Souza Maria do Carmo Borges de, Silva Layna Almeida Barbosa da, Sequeira Flavia Fernandes, Azevedo Antunes Roberto de, Souza Marcelo Marinho de
Centro de Reproducao Humana, Fertipraxis, Rio de Janeiro, Brazil.
UFRJ - Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Women Health. 2023 Mar;63(3):194-203. doi: 10.1080/03630242.2023.2165599. Epub 2023 Jan 25.
To conduct this review of primary care, we looked for related papers in PubMed from the last 15 years. WHO's initial concept of Health defined a condition of physical, mental, and social well-being, nowadays extended to quality of life. Infertility or not being able to form a family fits perfectly into the definition. Primary care is responsible for mandatory discussions about fertility as part of a broader aspect regarding reproductive health issues. Having children is a decision taken by heterosexual couples, same sex couples, or single individuals. Understanding factors associated with infertility help guiding propedeutic. Although woman's age is one of the main factors to influence treatment success rates, multifactorial male factor may contribute to 50 percent. Infertility consultations should include partners, alleviating the accompanying stress and anxiety. Anamnesis must focus on duration of infertility, primary or secondary, sexual activity, and lifestyle habits such as smoking, alcohol consumption, diet, physical activity, use of licit and/or illicit drugs, and occupational risks. Previous treatments should be accessed. Management of infertility by primary care is mandatory, and patients requiring specialized treatments must not have their journey protracted. Strategies and couple-based interventions are essential to continuity of care and close follow-up should follow these patients.
为了进行本次初级保健综述，我们在PubMed上搜索了过去15年的相关论文。世界卫生组织最初的健康概念定义了一种身体、心理和社会福祉的状态，如今已扩展到生活质量。不孕不育或无法组建家庭完全符合这一定义。初级保健负责将生育问题作为生殖健康问题更广泛方面的一部分进行强制性讨论。生育子女是异性恋夫妇、同性伴侣或单身人士做出的决定。了解与不孕不育相关的因素有助于指导治疗。虽然女性年龄是影响治疗成功率的主要因素之一，但多因素男性因素可能占50%。不孕不育咨询应包括伴侣，以减轻随之而来的压力和焦虑。问诊必须关注不孕不育的持续时间、原发性或继发性、性活动以及生活方式习惯，如吸烟、饮酒、饮食、体育活动、合法和/或非法药物的使用以及职业风险。应了解既往治疗情况。初级保健对不孕不育的管理是强制性的，需要专科治疗的患者不应延误其治疗进程。策略和基于夫妻的干预措施对于持续护理至关重要，应对这些患者进行密切随访。
