Infertility caused by cervical abnormalities is generally not taken seriously by people. According to statistics, this type of patients accounts for about 20% of infertility factors. The cervix is the first barrier for sperm to pass through, and any changes in its anatomy and physiology can affect the passage of sperm.
(1) Cervical atresia or stenosis: Congenital cervical atresia or stenosis is mostly caused by incomplete formation and fusion of the lower segments of the bilateral Mullerian ducts. It is rare clinically and is often accompanied by uterine hypoplasia, and most secondary sexual characteristics develop normally. For example, when a patient\’s endometrium has good endometrium function, periodic lower abdominal pain may occur due to intrauterine hemorrhage, or menorrhagia may be accompanied by dysmenorrhea. Menstrual blood may also flow backward into the abdominal cavity through the fallopian tube, causing pelvic endometriosis. Acquired cervical atresia and stenosis are more common after artificial abortion or after electrocautery and cryotherapy for cervicitis. The main reason is that the cervix is not sufficiently dilated during suction, or the suction tube is taken out with negative pressure, causing damage to the endocervix and adhesion and atresia of the wound. Cervicitis treatment: Electrocautery or excessive freezing can cause cervical canal adhesion or stenosis. The clinical manifestations are amenorrhea accompanied by periodic lower abdominal pain after artificial abortion or cervicitis treatment. The gynecological examination revealed that the vagina was purple-blue, the cervix was painful, the uterus was slightly full, and there was tenderness during movement.
(2) Cervical dysplasia may be accompanied by uterine dysplasia: Cervices with severe dysplasia are elongated. The ratio of moderately dysplastic cervical length to uterine body is 1:1, which is the so-called \”teenage uterus\”. Cervical dysplasia can lead to insufficient secretion of cervical glands.
(3) Abnormal position of the cervical canal is often accompanied by abnormal position of the uterine body: Chronic pelvic inflammatory disease or endometriosis can cause extreme retroversion and retroflexion of the uterus Or bending forward makes the external cervical opening touch the forward fornix, causing the posterior fornix to become shallower and lose the role of the sperm storage pool, which is not conducive to the upward movement of sperm. In addition, a long, short cervix or cervical prolapse may also change the normal positional relationship between the external cervical os and the posterior fornix, hindering the upward movement of sperm.
(4) Cervical fibroids: The main cause of infertility caused by cervical fibroids is the deformation and narrowing of the cervical canal, which affects the passage of sperm. The main clinical manifestations are irregular menstruation, increased menstrual blood volume, increased leucorrhea or bladder and rectal symptoms. Some patients are asymptomatic. Gynecological examination may reveal that there are protruding fibroid nodules on the cervix or the appearance of the cervix has changed. The cervix on one side where the fibroids are located is enlarged, while the opposite side is compressed and thinned, and the external cervical opening is stretched and flattened into a twist shape.
(5)Chronic cervicitis:It is a common gynecological disease that generally does not affect pregnancy. Normal cervical mucus protects sperm, supplies energy, and is where sperm is stored. The main clinical symptom is increased leucorrhea. Due to the different scope and degree of pathogenic bacteria and inflammation, the amount, nature, color and smell of leucorrhea are also different. It can be milky white mucus, sometimes light yellow purulent, and when accompanied by polyps, it is easy to have bloody leucorrhea or bleeding during sexual intercourse. When the inflammation spreads to the pelvis through the uterosacral ligaments, there may be pain in the waist and sacral region, pelvic pain and dysmenorrhea, etc., which are often aggravated during menstruation, defecation or sexual intercourse. During the examination, it can be seen that the cervix has varying degrees of erosion, hypertrophy, and sometimes hardening, and lesions such as polyps, lacerations, ectropion, and glandular cysts can be seen.
(6) Abnormal cervical mucus: The glucose and other nutrients contained in cervical mucus have a great impact on the survival and motility of sperm when crossing the cervix. Because the sperm itself only stores a small amount of glycogen, it must rely on extracellular nutrients to meet its own energy needs when it stays and travels through the female reproductive tract. Ovarian hormones regulate the secretion of cervical mucus. The physical properties and certain chemical compositions of cervical mucus change periodically to facilitate sperm penetration, nutrition and survival.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao