Home » Hiếm muộn » Hiếm muộn,vô sinh-Một số điều cần biết

Hiếm muộn,vô sinh-Một số điều cần biết

Theo các nghiên cứu về sinh lý sinh sản cho thấy: một cặp vợ chồng khoảng 25 tuổi, mỗi tháng sẽ có khả năng thụ thai gần 25% nếu tinh hoàn hoàn toàn bình thường về phương diện sinh sản. Nếu không tránh thai thì khoảng 90% các cặp vợ chồng này sẽ có con sau một năm chung sống, sinh hoạt cùng nhau.

Một cặp vợ chồng được cho là hiếm muộn, vô sinh khi hai vợ chồng mong muốn có con và chung sống với nhau bình thường mà không sử dụng một biện pháp tránh thai nào sau một năm vẫn không có khả năng có con.

Những điều cần biết về vô sinh hiếm muộn

Khả năng sinh sản giảm dần đối với nam và nữ khi tuổi càng cao. Theo ước tính, phụ nữ dưới 25 tuổi sinh hoạt vợ chồng bình thường trung bình từ 2-3 tháng là có thể có con. Trong khi phụ nữ trên 35 tuổi thời gian này kéo dài đến hơn 6 tháng. Đối với nam giới, hiện tượng này cũng xảy ra nhẹ nhàng, chậm rãi hơn, từ khoảng 40 tuổi trở về sau khả năng sinh sản của nam giới giảm rõ nhất sau 60 tuổi.

Nguyên nhân hiếm muộn có thể do người vợ hoặc người chồng. Nói chung, khoảng 30% trường hợp hiếm muộn là hoàn toàn do chồng, 30% trường hợp do vợ và phần còn lại là do cả hai vợ chồng (sự tương thích về môi trường thụ thai). Do đó, việc đi khám, chữa hiếm muộn nhất thiết phải có mặt của cả hai vợ chồng. Nói một cách chính xác thì hiếm muộn là vấn đề của một cặp vợ chồng, chứ không phải là từ một phía vợ hay chồng.

Hiếm muộn thường gặp ở nam giới bao gồm một số nguyên nhân sau: tinh trùng quá ít, mức độ di chuyển của tinh trùng yếu, tinh trùng bị dị dạng, không có tinh trùng. Các vấn đề này có thể được chuẩn đoán khi có các xét nghiệm về tinh dịch (thường gọi là phân tích tinh dịch hay tinh dịch đồ). Ngoài ra, nam giới có thể hiếm muộn do xuất tinh sớm hay xuất tinh ngược dòng (tinh dịch không phóng ra ngoài được, mà chảy ngược vào bàng quang và sau đó ra ngoài khi đi tiểu) hoặc bị bất lực .

Tinh trùng ít cũng là một trong những nguyên nhân gây vô sinh

Hiếm muộn thường gặp ở phụ nữ gồm các nguyên nhân: tắc vòi trứng, không rụng trứng, bệnh u xơ tử cung, bệnh lạc nội mạc tử cung…

Trong một vài trường hợp, khả năng sinh sản của cả hai vợ chồng đều bình thường, nhưng tinh trùng người chồng không thích hợp với môi trường chất nhầy ở cổ tử cung người vợ, dẫn đến tinh trùng bị chết và không thể đi vào đường sinh dục nữ được. Trường hợp này, được chuẩn đoán bằng xét nghiệm sau giao hợp: chất nhầy ở cổ tử cung người vợ sẽ được lấy ra vài giờ sau giao hợp để kiểm tra sự di động và khả năng sống của tinh trùng.

Hầu hết các thống kê hiện nay trên thế giới đều cho thấy tỉ lệ hiếm muộn ngày càng tăng cao.

Điều này có thể do nhiều nguyên nhân

  • Nhiều thống kê trên cho thấy chất lượng tinh trùng của nam giới đang giảm dần, có thể do ảnh hưởng môi trường và hoàn cảnh sinh sống.
  • Phụ nữ lập gia đình muộn và muốn có con ở tuổi lớn hơn.
  • Các bệnh lây truyền qua đường tình dục xuất hiện ngày càng nhiều, dẫn đến giảm chất lượng tinh trùng, tắc vòi trứng, rối loạn khả năng sinh sản.
  • Sinh hoạt tình dục sớm; quan hệ với nhiều bạn tình ngày càng phổ biến và càng làm tăng nguy cơ mắc các bệnh lây nhiễm qua đường tình dục dẫn đến hiếm muộn.
  • Hiện nay ở nước ta tỷ lệ nạo phá thai ở phụ nữ khá cao. Nạo phá thai là biến chứng nặng nề và là nguyên nhân chính gây ra hiếm muộn, vô sinh. Nhiều phụ nữ sau vài lần nạo thai bị vô sinh do tắc vòi trứng hoặc viêm dính buồng tử cung. Vì vậy, nếu chưa muốn có con, tốt nhất bạn nên sử dụng các biện pháp tránh thai an toàn để phòng tránh khả năng biến chứng vô sinh sau nạo thai.

Khám và điều trị vô sinh, hiếm muộn

Bạn nên đi đến bác sĩ để tìm nguyên nhân không có thai nếu sau 12 tháng giao hợp đều đặn. Tuy nhiên, bạn nên khám bác sĩ sớm hơn. Trong vòng 6 tháng, nên đi khám đối với một số trường hợp sau:

Nếu bạn nghi ngờ vợ chồng bạn có một bệnh lý,  nguyên nhân gây hiếm muộn:   kinh nguyệt không đều, không có kinh, bị viêm phần phụ trước đó,v.v…

Người vợ trên 35 tuổi. Có 2 lý do bạn nên đi khám sớm: khả năng sinh sản sẽ giảm theo tuổi; quĩ thời gian để điều trị không còn nhiều. (Càng để lâu càng thêm tuổi)

Như đã nêu ở trên, hiếm muộn là vấn đề của một cặp vợ chồng, nguyên nhân có thể do vợ hoặc chồng hoặc cả hai. Vì vậy, khi đi khám thì cả hai vợ chồng nên đi cùng để bác sĩ dễ dàng chuẩn đoán và điều trị. Khi đến phòng khám, nói chung các vấn đề bạn cần phải trả lời bác sĩ có thể như sau:

Về phía vợ

Tuổi, số lần sanh, sẩy, muốn có con bao lâu, nạo thai, các cách ngừa thai trước đó, kinh nguyệt đều hay không đều, kinh nguyệt kéo dài bao lâu, bao lâu có kinh một lần, có bị đau khi hành kinh hay không, có mổ hay mắc bệnh gì trước đây không… Bạn có thể sẽ phải đi siêu âm và làm thêm một số xét nghiệm như: HSG (chụp X quang để đánh giá tử cung và vòi trứng), xét nghiệm nội tiết.

Về phía chồng

Bạn có thể sẽ phải làm xét nghiệm về tinh trùng (còn gọi là phân tích tinh dịch hay tinh dịch đồ ). Để có được mẫu thử chính xác thì bạn nên tuân theo hướng dẫn của nhân viên phòng khám. Ngoài ra, bác sĩ có thể hỏi về sức khỏe của bạn hiện tại, nghề nghiệp bạn đang làm, bạn có hút thuốc lá, uống rượu hay không, có bị bệnh quai bị lúc nhỏ hay không, bạn có thường thức khuya hay không, bạn hiện có sử dụng thuốc để điều trị bệnh nào khác không, trước đây bạn có mắc bệnh gì đường tiểu hay không…


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