Infertility refers to a couple of childbearing age who has a normal sexual life and does not use contraception, but never gets pregnant within a certain period of time. The so-called certain period is not consistent in various countries. Our country uses one or two years as the standard, which is consistent with the regulations of the World Health Organization.
To achieve pregnancy, the following elements must be present:
① A normally developed egg meets a normal sperm to form a fertilized egg.
②There is a healthy and functional channel-the fallopian tube.
③The fertilized eggs can be safely implanted in the uterine cavity and develop and grow. If any one of these three links is missing, or there is a problem in any one place, it may cause infertility.
There are male factors and female factors. Infertility caused by male factors accounts for 40%, mainly due to sperm abnormalities or low sperm count. In addition to male causes such as sperm abnormalities, sexual dysfunction and vas deferens obstruction, the main female causes are:
(1) Ovulation disorder:Normal ovulation requires a fully functional hypothalamus-pituitary-ovary axis. Functional and organic changes in these parts can affect ovulation. Infertility caused by anovulation accounts for 29.1% of women. ①Ovary. Congenital ovarian hypoplasia or absence, ovarian tumors require surgical resection or radiation destroys ovarian tissue. ② Pituitary tumors, Sheehan syndrome, primary hypopituitarism. ③Hypothalamus. Polycystic ovary syndrome, amenorrhea lactation syndrome, excessive mental stress, fatigue, changes in living environment and chronic wasting diseases, etc.
(2) Affects the combination of sperm and egg: ① Fallopian tube. The important role of the fallopian tube in reproduction is to provide a place for fertilization, so the fallopian tube must be unobstructed and functional, and must be of a certain length. Infertility can result when the structure and function of the fallopian tubes are damaged. Infertility caused by fallopian tube factors accounts for 30% to 50% of women. Infertility caused by fallopian tube factors is mostly caused by infection. The causes of infection include aerobic bacteria, anaerobic bacteria, Mycobacterium tuberculosis, Gonorrhoeae, Mycoplasma and Chlamydia. Acute salpingitis is more common in childbirth, miscarriage, and uterine cavity surgical infection. Such as acute inflammation treatmentIf the treatment is not complete, it can evolve into chronic inflammation, forming hydrosalpinx or nodular isthmic salpingitis, which can lead to fallopian tube obstruction. Tuberculosis infection is one of the main causes of fallopian tube disease. Most fallopian tube tuberculosis is infected by the spread of pulmonary tuberculosis through the blood circulation. A few are infected by intestinal tuberculosis and peritoneal tuberculosis that spread directly through lymphatic vessels. Fallopian tube tuberculosis infection can lead to adhesions and atresia at the fimbriae of the fallopian tube, and the lumen of the fallopian tube is filled with caseous necrosis, mucosal destruction, and fibrous tissue hyperplasia, resulting in occlusion of the fallopian tube lumen and loss of function. Congenital defects of the fallopian tubes are rare and are often accompanied by abnormal uterine development. Fallopian tube defects include segmental atresia, hypoplasia, and absence of accessory fallopian tubes and fallopian tubes. ② Pelvic adhesions after surgery. Any pelvic surgery may cause trauma to the peritoneum, causing inflammatory exudation and fibrin deposition, and then fibrosis and scar contraction may push and stretch the fallopian tube, leading to fallopian tube dysfunction. ③Pelvic endometriosis. It can cause extensive adhesion in the pelvic cavity, blockage of the fallopian tubes or weakened peristalsis, affecting egg retrieval or the movement of fertilized eggs. ④ Pelvic tumors. Pelvic tumors can compress the fallopian tubes, causing them to deform, block the lumen, or affect fallopian tube function, leading to infertility. ⑤ Reproductive tract inflammation. Inflammation of the vaginal cervix changes the vaginal environment, which is not conducive to the survival and upward movement of sperm, such as trichomonas, fungal vaginitis and severe cervical erosion. ⑥ Developmental malformation of the reproductive tract. A complete vaginal diaphragm prevents sperm from reaching the fallopian tube and meeting the egg.
(3) Influence on fertilized egg implantation:①Endocrine disorders. Insufficient corpus luteum function causes the development of the endometrium and the fertilized egg to be out of sync, affecting the implantation and development of the fertilized egg. ②Uterine factors. Uterine dysplasia, uterine malformations, submucosal uterine fibroids, endometrial tuberculosis, etc. affect the implantation of a fertilized egg.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao