The Truth About Infertility

Infertility is the inability to conceive; it may be remedied. However, should the conditions persist, it is referred to as sterility.

In the United States, one out of every 8 to 10 couples are childless because of infertility; it is a major medical and social problem. Both husband and wife are urged to seek medical attention for complete examinations and evaluation, since almost as many men as women cause a sterile marriage.

It is usually recommended that the male be evaluated first, because tests for the female are more expensive and time-consuming. Such tests may require the services of a urologist, gynecologist, endocrinologist, and internist.

In the female, the organs of reproduction and the glands influencing them are evaluated. Among the causative factors may be displacement and tumors of the uterus, genital infantilism, and inflammation. To allow fertilization of an ovum, it is necessary that the vagina, cervix, and uterus to be patent and have mucosal secretions receptive to the sperm. Semen is alkaline, as is cervical secretion; normal vaginal secretion is acid.

Treatment is directed towards correcting the deficiencies encountered in the individual patient. The following tests assist the gynecologist in delimiting the problem.

1. Rubin test

This procedure is to determine the potency of the fallopian tubes by introducing carbon dioxide through a sterile canula into the uterus, into the tubes, and into the peritoneal cavity.

By listening with a stethoscope on the abdomen, the physician may hear the gas swishing into the abdomen. If the pressure gauge reaches 200 mm. of a mercury, an occlusion may be suspected.

2. Salpinogram; Hysterosalpingogram

A radiopaque substance is often used to determine the site of tubal obstruction; an x-ray picture then shows the outline of the tubal lumen.

3. Hubner test

Within an hour or two after intercourse, the physician aspirates cervical secretions with a long cannula. The woman is to be instructed not to void, bathe, or douche between coitus and the examination; a perineal pad is worn until she is placed in