The inability to maintain pregnancy to term delivery is also an aspect of infertility. More than 80% of women with a history of habitual abortion eventually have their own children. Therefore,there is no need to worry about infertility even if you have a history of miscarriage. According to statistics, 10% to 15% of pregnancies end in spontaneous abortion within 3 months of pregnancy. About 20% of pregnancies that are successfully implanted will miscarry, and 50% to 60% of fertilized eggs cannot be implanted and cannot develop into a detectable pregnancy. Strictly speaking, it is a wrong concept to call miscarriage infertility. After all, it is not the inability to conceive, but the inability to maintain the pregnancy. There are many causes of spontaneous abortion. Early clinical miscarriage is very common. As long as the number of miscarriages does not exceed 3 times, doctors will pay special attention to these patients. In addition, many early pregnancy miscarriages occur without even the pregnant women noticing it. It was not until the mid-1960s that three consecutive miscarriages were defined as habitual miscarriage, and the possibility of another miscarriage was considered to be 80% to 90%. However, research shows that despite a history of multiple miscarriages, the risk of another miscarriage is only 20% to 30%. However, the miscarriage rate is higher among the following women, so sufficient attention should be paid to it. ① Aged over 35 years old; ② Have a history of stillbirth, stillbirth or neonatal death.
The causes of miscarriage are:① Chromosomal abnormalities in the embryo; ② Maternal chronic diseases, such as diabetes, thyroid dysfunction, heart disease, kidney disease and immune system diseases, such as systemic lupus erythematosus etc.; ③ maternal infectious diseases; ④ uterine and cervical diseases; ⑤ luteal corpus luteum dysfunction and endocrine disorders; ⑥ exposure to harmful substances in the living and working environment; ⑦ immune factors.
50% to 60% of miscarriages in the first 3 months of pregnancy are caused by chromosomal abnormalities. Since they cannot survive, they are rarely found in living bodies. Because many women are unaware of their early miscarriage, the incidence of chromosomal abnormalities is actually higher than statistics indicate. If there has been a history of three miscarriages, both couples must undergo genetic counseling.
If the pregnant mother is infected with bacteria or viruses, it will lead to miscarriage or habitual abortion, and even birth defects in the newborn. There are two ways for bacteria or viruses to infect the fetus: one is mother-to-child transmission, that is, microorganisms in the blood circulation are transmitted to the fetus through the placenta. The second is an ascending infection originating from the vagina, that is, passing through the cervix into the uterus and fetal membranes. Infections may occur during conception or shortly after conception. Most cases caused by viral infectionsCongenital malformations are malformations of the central nervous system. Since early pregnancy is the period of fetal organ formation and differentiation, it is most sensitive to interference from external factors. Therefore, the earlier the infection occurs during pregnancy, the more serious the damage to the fetus will be. Infections that may cause habitual miscarriage include: ① Chlamydia and Ureaplasma urealyticum infections: They are a type of microorganisms between bacteria and viruses, and are a new infectious flora. This infection can be spread through sexual intercourse. Therefore, when the infection is difficult to control, both infected couples must be treated with tetracycline. Infections in pregnant women are treated with erythromycin instead. This infection may have no obvious clinical symptoms, but may cause recurrent miscarriage. ②Herpes virus infection: Genital herpes virus infection during early pregnancy can also cause miscarriage and is a sexually transmitted disease. ③Rubella, measles, mumps, influenza and Toxoplasma infection may cause miscarriage.
Uterine malformations, uterine fibroids and uterine polyps can cause repeated early miscarriage. But with proper surgical treatment, pregnancy can still be successful. Usually miscarriage due to the above reasons occurs in the second and third trimester of pregnancy. Adhesions can affect the implantation of fertilized eggs and miscarriage. Intrauterine adhesions caused by infection, IUD operation, and improper diagnosis and curettage can be removed by laser and microsurgery to improve pregnancy rates. Cervical disease can also cause miscarriage. Cervical insufficiency refers to the phenomenon of progressive cervical dilation before full-term pregnancy, leading to miscarriage. The cause of cervical insufficiency is unknown. However, women with cervical insufficiency often have the following medical histories: multiple miscarriages and gynecological surgeries, such as cervical electrocautery. Miscarriage caused by cervical insufficiency mostly occurs in the 4th to 6th month of pregnancy. Patients with two previous miscarriages in the 4th to 6th month of pregnancy should undergo prenatal check-ups once a week after 12 weeks of pregnancy. to see if the cervix is dilated. Once cervical dilatation is diagnosed, cervical cerclage should be performed promptly under anesthesia, so that it is possible to maintain the pregnancy to term. Although cervical cerclage is unlikely to be completely successful, it can fulfill the dream of motherhood for many women who would otherwise go into premature labor. There is currently controversy over the timing of preventive cervical cerclage: some recommend performing cerclage when pregnancy is imminent, while more doctors recommend performing preventive cerclage around 14 weeks of pregnancy, and some even Cerclage is recommended before pregnancy. No matter when the surgical treatment is performed, the stitches must be removed at the beginning of labor.
After ovulation, if the egg is not fertilized, the corpus luteum begins to shrink. Once pregnant, the corpus luteum begins to secrete high levels of hormones, which further enlarges and thickens the endometrium to better support and nourish the growth and development of the embryo. During this period, the ovaries secrete a lot of hormones, so that in the first few months of pregnancy, ovaries often enlarge and cysts form. These conditions generally return to normal around 4 months of pregnancy. In the third month of pregnancy, the placenta forms and begins to secrete estrogen and progesterone, and the function of the corpus luteum, which maintains pregnancy, is replaced by the placenta. Human chorionic gonadotropin is the main hormone that maintains pregnancy throughout pregnancy. Proper hormone levels are key to maintaining pregnancy. If it has been caused by low hormonesIf you have a history of miscarriage, progesterone suppositories, clomiphene, and low-dose human chorionic gonadotropin can help maintain pregnancy. However, the use of synthetic progestins should be avoided to avoid causing damage to the fetus. If you are taking synthetic progesterone, you must switch to other drugs before pregnancy.
Research shows that women working in operating theaters will have an increased miscarriage rate due to the influence of gas anesthetics; men and women working in paint and plastic production companies will also have an increased incidence of infertility and miscarriage. There are few reports of miscarriage among people who work in front of computer terminal screens; women who work in the metallurgical industry, electronics industry and radio and television production companies also have a higher miscarriage rate. The metallurgical industry is mainly exposed to lead, arsenic, cadmium, copper and silver; the electronics industry is exposed to acidic solvents; and radio and television production companies are exposed to welding gases. Beauty salon operators and cosmetic experts may also suffer miscarriages due to exposure to chemical substances such as hair dyes and perm solutions; some women in the textile industry may also suffer miscarriages due to the influence of synthetic toxic particles.
30% of women with recurrent miscarriage cannot be explained by genetic factors, endocrine factors, gynecological diseases or bacterial and viral infections. They may develop a special immune response to their partner\’s sperm. Women with positive antisperm antibodies have a miscarriage rate of approximately 50%. The reason is that bacterial infection stimulates the body\’s immune system to produce antibodies, mistaking sperm as \”foreigners\” and rejecting them. To solve this problem, some women receive leukocyte injection therapy, which involves injecting white blood cells from their partner\’s body into the woman\’s body every six weeks. In this way, some women can no longer reject sperm and can become pregnant successfully.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao