Monday, 7 September 2015

Male infertility, threatened four men out of ten

Male infertility, threatened four men out of ten. Continues to decline, the average concentration of sperm, pollution and environmental factors the main causes. The analysis of the center of reproductive medicine .

Continues to decrease male fertility. Halved in the second half of the last century, the average concentration of sperm in the 2000s has decreased by about 15%. "We estimate that about four out of ten men in the age group 20 to 45 years old may have a low sperm quality, then problems to have a child," he pressed specialist in Reproductive Medicine of the fertility center , only one in four men have a semen quality considered excellent; the quality would be fair to 20-30% and this may take longer to arrive at a conception; while for 10-15% would be just enough, or to the limit with infertility problems.

"By the standards of the World Health normal sperm concentration it is 15 million per milliliter; below this threshold, the talk is of low sperm counts, then of possible problems in getting a pregnancy, "continues . "Based on these values ​​it is important that you pay more attention to reproductive health in humans through awareness campaigns targeted."The quality of the male seed depends on several factors. "There are many elements that can affect the mean concentration of sperm and their motility. Among the causes that have led to the lowering of quality there are environmental factors. We live today in an environment far more polluted and, compared to a few decades ago, we are more easily subject to come into contact with harmful chemicals. Some plastics, pesticides and nitrates are so-called endocrine disruptors that can cause fertility disorders. The thesis of environmental causes is supported by several studies of migration: people moving from one place to another tends to take the same problems found in the natives', continues Bellavia. "Even sexual freedom is a causative factor as it leads to a greater spread of infections that can impair male fertility. Certainly not the last, unhealthy lifestyles - such as smoking - lead to a deterioration in the quality of the seed, lowering the traditional parameters of concentration and sperm motility. "

In many cases the problem is solved: "Thanks to new specific examinations, sometimes simply follow the targeted treatments, or simply to change habits, to return to a full reproductive health", continues . The specialist of reproduction should in fact encourage the prevention of infertility through important advice to the couple on the lifestyle and how to avoid those toxic substances that can have a negative influence on fertility. The situation is different in cases where infertility is diagnosed. Continue the specialist ProCrea: "It is estimated that a third of men defined infertile, when subjected to adequate care, failure to obtain a natural paternity. The remaining can enlist the help of assisted reproduction. Even men once considered absolutely sterile, can become fathers, recovering sperm directly from the testis and injecting them into the ovum (ICSI). But in 3% of infertile couples, there is a condition of azoospermia, it is necessary to resort to heterologous fertilization using donor sperm.

Born premature after three cycles of assisted reproduction

It was born premature after three cycles of assisted reproduction and three miscarriages. His mother suffers from a severe form of endometriosis, known for crippling 80% by the State. Endometriosis and pregnancy are at odds, and Georgia is incredibly came into the world after a natural conception. Viviana mom is 30 years old and after two laparoscopies to say that even with IVF will have really serious difficulties in having children. In fact with the in vitro fertilization can begin three pregnancies, but unfortunately all interrupted for lack of heartbeat between the seventh and the tenth week.
Blame endometriosis, chronic and complex, originated by the presence of abnormal tissue that lines the inner wall of the uterus (the endometrium that is) in other organs such as the ovaries, fallopian tubes, peritoneum, intestines. This causes internal bleeding, recurrent inflammation, scar tissue, adhesions and infertility especially. After many failed attempts Viviana suspends care to recuperate psychologically and physically, her endometriosis worsens but last December surprise becomes pregnant. She and her husband conceive naturally, without the help of science.
Viviana is followed by Dr. Peter Litta Clinic of Gynecology and Obstetrics of the Hospital, directed by Professor Gianni Nardelli. He is to warn you that the creature she is carrying - a girl - could, because of illness, premature birth. On August 5, Viviana, who has now learned to "listen" to her baby in the womb, he realizes that something is wrong, he does not feel the move as usual. The following day he went to Clinic here and they realize that the child has serious bowel problems, which is filled with liquid. The diagnosis makes the Professor Donato D'Antona: Georgia is serious, it should be born at 32 weeks, compared with the canonical 40.
So is the light at 20.30 by Caesarean section performed by the same Litta and colleague Alessandra Andrisani, at midnight of the same day is made by Dr. Patricia dall'Igna team of Pediatric Surgery directed by Piergiorgio Gamba: 70% of the excise ' intestine; removed 20 cm of necrosis, the two flaps are sewn together to avoid having to apply the external drain.
"Hours dramatic and even days, but Georgia is proof that in life the worst prejudices are judgments: Giorgia is proof that willpower can work wonders," says Cristina Bernardi, president of the PMA that Sos Viviana says three years and is now rejoicing with her for this unexpected, and healthy, pink bow. "This success story makes me very proud because many people think that we push couples to rage at all costs in the search for a child when in fact - reflects Bernardi - we take care of welcoming and giving psychological support especially to those in front of events so devastating risks falling into despair and give up whatever life project. Viviana and her child are proof that science can make mistakes and that life can reserve more surprises. "

A black hole of infertility and treatment

Our country, according 9 gynecologists, urologists and urologists of 10 is afflicted by the serious problem of low birth rate is what emerges from Censis survey "Becoming parents today: the point of view of the specialists' in collaboration with the Foundation and presented IBSA in Rome by Giuseppe Zizzo, Secretary of the Foundation IBSA, and Ketty Vaccaro, Head of Health and Welfare of Censis, and discussed by Andrea Lenzi, Professor of Endocrinology at the University 'La Sapienza' in Rome and President of the National University Council, Happy Petraglia, director of Obstetrics and Gynecology of the School of the University of Siena, William Pepper, former Director of "Health-the Republic," and Maurizio Roman, Vice President of the Health Commission of the Senate. And the reluctance of Italians to have children is attributed mainly to economic reasons (75.3%). 75% of specialists is also convinced that the economic crisis discourages couples who have to resort to medically assisted procreation. Couples treated in Italy with assisted reproduction techniques were 54,458 in 2012 (latest official figures available): + 77% compared to 30,749 in 2005. In 23.2% of cases it comes to pregnancy. Children conceived in a test tube that came to light were 9,818 in 2012: + 169% compared to 3,649 in 2005. Half of the specialists consulted by Censis believes that infertility problems affecting 20-30% of couples Italian, against estimates the World Health Organization that speak of 10-15%. And it is certain that the problems of infertility and sterility have increased compared to the past: I think 91.3% of the doctors surveyed.
When you start to worry. Half of specialists believes that a couple should start worrying about between 12 and 24 months after the first attempts at conception. But 36% believe that we should worry about before, after 6 to 12 months from the first attempts. 4.7% is useful to anticipate within 6 months, 9.3% expect at least 2 years. Among the population, however, it increases to 44% the percentage of those who believe that we should wait for more than two years from the first attempts before worrying. According to a little less than half of the specialists, the age at which a woman who aspires to be a mother should start worrying is over 35 years. The majority of the sample identified after age 25 the right age to start screening examinations infertility (the inability to carry their pregnancies to term with the birth of a healthy child) and infertility (the inability to conceive) . 77.3% favored the activation of regional and national programs to screen infertility of women and in favor of screening for men and an even higher percentage equal 81.3%.
Who takes care of it. Patients with infertility problems are followed in almost half of cases in private (46.6%), 39.7% in public and 13.7% in both the public and private sectors. Nearly 75% of specialists believe that couples with infertility problems tend to consult more than one specialist before committing to the care of one chosen at the end. 62% of specialists judging their patients with little or no informed both about the problems of infertility and sterility, is on the techniques of medically assisted procreation. The gynecologists, urologists and urologists agree on the importance of the law 40/2004 on assisted reproduction (89.3%). But it indicates that there are significant geographical differences in law enforcement. The 88.7% of the doctors emphasizes that not all Italian regions is assured the same level of quality in treatments for medically assisted procreation and that, despite declarations of principle, not in all regions is assured of the free ' access to treatment for the LDCs (83.3%). In Italy 54% of centers where you can make the PMA enrolled in the National Register are private, and the percentage rises to 69% in the South. 76% of the specialists agree with a revision of the law 40/2004. The aspect that should be changed first of all to the possibility of actually offer couples the opportunity to access all'eterologa (60.5%).

