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The Care of Couples Requires a Multidisciplinary Approach
**You are responsible for the "fertility" sector. Is infertility affecting more and more couples?**
First of all, I would like to clarify the official definition of infertility.
It corresponds to the absence of pregnancy after more than 12 months of regular sexual intercourse without the use of contraception.
Next, it is important to distinguish infertility from sterility. Sterility refers to the total inability of a couple to conceive a child. In the case of infertility, it refers to difficulties in conception.
Globally, one in five couples seeks consultation for infertility problems.
What is the trend in this context?
Over the past thirty years, we have seen a marked increase in cases of infertility.
At the same time, understanding and knowledge about infertility have evolved significantly. There is growing awareness of the extent of the infertility problem, as well as its emotional and psychological impact on affected couples.
Medical advances, such as medically assisted reproduction (MAR) techniques, have allowed us to treat certain types of infertility and have provided new options for couples wishing to conceive a child.
Scientific research continues to better understand the causes of infertility, to identify new treatment strategies, and to improve the success rates of MAR techniques.
What is the main cause of infertility?
Within the couple, the causes can be attributed to both men and women, and also to both simultaneously.
The primary cause is related to age. The age of the woman is a crucial factor. Today, many women first focus on their professional life, their career, and postpone their desire for a child until later.
In 2023, in Luxembourg, as in many countries in Europe, the average age for a first pregnancy is around 30 years.
The older a woman is, the fewer oocytes she has in reserve, and the greater the risk that their maturation will be disrupted.
But the age of the man (often overlooked) is also important, and if both partners are older, the risks are even higher, as there is no compensatory mechanism!
What about sperm quality?
In men, sperm concentration and quality decrease with age.
The genetic material in the sperm (the chromosomes) can be altered with age, increasing the risk of miscarriages.
The causes of this decline are the subject of much research. Results point to individual lifestyle factors (smoking, sedentary lifestyle, diet) as well as environmental causes related to pollution (air, water) and the pervasive presence of certain synthetic substances in the environment and food chain: endocrine disruptors.
The tests that provide indications on this topic are the spermogram and the sperm survival test (TMS).
Sperm quality plays an important role but is not solely responsible!
What are the first steps for couples?
The MAR journey begins with an initial consultation with a gynecologist.
The purpose of this consultation is to ensure that all the necessary conditions for natural fertilization are met, to detect risk factors and pathologies that could impact fertility and a future pregnancy.
Following this initial step, biological analyses are prescribed and carried out in the laboratory.
More specifically, for the woman, a hormonal assessment will help evaluate the ovarian reserve and rule out a hormonal cause of ovulation disorders.
For the man, the main examination is the spermogram to evaluate the quantity and quality of sperm.
The results of this assessment allow the doctor to define an initial treatment. For the man, in case of abnormalities, a consultation with a urologist will be recommended to perform a clinical assessment and additional tests.
Do you work closely with doctors?
The medical approach is multidisciplinary; gynecologists, urologists, reproductive biologists, as well as psychologists, nutritionists, and smoking cessation specialists all play a role in the care of couples engaged in a MAR journey.
We exchange information regularly.
What is the timeline for taking care of couples at the BIONEXT laboratory?
Our patients are our priority, which is why we offer very rapid appointments for biological analyses.
At BIONEXT, couples are taken care of within 1 to 2 weeks after their initial contact.
How do you support your patients?
The MAR journey is often complicated for patients to understand, and our role is to guide them with clear instructions and understandable explanations. We are there to support, reassure them with kindness and professionalism, to reduce their stress.
We focus on concise and accessible information. Quick information and care are crucial.
We offer a complete and quality biological diagnosis. We are also accredited according to the ISO 15189 standard for all fertility tests as well as for the preparation of sperm for insemination.
And the feedback...
... is very positive. It is very clear that couples need assistance, kindness, and information.
Interview with Dr. Thibault Ferrandon, Medical Biologist, BIONEXT