of the current theoretical knowledge and technology to progress very far.
For people to have children then. Husband have a healthy sperm. His wife must have a nest egg due to be fully functional both before and after the egg drop "sperm" to find the "egg" in the appropriate environment. Normally, the first meeting place will be "oviducts" Therefore, "the oviduct, have ease of travel and the atmosphere is non-toxic. Once the sperm have met mixed with eggs, because both the short lifetime of only 24-48 hours, mixing only (Fertilization) must be decent. Too early or too late will be "embryonic" is not good.
Embryos derived from the combination will travel to the fallopian tube toward the uterus which is on the way to divide and grow, but not what to stop, otherwise "the fetus" is dead or stopped, embedded there, "embryo." Travel in the oviduct to the uterus is 5-7 days for a while. And embedded in approximately 7-9 days from the date of conception. The womb of women is valuable in life, "the fetus" to the uterus, but if this is not good. Such as tumor tissue or the uterus is too thin, "embryo" may not be embedded. And women who died, it will not be pregnant.
Therefore, it can be said that Most people are born to be. Elements must be completed at least five good reasons.

• The man must have "sperm" quite a lot. Healthy and moving well.
• The female must have "egg" the perfect good and consistent with ovulation.
• Cervical mucus must be of good quality appropriate amount. Friendly and to assist the travel of the "impure" to the destination.
• Route from the cervix, uterus and fallopian tubes must not hinder the great convenience to both legs and back legs.
• There was no need to uterine tumors. Endometrial thickness must be sufficient to support implantation and growth of the "embryo" with no problems. Out until the birth.

Detection of the cause. It is not complicated. But the problem was not her husband is very understanding. Despite the opposition, and perhaps by themselves hardly have hurt at all. Unlike his wife who is eager to keep traveling Dan Dgn. Endure the pain for a variety of families. "What is the maximum value", which will bring "Happy family" completely
Caused by man as far as the report was about 20-30% of the female was about 40-50 in the group that has been caused by both sides. And the unknown were equally is about 10-20%.  ancients when it was found that due to man. Doctors who will treat ปวดเศียรเวียนเกล้า. Whether it will use any means to accomplish minimal results. Not worth the time and language on the patient.
But after 1992 (2535), since treatment of a doctor who can talk big boast is that Problems of man. Solve almost all cases, even without the "sperm" in the semen and success is quite high. Since the discovery technology called "This Taxi" (Drilling "egg" put "sperm" into one.)

The assessment of the "difficult people to have children" (Infertility evaluation). 
Let's explore it together at a party I offline. From the Department that the father first.

Male factor. (Malefactors). 
Be determined by simple analysis of semen with a normal microscope. Or rely on computer-aided detection. If the results come out wrong. Method of treatment is to skip the step to do "This Taxi" or "child vitro, it is not an issue anymore.
If the output may be a separate regular testing. If you want to know why that Why not diarrhea at How to test the properties of the "sperm" that were done.
1. The test after having sex (Postcoital test).  the ability to check the "sperm" in the new environment. (Cervical mucus) to survive and move or not normal cervical mucus acts as a friendly, very protective of "sperm" from a hazardous environment inside the vagina. And a bridge for the "impure" moving to the fallopian tubes faster. While waiting to be grating filter "sperm" with the unusual.
However, in some cases, cervical mucus acts as an enemy of the "impure" lose yourself to "impure" movement that has been exposed or not killed. This test is enough to say that. The problem is that the cervix (Cervical factor).
Methods. is the examination of cervical mucus during the period 2-12 hours after having sex around mid-month (Midcycle) to determine the number and movement of the "sperm."
Desired results is the number of "sperm" more than 10 per unit area higher magnification (High power field) moving forward quickly.
The result is not satisfactory.  do not see the "sperm" or found it very small number.  "impure" in general are not moving or moving of "convulse".
When the results appear to come out as "happy" not to do anything. Standard treatment methods will give good results. If it came out as "not satisfactory" means that the problem is the cervical mucus must be modified or cross-step to the method that does not rely on the cervical mucus.

2. Psychometric testing "sperm" other , such as detection of the immune system (Sperm antibodies) or the ability of fertilization. (Fertilization capacity) of the "impure" quite complicated. Will not be mentioned here.