"The Foundation has strongly supported this second IBSA research on infertility that is ideally complements the more held last year on the whole population. I posed the question about the infertility experienced by those who come in contact with every day, so the specialists. And this time were many interesting ideas and even surprising, demonstrating that very often the daily reality is a source of valuable information too often underestimated. How, for example, strong demand and unique to activate as soon as screening programs for infertility and sterility, national and regional, both for women than for men, "said Joseph Zizzo, Secretary of the Foundation IBSA. "Another element that shows how the growing infertility is a real critical in Italy is the appeal of the specialists to increase the population's awareness about the problem, either through a broader confrontation with your gynecologist well before deciding to have a child , with both proactive and counseling to the forefront on these issues by the general practitioners. The hope is that these IBSA Foundation data and research done with Censis are another step in this direction, for increased awareness and information, "concluded Zizzo.

Surrogacy: ethical doubts and new rights

Under the circumstances, his mother Anne-Marie offered to act as a surrogate mother and hosting embryos from gametes son and ova from a donor, she takes a pregnancy to term. It happened in August 2014 in England, where a 46 year old woman became a mother and grandmother of Mils, the son of his son Kyle. The English High Court then accepted the request for adoption by Kyle and the child is now legally his son and his brother.
Criticism came Kyle then answered: "I have a son and now I am happy. If you are able to provide support and love, I do not see why someone should be denied the right to be a parent. For this child I paid, not taxpayers' money. " And on why he chose his mother for subrogation, he says: "The advantage of a surrogate mother that you know and you trust is that there are fewer risks associated with the adoption. If you are using a surrogate alien may also decide to keep the baby, since legally it is the mother. "
This is precisely what happened to Gordon and Manuel.
After giving birth to a child, the Thai Patidta Kusolsang, surrogate mother, aware of the fact that the couple customer - Gordon Lake and Manuel Santos, respectively American and Spanish - is actually a gay couple, refuses to sign the necessary documents for the passport of the child. In Thailand, a woman who gives birth to a child retains all legal rights to the child who can not leave the country without his approval. Even the US Embassy has taken steps to resolve the situation, without success, because "under US law, the Department can not issue passports to children without the consent of the parent or legal guardian".
Today, Gordon and Manuel, for fear that the small Carmen is taken away, living with her and the other two year old son, Alvaro - he had with surrogacy in India - in a secret location in Thailand waiting that the intricate issue will be resolved. The couple last year had turned to an agency, the New Life Thaildan, and the two had first chosen the egg donor, then approved the surrogate mother, Patidta Kusolsang, a woman from a middle class family with a daughter and a job stable. Patidta therefore, is a mother to gestational surrogacy, which means that the eggs used in fertilization does not belong to her.

In late July, just as Patidta is pursuing pregnancy, due to a series of scandals Thailand outlaws surrogacy for profit, prohibiting even the subrogation to foreign couples. Patidta now denies that his rethinking is because of sexual orientation of the two men and that concerns rather a feeling of attachment to the child, and also said that he would have returned to the couple the monetary compensation received in exchange for subrogation. Gordon and Manuel, for their part, have repeatedly stated that they will not leave Thailand without Carmen. "It is our daughter (Gordon Lake is its biological father) and belongs to us. We trust that the surrogate mother will be convinced that we are good parents and will sign the papers to go home with Carmen. " Meanwhile, on launched a petition and Facebook page open Bringcarmehome.
Those opposed to the subrogation see this opportunity as an exploitation of the female body, only victim. However, even the couple customer can be exploited and humiliated by the economic point of view and emotional when the mother changes her mind and takes the child. The questions that arise are many such stories. Biotechnology and science progresses every day and determine the emergence of new rights: how to regulate these new demands? And where and when you should stop the law? From the ethical point of view, that there are objections to surrogacy if it's a free choice? Because it goes well a child left to nurse for most of her childhood and not good hosted a fetus for nine months in the womb of a mother to gestational surrogacy? How far can you push the desire for parenthood?