Which examinations are carried out?
From the beginning, both partners should be involved in conversation and diagnostics. The survey of the history and medical history are as much part of it as a first general examination.
- The woman is examined by various methods, whether she has an ovulation and whether the fallopian tubes are consistent. This is done using contrast media and ultrasound, sometimes a laparoscopy is necessary.
- In men, the reduced fertility is usually due to changes in the sperm. Therefore, it is often enough that he gives a sample of his sperm, which he gains after about three to five sexually abstemious days by masturbation. Seed delivery is usually undisturbed in shielded rooms practice. The sample can also be collected at home and given to the laboratory as soon as possible. Prerequisites for this, however, is that the man is previously informed by the doctor exactly about extraction and storage.
What happens to the semen sample?
From the ejaculate a so-called spermiogram is created in the laboratory as soon as possible. To be checked:
- pH of sperm,
- its sugar content (fructose index),
- its viscosity (viscosity).
- The motility, number and shape of the sperm are then assessed under the microscope.
In a normal volume of 2-6 ml a total of at least 40 million, per milliliter 20 million sperm should frolic. Of these, more than 65% should be normally shaped and over 65%, of which at least 25% should be significant. If all or part of these values are abnormally altered, fertility is reduced, in rare cases nonexistent.
What happens with an altered spermiogram?
If the result is not normal, at least one second study should be done at intervals of one month since the values may vary widely from sample to sample.
If only a few or less active sperm again show up, additional investigations are necessary. In addition to an ultrasound of the testes and prostate, with the tissue changes z. B. revealed by a tumor, hormone examinations are performed. Tissue samples under local anesthesia are only taken if there are extremely few sperm in the spermiogram. This makes it possible to check whether sperm cells are even produced. In a blood sample may be searched for genetic abnormalities. This is especially recommended before artificial insemination (for both partners).
In most cases, the cause is found and childlessness can thus be specifically targeted by a doctor. The spectrum ranges from the successful hormone treatment of the woman or - in the case of a poor spermiogram - of the man to artificial insemination with unfortunately lower success rate and higher complication rate. Experts estimate that - with all measures included - around 60-70% of the initially infertile couples with medical support and targeted treatment of the desire to have children are satisfied. On average, they need patience and perseverance for about a year.