Guidelines for treatment of male problem.
Drug treatment or surgery do not always work. But in places where no advanced technology tools. I need treatment that could cause a "mild infection, before diseases such as thyroid conditions, high Prolactin in the bloodstream. Including vascular surgery, I express the testis. Semen or sperm tubes cut to solve the dead.
Your guy is try to see if the survey itself. Impaired by the behavior of you or not. But if they have not completed Hnแegyhnrnod emotional meaning there caress Ouแyg Ouแyg it once. I need to consult a doctor anyway. Analysis will follow each other closely.
Now let's see what factors from the same female.

Factors from the female (Female Factors). 

1. Cervix (Cervical Factors).
Trip of the "sperm" from the cervix to fertilization with the "egg" that require uterine cervical mucus is an important factor, so the cervix may be a problem interfere with the travel of the sperm. If a chronic infection has been destroyed by surgery or pendant electricity and oral mucus ants get immune to the "impure" and so on.
Testing mainly check the properties of cervical mucus, such as checking pH - pH (usually pH = 8), the test after having sex (Postcoital Test), inspection of crystallized into form ferns and elongation in the egg drop (Crystallization & Spinnbakeit) and because of the infection and so on.

Guidelines for treatment.

• Hormone low nitrogen cervical mucus, causing more clear.
• Eating antibiotics reduce the inflammation around the cervix.
• Intrauterine insemination to a "Gift" and "child tube" for Lee to avoid touching or living through cervical mucus.

2. Uterus (Uterine Factor).
Is responsible for supporting "the fetus" from the womb to grow wings and embedded. At the same time protect the environment from external dangers.
Assessment of the uterus. By injecting into the uterus. (Hysterosalpingography), endoscopy to look inside the uterus. (Hysteroscope), abdominal puncture endoscopic view of pelvic pathology. (Laparoscope) and curettage. To determine ovulation and ovarian function and so on.

Guidelines for treatment.
Most of the surgery. This is done in the case of a tumor (Myomectomy) uterus disfigurement innate. (Metroplasty) or a membrane in the uterus (Removal of Intrauterine Synechiae).
The drug treatment. Often used in case of intrauterine infection. (Endometritis) or hormones in order to restore the lining of the uterus. Membrane inside the uterus after removal from it.

3. Uterine or fallopian tube (Tubal Factor).

Serves as a pathway of germ cells (eggs and sperm) is the first origin of man and nurture "the fetus" before drifting into the uterus. Therefore, uterine is very important. Especially There will be a convenient transportation routes throughout the line. Between the two sides end (Fimbria and Ostia).
Inspection of the uterine mainly focuses on how to test that. Obstruction or not (Obstruction or Patency) but may indicate a tumor in the uterus (Polyp or Submucous Myoma), the place where (Location) and function (Function) of the uterine too.

How to detect uterine include
Injected into the uterus and X-ray colors. (Hysterosalpingography), endoscopic puncture the stomach. (Laparoscope) with Methylene Blue injection of color into the cervix, through the injection of air into the uterus and out through the uterine (Tubal Insufflation) and injection of liquid through the cervix with Ultrasound examination of the vagina. See through the uterine fluid to accumulate at the bottom pelvic floor. (Hysterosalpingo-Contrast-Sonography).
Guidelines for treatment.
Surgical dressing of the fallopian tube. If stenosis or solve tons Lo Man membrane around. Fallopian tube and do "Children tube" drops in the case of cervical oviduct obstruction on both sides.

4. Ovary (Ovarian Factor).
A duty to produce "eggs" and the hormone, which influences the structure and functioning of reproductive age women revealed.
The assessment of the "nest" by checking blood hormone (FSH, LH, Estradiol, Progesterone) and ultrasound monitoring of the vagina over time. To determine the ovulation (Ovulation) or ovarian function before and after the egg becomes how

There are also indirect costs of the investigation of other such basic body temperature (Basal Body Temperature), scraping the lining of the uterus to remove the check. For ovarian function after egg drop (Endometrial Biopsy) etc.
Guidelines for treatment.
If eggs do not fall (Anvulation) to find the cause of diseases such as thyroid gland disease, P. Se.oo.de. (PCOD), serious organized so changed cause it, and then to trigger eggs (Ovulation Induction) in combination with insemination (IUI), a "GIFT" (GIFT), a "child vitro" (ZIFT) or ". Ing Taxi "(ICSI) is a case by case basis as appropriate.
If ovarian tumors or cysts are large, it is necessary to perform surgery (Cystectomy & Oophorectomy).
If the ovaries are not working (Ovarian Failure) if it is to have the ball. Would have to "hold merit" out "egg" instead of someone else (Ovum Donation).

