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Câu hỏi thường gặp về hiếm muộn

Hiếm muộn là gì?

Tỉ lệ hiếm muộn hiện nay là bao nhiêu?

Hiếm muộn là bệnh của vợ hay chồng?

Các nguyên nhân gây hiếm muộn, vô sinh thường gặp?

Xét nghiệm thường thực hiện khi khám và điều trị hiếm muộn?

Mổ nội soi?

Tinh dịch đồ?

Chụp X quang buồng tử cung và vòi trứng (HSG) là gì?________________________________________

Hiếm muộn là gì ?

Hiếm muộn là tình trạng một cặp vợ chồng không thể có thai hoặc không có con sau ít nhất một năm giao hợp bình thường, không sử dụng biện pháp tránh thai. Đối với những người có độ tuổi > 35 tuổi thì khả năng có thai sẽ giảm. Khuynh hướng hiện nay là rút ngắn thời gian chẩn đoán hiếm muộn xuống 6 tháng (thay vì 1 năm) cho những cặp vợ chồng lớn tuổi (trên 35 tuổi). Vì vậy, bạn nên điều trị sớm, đề phòng hiếm muộn để tránh các vấn đề về hiếm muộn.

________________________________________

Tỉ lệ hiếm muộn hiện nay là bao nhiêu ?

Theo Tổ chức Y tế Thế giới (WHO), có khoảng 10-12% cặp vợ chồng có vấn đề liên quan đến hiếm muộn. Tuy nhiên, tỉ lệ hiếm muộn ở một số quốc gia có thể cao hơn do điều kiện sinh sống và tác động của môi trường. Ví dụ ở Pháp, nghiên cứu gần đây ước tính có khoảng 20% số cặp vợ chồng trong tuổi sinh sản có vấn đề hiếm muộn. Ở nước ta, theo số liệu điều tra dân số những năm gần đây, tỉ lệ hiếm muộn ngày càng tăng cao, con số này khoảng 12%.

________________________________________

Hiếm muộn là bệnh của vợ hay chồng ?

Hiếm muộn được xem là một tình trạng bệnh lý của một cặp vợ chồng, không hoàn toàn phụ thuộc vào một bên. Nguyên nhân hiếm muộn do vợ và chồng là tương đương nhau. Và theo nhiều số liệu thống kê, nguyên nhân hiếm muộn do vợ chiếm 30-40%, hiếm muộn do chồng chiếm 30%, và do cả vợ và chồng chiếm 15-30%. Ngoài ra, có khoảng 10% hiếm muộn không rõ nguyên nhân .

________________________________________

Các nguyên nhân gây hiếm muộn – vô sinh thường gặp ?

Đối với người vợ, hiếm muộn thường có các nguyên nhân sau:

  • Lạc nội mạc tử cung
  • Không có hiện tượng rụng trứng hay rụng trứng không thường xuyên.
  • Tổn thương vòi trứng

Đối với người chồng, hiếm muộn thường do:

  • Thường gặp nhất là sự thay đổi bất thường về số lượng và chất lượng tinh trùng.  Trường hợp hiếm muộn này chiếm đến 90% hiếm muộn do nam giới.
  • Một số nguyên nhân khác ít gặp hơn có thể là rối loạn cương, không xuất tinh hay xuất tinh ngược dòng…

________________________________________

Xét nghiệm thường thực hiện khi khám, chữa hiếm muộn?

Đối với người vợ:

  • Siêu âm
  • Nội soi chẩn đoán
  • Chụp X quang vòi trứng, tử cung (HSG): thường thực hiện sau khi sạch kinh.
  • Xét nghiệm định lượng nội tiết: tuỳ từng xét nghiệm, được làm theo đúng ngày nhất định trong chu kỳ kinh.

Đối với người chồng:

  • Hầu hết tất cả người chồng khám hiếm muộn đều phải kiểm tra tinh dịch đồ (phân tích tinh dịch). Đây là xét nghiệm cơ bản, cần thiết để chấn đoán và điều trị bất kể nguyên nhân hiếm muộn là do vợ hay chồng.

________________________________________

Mổ nội soi ?

Trong quá trình chuẩn đoán và điều trị hiếm muộn, bác sĩ thường chỉ định bạn thực hiện mổ nội soi khi nghi ngờ có tổn thương ở vòi trứng do nhiều bệnh lý khác nhau. Mổ nội soi thường là một cuộc mổ nhẹ, thời gian hồi phục nhanh và có thể xuất viện khoảng 2 ngày sau mổ. Vết tích sau khi mổ chỉ là một nốt sẹo nhỏ khoảng 1cm trên bụng.

Mổ nội soi giúp bác sĩ biết rõ tổn thương của buồng tử cung, buồng trứng, vòi trứng và các tổn thương khác nếu có. Các chức năng vòi trứng và điều trị một số bệnh lý khác của tử cung, vòi trứng và vùng chậu có thế được phục hồi sau khi mổ nội soi.

________________________________________

Tinh dịch đồ (còn gọi là phân tích tinh dịch) ?

Tinh dịch đồ là xét nghiệm cơ bản để chuẩn đoán khả năng sinh sản của nam giới. Tinh dịch đồ không những cho biết được số lượng, chất lượng tinh trùng có trong tinh dịch, mà còn có thể chuẩn đoán được nguyên nhân thay đổi bất thường về tinh trùng. Phần lớn các cặp vợ chồng điều trị hiếm muộn đều cần phải thực hiện tinh dịch đồ.

Để lấy được tinh dịch thì vợ chồng phải kiêng giao hợp 3-5 ngày. Phải lấy tinh dịch bằng tay (thủ dâm) mới đảm bảo được kết quả chính xác. Mẫu tinh dịch phải được chuyển đến phòng xét nghiệm trong vòng 1h nếu lấy mẫu ở nhà. Mẫu phải được bảo quản trong lọ vô trùng và được giữ ấm(<40oC) trước khi thực hiện xét nghiệm tại cơ sở khám chữa bệnh.

________________________________________

Chụp X quang vòi trứng , buồng tử cung (HSG) là gì ?

Đây là xét nghiệm đánh giá vòi trứng có thông hay không và phát hiện những bất thường khác ở tử cung của người phụ nữ. HSG được thực hiện sau khi sạch kinh hoàn toàn sau khoảng 2 ngày. khi thực hiện, một thuốc cản quang được bơm vào vòi trứng và buồng tử cung. Nếu vòi trứng thông, thuốc sẽ chảy ra ngoài ổ bụng và được nhìn thấy khi xem phim chụp X-quang. Nếu có nghi ngờ tổn thương vòi trứng, bác sĩ sẽ đề nghị bạn thực hiện mổ nội soi để chuấn đoán tổn thương hoặc thông vòi trứng.

 


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