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Insurance

Infertility: What coverage by Social Security and mutual insurance?

Faced with difficulties in conceiving a child, a couple’s fertility can be questioned. Whether it is the man, the woman, or both partners, it is essential to carry out the necessary examinations with a specialist who will offer appropriate care.

What is infertility?

Health insurance establishes that a fertile couple aged 25 has a monthly probability of naturally obtaining a pregnancy of 25%. Thus, it is common for several months to be needed to achieve pregnancy spontaneously. For 10% of couples, this period can sometimes reach 18 months. Encountering difficulties during the conception of a child is therefore not always synonymous with infertility.

We speak of infertility when a couple cannot conceive a child after 12 to 24 months of regular sexual intercourse (2 or 3 times a week) at reasonable times and when no means of contraception is used.

What is the difference between sterility and infertility?

Note: infertility and sterility, although often used to mean the same thing, do not have the same meaning:

  • We speak of sterility when an individual or a couple cannot conceive a child naturally.
  • We speak of infertility when a person is unable to conceive and father a child after 12 to 24 months of regular intercourse.

Fertility declines with age

The decline in fertility with age mainly affects women. For a 25-year-old woman, the risk of not being able to conceive is around 5%. It is 10% for a woman aged 30, 20% for 35, and 50% for 40. Although it is associated with a decrease in fertility, the age of the man is less impactful and does not have a precise threshold.

Primary infertility or secondary infertility?

Primary infertility concerns couples who have never conceived a child. Secondary infertility is mentioned when a woman who has already devised a child finds herself unable to create again.

What is male infertility?

Male infertility factors are still little known to the scientific world. Specialists implicate two main mechanisms:

  • Oligospermia is one of the most common causes of infertility in men. It corresponds to a decrease in the number and mobility of spermatozoa, the cause of which may be age, tobacco, heat, the environment, or specific physical abnormalities;
  • Azoospermia corresponds to the absence of spermatozoa in the semen, which may be due to the lack of production or an anomaly in the evacuation of spermatozoa.

What is female infertility?

Better known than men, the causes of female infertility are also more numerous. However, the possible treatments are more accessible than those for male infertility. Two leading causes have been identified:

  • Ovulation disorders, whether it is an absence of ovulation or poor quality ovulation (20% of infertility cases in the couple). The origins of these disorders are multiple: early menopause, hormonal imbalance, chromosomal abnormality, polycystic ovaries, sequelae of chemotherapy, etc.
  • Obstructive and mechanical causes can take the force of an obstruction (total or partial) of the fallopian tubes following a sexually transmitted infection, congenital malformations, uterine polyps, uterine fibroid, endometriosis, or sequelae due to surgery.

It is strongly advised to submit a request for reimbursement to Social Security before carrying out the most expensive examinations or treatments to ensure that you benefit from 100% reimbursement of these expenses.

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