| Infertility is the inability to | | | | secretions with a long cannula. The |
| conceive; it may be remedied. However, | | | | woman is to be instructed not to void, |
| should the conditions persist, it is | | | | bathe, or douche between coitus and the |
| referred to as sterility. | | | | examination; a perineal pad is worn |
| In the United States, one out of every 8 | | | | until she is placed in ?lithotomy |
| to 10 couples are childless because of | | | | position? in the examining room. |
| infertility; it is a major medical and | | | | Aspirated material is placed on a slide |
| social problem. Both husband and wife | | | | and examined under microscope for |
| are urged to seek medical attention for | | | | presence and viability of sperm cells. |
| complete examinations and evaluation, | | | | Treatment |
| since almost as many men as women cause | | | | The treatment of sterility is a |
| a sterile marriage. | | | | difficult matter, because it may be |
| It is usually recommended that the male | | | | caused by a combination of several |
| be evaluated first, because tests for | | | | factors. Efforts are made to build up |
| the female are more expensive and | | | | the general health of the patient, |
| time-consuming. Such tests may require | | | | supplying lacking glandular hormones as |
| the services of a urologist, | | | | indicated. |
| gynecologist, endocrinologist, and | | | | Operative treatments include removal of |
| internist. | | | | obstructions and plastic operations to |
| In the female, the organs of | | | | restore tubal potency. Unfortunately, |
| reproduction and the glands influencing | | | | these are not too successful; in |
| them are evaluated. Among the causative | | | | addition, there is a high incidence of |
| factors may be displacement and tumors | | | | tubal pregnancy following such |
| of the uterus, genital infantilism, and | | | | operations. |
| inflammation. To allow fertilization of | | | | The psychic and social factors of |
| an ovum, it is necessary that the | | | | infertility must not be overlooked. |
| vagina, cervix, and uterus to be patent | | | | Among some religious groups and |
| and have mucosal secretions receptive to | | | | nationalities, it is important to have |
| the sperm. Semen is alkaline, as is | | | | blood descendants; adopting children is |
| cervical secretion; normal vaginal | | | | not acceptable in these families. |
| secretion is acid. | | | | In other family groups, the man?s |
| Treatment is directed towards correcting | | | | virility, or woman?s femininity are |
| the deficiencies encountered in the | | | | suspected when a couple fails to have |
| individual patient. The following tests | | | | children. Many pregnancies have occurred |
| assist the gynecologist in delimiting | | | | after an infertile couple has adopted a |
| the problem. | | | | child, moved to another location, or the |
| 1. Rubin test | | | | husband had a change of jobs. |
| This procedure is to determine the | | | | All of these things indicate that the |
| potency of the fallopian tubes by | | | | concepts behind infertility are not |
| introducing carbon dioxide through a | | | | absolute and concrete. There are |
| sterile canula into the uterus, into the | | | | instances that the information about |
| tubes, and into the peritoneal cavity. | | | | this particular problem may have |
| By listening with a stethoscope on the | | | | underlying causes that should not be |
| abdomen, the physician may hear the gas | | | | blamed on the inability of the person to |
| swishing into the abdomen. If the | | | | conceive. |
| pressure gauge reaches 200 mm. of a | | | | Boiled down, the problem on infertility |
| mercury, an occlusion may be suspected. | | | | is more of a social problem than a |
| 2. Salpinogram; Hysterosalpingogram | | | | biological problem. It is not the aspect |
| A radiopaque substance is often used to | | | | of not being able to conceive that |
| determine the site of tubal obstruction; | | | | persons involved are hesitant to |
| an x-ray picture then shows the outline | | | | disclose the matter. |
| of the tubal lumen. | | | | If it is more than just biological |
| 3. Hubner test | | | | malady, then, it requires tough |
| Within an hour or two after intercourse, | | | | solutions. |
| the physician aspirates cervical | | | | |