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Media Backgrounder: Conception Difficulties and
What is the problem?
For millions of couples around the world, the inability to have childrenis a personal tragedy. For a significant proportion of them, the privateagony is compounded by a social stigma, which can have seriousand far-reaching consequences.
Those who are having difficulty conceiving experience a range ofemotions, including feelings of inadequacy, anger, guilt and depres-sion. These feelings and experiences can impact many aspects of acouple’s life – their self-esteem, their relationship with each other,and their relationships with friends and family.
At least 10-15% of couples worldwide are unable to conceive withoutassistance. A WHO study in 2002 estimated this number to be inexcess of 80 million.i A more recent study found that this number hasincreased to around 90 million.iii Of that number, only a small propor-tion of couples (6%) actually receive the medical help they mayrequire.iii
Why ‘difficulty conceiving’, not ‘infertility’?
For many people the term ‘infertile’ and the condition of ‘infertility’ aretaboo subjects, which can prompt feelings of isolation, embarrass-ment or even shame and prevent couples seeking treatment. Assuch, the Assisted Conception Taskforce (ACT) are calling for doc-tors, journalists and other opinion leaders to refer to patients as hav-ing ‘difficulty conceiving’ rather than ‘infertility’.
When should couples seek help?
Couples having difficulty conceiving should seek help when theyhave had no success after 12 months of regular unprotected sexualintercourse.
What can cause difficulties in conceiving?
The causes of difficulties in conceiving are many and varied. They
can include problems with either the sperm or the eggs, complica-tions with the fallopian tubes or the uterus, endometriosis, frequentmiscarriage, as well as hormonal and autoimmune disorders, whichcan occur in both men and women. Ovulatory disorders, such asirregular ovulation, account for approximately 20-30% of conceptiondifficulty cases.
What is assisted conception?
Assisted conception describes the range of treatments available tocouples who are experiencing difficulty in conceiving. Treatmentoptions available to couples are not as daunting as most peoplethink, with many modern treatments being simple, non-invasive andvery effective.
Assisted conception treatment options:
There are in fact a number of routes that can be explored when think-ing about assisted conception. Some of the most common forms oftreatment are:
Up to 80% of women whose difficulties in conceiving stem fromphysical disorders, can be helped with assisted conception treat-ments that promote the growth and development of ovarian folli-cles. The most common medications used in this treatment areclomiphene citrate (also known as Serophene® or Clomid®) andgonadotrophins, which stimulate the body’s production of folliclestimulating hormone (FSH) or replace it if the body is not producingenough/any of its own.
• Assisted Reproductive Technology (ART)
ART is usually used for patients who experience conditions such asblocked fallopian tubes, widespread endometriosis, male condi-tions and unexplained infertility. The most common ART tech-niques include:
Intrauterine insemination is used to overcome male difficulties inconception by directly introducing seminal fluid into the uterus.
This is also used in cases of mild endometriosis or cervicalmucus of poor quality or hostile to sperm.
In Vitro Fertilization is a process in which the egg and the spermare placed together into a dish outside the body. The actual fer-tilization occurs spontaneously and the embryo is transferredinto the uterus. This technique is used, for example, in cases ofblocked fallopian tubes.
o Intra-Cytoplasmic Sperm Injection (ICSI)
ICSI is a procedure in which a single sperm is injected directlyinto an egg. This procedure is most commonly used to over-come male infertility problems.
Across the world, education, availability and attitude towards assist-ed conception vary considerably. This is a subject which has beentaboo since the first assisted conception birth took place over 25years ago. It is time now to leave all negative perceptions behind andunderstand all the benefits that assisted conception can bring to peo-ple all over the globe.
i http://www.who.int/reproductive-health/infertility/index.htmii Kerr et al. National Infertility Awareness Campaign (NIAC) study,
iii Professor John Collins, McMaster University, Hamilton, Ontario.
Global Epidemiological Fertility Model.
iv http://www.access.org.au/about_infertilityv Serono International S.A. A tale of two hormones. Geneva:
Il testo dell’interrograzione Carrara - Al Ministro della salute - Premesso che: in Italia il metilfenidato - un noto psicofarmaco stimolante del sistema nervoso centrale, una meta- anfetamina precedentemente classificata come sostanza stupefacente al pari di eroina e cocaina - è stato reintrodotto sul mercato, assieme ad un altro farmaco psicoattivo (atomoxetina), e questi due prodotti
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