5. Sexual intercourse (Coital Factor).

Is a major problem that most Thai people dare not reveal because of cultural attitudes that may be transmitted to other parties, including the time has come for each other, it is less bare.
Solutions.
PSYCHOTHERAPY (Psychotherapy), attitude change and consult on introducing sex education (Sexual Therapy) probably have to inject her husband to bring the infection into the uterus and then copy directly to it. (Intrauterine Insemination).
Conditions that cause the ball hard no (Unexplained Infertility). 
This means that couples with children is difficult. Tested all the way to process the source of possible disorders is not surprising both sides. But is not that there is no real reason. Perhaps when the next test vehicles better. I have the opportunity to find out why 10 years ago the incidence was about 10-20% is present in some institutions have reduced the incidence of only 0-5% only because of modern tools.

Technology Support and treatment of children with difficult times to date.

1. The injection into the uterus. (Intrauterine Insemination initials "IUI") at the rate of pregnancy, around 15-20% per menstrual cycle.
2. What does "Gift" ("GIFT" stands for Gamete Intrafollopian Transfer) pregnancy rate is 30-40%.
3. What does "child vitro, conventional and drop" embryo "of the vagina (" IVF-ET "In Vitro Fertilization Embryo Transfer) pregnancy rate of 20%.
4. What does "child vitro" and drops "embryo" of uterine ("ZIFT" stands Zygote Intrafollopian Transfer) pregnancy rate of 30-40%.
5. Drilling "egg" put "sperm" into one. (Micromanipulation).

• PZD (Partial Zona Dissection) today is not popular to do anymore.
• SUZI (Subzonal Sperm Injection) is currently not popular to do anymore.
• "This Taxi" ("ICSI" stands for Intracytoplasmic Sperm Injection).

      6. Freezing (Cryopreservation) is currently done only "sperm" and "fetus."
      7. The use of "egg" donation, or "hold merit" (Ovum Donation).
      8. Extraction "sperm" from the testes of the case without the "sperm" in the semen.

• "The Lisa" ("MESA" stands for Microscopic Epididymal Sperm Aspiration) extracted from the semen tube Epididymis.
• Stephen Se "(" TESE "stands for Testicular Sperm Extraction) extracts from testes because direct

The success of treatment depends on the ability of a doctor. Standards of the institution and the patients themselves.

From research to results of treatment of a difficult child. At the end of the year will have a chance at a pregnancy varies according to the following causes.

• Case is due to "egg" does not fall or drop is not uniform. (Anovulation) has a very high chance of pregnancy is about 80-90%.
• If the cause is not found (Unexplained Infertile) are rather high chance of pregnancy approximately 70%.
• Case "sperm" with a number of regular features, but some defects (Sperm Disorders with Normal Counts) will have 30-40% chance of pregnancy.
• If the "fallopian tube" problem (Tubal Damage) has 20% chance of success.
• The other hand, the problems and achieve the same number, but is "sperm," a smaller number than usual (Sperm Disorders with Low Counts) will have a 10% chance of pregnancy only.

Mentioned above. The performance of institutions that do not have to do "This taxi, but after 1992 (2535) found that the technology" commented the agency, "then the problem is a difficult child. due to the "sperm" gone wrong with the pregnancy success rate in the case of "mild infection, as high as 30-40%, an increase from 3-4 times.
Labour is not difficult disease to have children should make "time" with doctors who treat to find out why. Will be the fix. If you do not see why. (Unexplained) is not to be irrecoverable Success may be better for some reason find it again.
Important for married couples to have children is difficult. But institutions should maintain a standard. With advanced technology tools and technology advanced. More important than it is. The patients themselves have to cooperate very well and have a physical condition. Which means that the germ cells in the areas of modern medical help.
Child is most valuable for all the family. Do not let time slip away while still hopeful Be sought out to earn this precious thing I get offline. Because no one knows what we will leave this world when And who will be a continuing transfer of ideas. And virtue of our existence to our children if not true You mean.
 
[Source magazine Mother and Children ... The No. 22 326-327 April-May 2542].
From. Www.clinicrak.com.