bilde1De fleste friske og fruktbare par som ønsker seg barn bruker mellom 4-10 måneder på å bli gravide. Sjansen for å bli gravid er bare 20% i hver syklus.

Man kaller det nedsatt befruktningsevne, i motsetning til sterilitet som betyr manglende befruktningsevne.

Hvorfor blir ikke jeg gravid?

For at en kvinne skal bli gravid, må en hel serie hendelser skje i rett tid:

  • En frisk eggcelle må modnes og frigjøres fra eggstokken
  • Mannen må produsere friske sædceller
  • Eggcellen må kunne passere fra kvinnens eggstokk og gjennom egglederen
  • Paret må ha sex rundt tidspunktet der egget frigjøres
  • Sædcellene må kunne svømme opp i skjeden og livmoren, og videre inn i egglederen mot egget
  • Egget må befruktes av mannens sædceller
  • Det befruktede egget må kunne feste seg i kvinnens livmorvegg

Årsaken til at en graviditet ikke oppnås kan ligge hos kvinnen, mannen eller hos begge to. Etter medisinske undersøkelser er årsaken til infertilitet fremdeles uforklarlig hos bare 5 til 10% av parene.

Generelt sett ligger årsaken for infertilitet:

    • Utelukkende hos kvinnen i ca. 1/3 av tilfellene
    • Utelukkende hos mannen i ca. 1/3 av tilfellene
    • En kombinasjon av at begge partnere har påviselige abnormaliteter i ca. 1/3 av tilfellene.

Hos Kvinner fordeler det seg slik:
Uten navn

Eggløsnings-/hormonsforstyrrelser kan være manglende eller uregelmessig eggløsning, polycystisk ovariesyndrom (PCOS) eller problemer med at et befruktet egg ikke fester seg (implantasjonsproblemer).

Blokkerte eggledere og endometriose (livmorslimhinne utenfor livmoren) er de vanligste anatomiske forstyrrelsene. Andre anatomiske forstyrrelser kan være relatert til infeksjoner, kjønnssykdommer eller
svulster (godartet/ondartet).

Alderens betydning

En av årsakene til at flere kvinner i dag har problemer med å bli gravide, er at de er eldre når de prøver å få barn. Fra naturens side er det lettest for kvinner å bli gravide når de er i begynnelsen av 20-årene. Fruktbarheten synker med alderen, og etter 35-årsalderen har mange kvinner vanskeligheter med å bli gravide.
Aldersrelaterte infertilitetsfaktorer er bl.a.:

        • Færre antall sunne egg (eggdannelsen skjer i fosterstadiet, og kvinnen fødes med alle eggene hun noensinne vil ha – omkring 400.000)
        • Økt risiko for spontanabort (særlig over 40 år)
        • Økt risiko for sykdommer som kan påvirke forplantningssystemet (f.eks. endometriose, bekkenbetennelser)
        • Økt risiko for ektopisk graviditet (utenfor livmoren), særlig over 40 år

Hva med mannen?

Hos mannen er årsaken til nedsatt befruktningsevne som oftest ett eller flere av disse problemene:

            • Manglende evne til å produsere nok friske sædceller
            • Sædceller med unormal form som ikke beveger seg normalt eller klarer å befrukte et egg
            • Sædceller med nedsatt svømmeevne

Den nedsatte sædkvaliteten kan skyldes tette sædledere, immunologiske faktorer (antistoffer mot egne spermier), hormonelle forstyrrelser og miljøfaktorer som røyking, stort alkoholforbruk og at testiklene utsettes for varme (f.eks. varme bad eller badstue).

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