Infertility is the result of many etiological factors, it has its own unique characteristics in etiology, diagnosis and treatment. Infertility is related to many factors such as life, work, environment, society and psychology, and it can affect the patient’s psychology, marriage and family, etc. Therefore, it is especially important to give the correct knowledge of reproductive health to patients.
I. Factors affecting fertility in couples
In more than 50% of infertile couples, men have reproductive function defects. Almost 1 in 4 infertile couples are found to have factors in both partners; therefore, in 50% of male infertility, there may be factors in women as well. Infertile couples should consult with a doctor at the same time.
Fertility in women decreases with age. A woman’s fertility at age 35 is only about 50% of what it was at age 25, drops to 25% at age 38, and may drop further to less than 5% beyond age 40. In assisted reproduction, a woman’s age is the most significant factor affecting success rates.
Nearly 85% of couples can conceive naturally within 12 months. Infertility evaluation should be initiated only after 12 menstrual cycles or one year of unprotected sex or in women 35 years of age and older who have not conceived after 6 menstrual cycles or 6 months of unprotected sex. It is not necessary to postpone infertility testing beyond 12 months when there are family reasons or when either partner is suspected of infertility. Between couples, the more fertile partner can also compensate for the less fertile partner.
The duration of natural infertility is important in predicting its future fertility. Those infertile couples with a history of infertility close to 3 years or less have a better chance of conceiving naturally. If the duration of natural infertility is longer, the more serious the problem exists. In some cases, the natural conception rate can be incorrectly interpreted as a treatment effect. The natural conception rate should be considered in the assessment of the success of all treatments.
The timing of sex, frequency, and the presence of sexual dysfunction will affect conception, and the timing of intercourse should be chosen around the time of ovulation.
II. Factors of living environment and drugs affecting fertility
1.Life environment factors affecting fertility
There are some factors in the living and working environment that affect fertility, such as: prolonged exposure to heavy metals (such as lead, cadmium, mercury, aluminum, copper, manganese, etc.), chemical substances (such as pesticides, herbicides, carbon disulfide, dibromochloropropane, methyl ethyl ketone, formaldehyde, automobile exhaust, benzene paint, cigarette smoke, toxic decorative materials and paints, household gas, etc.), others (such as graphite, radiation, work in high-temperature environments) Can reduce fertility. Some scholars believe that exposure to substances that affect hormone production such as estrogen-like hormones, PCBs, bisphenol A, alkyl phenols, phthalates, or androgen antagonists can cause malformations in the reproductive tract, reduce sperm counts, and affect sperm production. See the section on “Environmental factors and male infertility”.
Lifestyle habits can also have an impact on fertility, such as. Smoking, alcohol, sauna bathing, etc.; long-term consumption of crude cottonseed oil can lead to infertility; sperm production can also be affected in sedentary men;. The effect of microwaves in life on male fertility has not been confirmed.
2.Drug factors affecting fertility
Commonly used drugs: If you have used these drugs, you should consider whether you can stop them or look for alternative drugs that do not affect sexual function and semen quality. Those who need long-term medication and have no alternatives as well as radiotherapy patients can consider freezing and preserving semen before treatment. Oncologic chemotherapy drugs, anserine, salbutamol, colchicine, allopurinol, tetracycline, erythromycin, cimetidine, calcium antagonists, minoxidine, hormonal therapy, furotoxin, nilidazole.
Third, the education points of semen examination
1. The real value of semen analysis is only to facilitate the classification of patients coming to the clinic into three categories: low fertility, uncertain fertility and good fertility; it can only indicate the degree of fertility possibility.
2. The length of abstinence will affect the parameters of semen analysis. Therefore, semen should be taken during 48 hours to 7 days of abstinence, no condom, lubricant or saliva should be used during semen extraction, and semen specimens should not be contaminated by urine, water, soap, etc.
3, If part of the ejaculated semen is lost, the specimen cannot reflect the true condition of the patient’s semen.
4. The semen sample should preferably be obtained in a separate room near the laboratory, otherwise it should be delivered to the laboratory as soon as possible (within 1 hour after the semen is taken). The semen sample should be well insulated during transportation.
5.If you want to do semen microbiological examination, you should urinate and wash your penis and hands beforehand, especially if you are circumcised, you should flip your foreskin for cleaning. Those with adherent foreskin or prepuce must deal with these problems first before masturbating for semen collection.
Fourth, infertility treatment situation education points
Generally speaking, a course of treatment to improve semen quality takes three months. Assisted reproductive technology may have an impact on the health of the newborn, and prevention of multiple pregnancies is the most effective preventive measure to reduce the occurrence of neonatal diseases.