Dúvidas frequentes sobre infertilidade

Dúvidas frequentes sobre infertilidade

1) O que é infertilidade?

É considerado infertilidade, quando o casal tem dificuldades para engravidar, devido a alterações do sistema reprodutor tanto do homem quanto da mulher. É considerado que o casal é infértil após 1 (um) ano de relações sexuais sem uso de métodos contraceptivos e sem sucesso de gestação. Porém, conforme a idade e a causa da infertilidade, o tratamento deve começar o quanto antes. Por isso a importância do check up da infertilidade.

 

2)Como saber se a pessoa é fértil ou não antes de tentar uma gravidez?

No homem é feito um exame simples que é o espermograma, realizado em laboratório de análises clínicas, nesse exame é analisado a concentração espermática, a motilidade e o formato do espermatozóide, como também as dosagens hormonais e testes cariótipos.

Na mulher os exames indicados são: histerossalpigografia é colocado um contraste no interior do útero, para visualizar a cavidade uterina permeabilidade e aspecto das trompas, ultrassonografia para avaliar o aspecto uterino e dos ovários, e exames hormonais que são necessários para avaliar todos os hormônios que podem influenciar na ovulação e no transcorrer de uma gestação.

Se acaso apresentar alguma alteração nos exames realizados não significa que esse homem ou essa mulher jamais terão filhos, porém, pode ser que seja necessária a ajuda médica para conseguirem uma gestação.

 

3) Qual a idade limite para a mulher engravidar?

Enquanto houver a menstruação e a ovulação a mulher pode engravidar, porém, estudos comprovam que uma mulher de 40 anos tem chance 80% menor de ser mãe quando comparada a uma de 30 que esta no auge reprodutivo. Porem, estes indícios são diferentes com os tratamentos de reprodução assistida.

Na reprodução assistida a idade limite para o tratamento é de 50 anos conforme a lei.

 

4) No homem qual a idade limite para fertilidade?

O homem é mais privilegiado nesse aspecto. Homens com idade avançada  podem ter filhos muitas vezes sem dificuldades.

 

5) É possível a mulher ter filhos após a laqueadura tubária?

Sim, há duas possibilidades. Pode ser feito a reversão da laqueadura por meio de uma cirurgia, ou através da Fertilização In Vitro. O critério para escolher entre uma ou outra vai depender da idade da mulher, das condições que as tubas se encontram, ou seja muitos médicos retiram pedaços grandes das trompas para garantir o máximo sucesso da esterilização, e nesses casos a chance de gravidez e menor.

 

6) Quais são as principais causas da infertilidade feminina?

Endometriose disfunções na ovulação (fator ovulatório), alterações nas tubas (fator tubário) e no útero (fator uterino).

 

7) E quais são as masculinas?

Varicocele, processos infecciosos, exposição a toxinas, obstrução dos ductos de transporte dos espermatozóides, alterações hormonais e fatores genéticos.

 

8) Qual e a porcentagem de casais que sofrem com problemas de infertilidade?

Atualmente 20% dos casais tem problemas para conseguir um gestação.

 

9) O uso de contraceptivo via oral se usado por um longo prazo causa infertilidade?

Não, independente do tempo. Em alguns casos o uso do anticoncepcional é tratamento de manutenção de endometriose e cistos ovarianos.

 

10) O que é ISCA (Infertilidade sem Causa Aparente)?

É quando o casal não tem alterações orgânicas ou fisiológicas que justifiquem o motivo de não conseguir engravidar, mesmo após terem realizados todos os exames necessários para a pesquisa das possíveis causas da infertilidade.

Cerca de 10 a 15% dos casais procuram um especialista em reprodução humana com esse diagnostico.

 

11) Existem Complicações na FIV( Fertilização in Vitro)?

A principal complicação é o hiperestímulo ovariano, que é uma resposta exacerbada dos folículos ovarianos, essa complicação é mais comum em mulheres jovens com quadro de síndrome de ovários policísticos, porem já é visualizado no controle de indução e na maioria das vezes o tratamento dessa complicação é o repouso, dieta hiperproteica e alguma medicação, existem casos em que há necessidade de internação devido ao acúmulo de liquido dentro de abdômen.

 

12) O procedimento de Aspiração dos Óvulos danifica o ovário?

Não. Os óvulos são aspirados com uma agulha própria e não causa traumas nos ovários.

 

13) Quais são as indicações para FIV?

Existem muitas indicações, porém essas são as que mais se destacam: Problemas de tubas (obstrução ou falta de motilidade – laqueadura tubária), espermatozóides em quantidade muito pequena (menos que 10 milhões), idade materna avançada, endometriose avançada, falha nos tratamentos de menor complexidade, fatores imunológicos, anticorpo antiespermatozóide, abortos de repetição, alterações genéticas no homem e/ou na mulher.

 

14) O uso do DIU pode gerar algum problema relacionado à infertilidade?

Sim. Esse alerta é importantíssimo para as mulheres. O DIU pode facilitar a entrada de bactérias no trato reprodutivo superior (trompas) e obstruí-las levando à infertilidade de causa tubária. Nesses casos, o único tratamento é a Fertilização in Vitro.

Esse quadro também pode ocorrer quando a mulher contrai doenças sexualmente transmissíveis. Por isso, é sempre importante usar preservativos, única forma de proteção contra as doenças. 

Para que o DIU  não provoque problemas de infertilidade é importante que as pacientes sejam orientadas para comunicarem aos ginecologistas quando apresentarem qualquer sintomas suspeitos, como corrimento vaginal, dor pélvica, dor na relação sexual, etc…

 

15) Toda mulher que recorre à Fertilização in Vitro terá gestação múltipla?

De maneira alguma. Hoje, nas clínicas de reprodução assistida mais modernas, as taxas de gêmeos são de15 a 20% e as de trigêmeos de 1%. Esses números ainda são considerados altos. Por isso, sempre buscamos formas para reduzirmos ao máximo a taxa de gemelaridade nas gestações.

 

16) A obesidade causa desequilíbrio hormonal. Isso pode levar à infertilidade?

Sim. O excesso de peso pode levar à anovulação crônica – quando a mulher não ovula, não menstrua e, consequentemente, não engravida. E, assim como no uso constante de anticoncepcionais, a falta de menstruação pode mascarar a existência de outros problemas.

 

17) Quais são as chances de sucesso da fertilização in vitro?

A chance de uma FIV resultar em gravidez é em média de 20 a 55% por tentativa, dependendo principalmente da idade da paciente. Em pacientes abaixo de 35 anos, as chances de sucesso são de quase 55%, enquanto que em pacientes acima de 40 anos as chances diminuem.

 

 

 

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Comentários



dirce dutra

27/09/2015 04:26
Tenho50 anos eumalaquiadura


Responder

Adelir Aparecida da Silva

30/04/2016 09:12
Tenho 39anos e uma laqueadura. Gostaria de saber quais as s chances de engravidar e como saber se minha laqueadura tem como ser revertida.Aguardo resposta obrigado


Responder

Marilene cavalheiro

19/05/2016 11:41
Uma mulher que teve um aborto retido tem chances de engravidar de novo pq faz três anos q tive esse aborto retido e des de então não consegui mais engravidar

Anac-2010@hotmail.com

15/09/2016 11:52
Completei 50 anos agora em setembro, gostaria de saber se tem como engravidar, sendo que tenho laqueadura, e fui submetida a uma cirurgia para retirada de mioma, foi preservado o colo do útero e os ovarios, continuo ovulando. Li uma matéria que seria possível engravidar, fazendo uma perfuração no final do canal da vagina. Por gentileza verificar se ainda posso conceber, tendo em vista que meu futuro marido não tem filhos. Eu tive 3 gestação sem nenhuma complicação, minha saúde é ótima.

Responder

JESICLEI

13/09/2017 08:39
Tenho 29 anos faz nove anos que fiz laqueadura gostaria de saber se tem reversão..


Responder

liuchunkai

07/11/2017 12:26
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Pamella

13/05/2018 03:34
Eu e meu marido, gostaríamos de manter um FIV, para em caso de algum problema futuro surgir com ambos, aí termos a possibilidade de uma gestação com barriga solidária. Vocês trabalham com essa possibilidade de manter o óvulo fecundado? Se sim, por quanto tempo?


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xukaimin

18/05/2018 09:44

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2018.5.18xukaimin


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