Fertility is the eternal theme of human life and an important factor in the happiness and harmony of women’s lives and families. Surveys have shown that the divorce rate of infertile couples is 2.2 times higher than that of the normal population, and in the late 1990s, WHO reported that the incidence of infertility worldwide had reached 10-20%. Therefore, it has become an important medical and social problem. With the accelerated pace of life, increased work pressure, environmental degradation, changes in diet, and changes in people’s fertility concepts, the resulting problems such as decreased fertility have become more prominent.
Fertility disorders refer to endocrine abnormalities or (and) reproductive anatomical abnormalities in both men and women, resulting in difficulties in sperm-egg union, embryo quality, implantation and further development, thus affecting the normal reproductive function of women, including infertility, habitual miscarriage and other related diseases. Repeated miscarriages not only affect women’s fertility, but also greatly destroy women’s physical health. Patients with PCOS have high levels of luteinizing hormone, hyperandrogenism and hyperinsulinemia, which reduce egg quality and endometrial tolerance, resulting in 58% of recurrent miscarriages. In addition, hyperprolactinemia and thyroid disorders can also lead to recurrent miscarriages.
1. Ancient doctors’ understanding of factors related to fertility disorders
Ancient Chinese physicians recognized the close relationship between menstrual disorders and infertility very early. Zhu Danxi proposed: “Women who are childless are mostly caused by the inability to take in semen due to the low blood and the irregularity of menstrual water, which prevents them from becoming pregnant”. In the Ming Dynasty, Zhang Jinyue clarified the relationship between menstruation and fertility and proposed the theory that “the regulation of menstruation is the heir of a child”. Menstrual disorders include early menstruation, late menstruation, irregular menstruation, low menstrual flow, dysmenorrhea, amenorrhea, and menorrhagia. From the point of view of modern medicine, most of the disorders of irregular menstruation are related to ovarian ovulation dysfunction. Zhu Danxi of the Yuan Dynasty and Wan Quan of the Ming Dynasty both proposed that genital malformations lead to inability to have children.
2. Modern medical research on factors related to reproductive disorders
In 1956, Tietze estimated the prevalence of infertility among women aged 20-40 years in the United States to be 15% by demographic estimation, and from the late 1970s to the early 1980s, scholars from various countries began to pay attention to the problem of infertility and carried out research on the incidence and etiology of infertility one after another. 2001, Prosser [2] in the United States attributed the etiology of infertility to three aspects: biological factors, environmental factors, and social factors. environmental factors, and social factors.
(1) Biological factors: mainly refers to female organic lesions, endocrine factors, immune factors and psychological factors. The lack of premarital sex and sexual precautions leading to multiple abortions or medical abortions, and the fear of letting people know after the operation and not being able to perform according to post-operative medical advice, often result in inflammation of the uterine cavity and adnexa, adhesions leading to tubal incompetence, incompetence and water retention, resulting in the development of tubal obstruction and causing secondary infertility.
It can be seen that although abortion is a clinically common means of terminating an unwanted pregnancy, which is relatively safe and easy, the procedure can have a great adverse effect on the female organism and physiological functions, especially its long-term complications can have a negative impact on female fertility and can even lead to the occurrence of infertility. Therefore, it is necessary to mobilize the whole society to strengthen education on adolescent health and sexual knowledge, prevent and reduce unmarried cohabitation and unmarried pregnancy in order to protect women’s reproductive health; strictly grasp the indications and contraindications for abortion, keep the quality of surgery, strict aseptic concept, and do a good job of post-operative contraceptive guidance and health education, so as to reduce secondary infertility caused by abortion; at the same time, popularize the knowledge of birth control and contraception. Medical personnel should take the initiative to promote contraceptive knowledge during premarital checkups, and family planning departments should also do too much work to implement contraceptive measures to every woman of childbearing age, so as to minimize the termination of unwanted pregnancy by abortion.
Polycystic ovary syndrome (PCOS) is the most common disease of ovulation disorder, mainly manifested clinically as abnormal menstruation and ovulation, hirsutism, obesity, infertility combined with ovarian enlargement in the form of polycystic changes, while causing endocrine abnormalities, the clinical abortion rate is high.
In addition to dysmenorrhea, endometriosis (EMT) can also lead to infertility and recurrent miscarriages in women.
First, causing local anatomical changes in the pelvis, affecting the function of the fallopian tubes.
Second, it affects the patient’s neuroendocrine. Disrupting the ovarian structure, leading to ovulation disorders.
Third, activating the immune system in the patient’s body, producing anti-sperm antibodies and anti-endometrial antibodies, which can interfere with and hinder fertilized egg union, implantation and blastocyst development, thus leading to the occurrence of infertility or miscarriage.
Fourth, it decreases the endometrial tolerance, which reduces the conception rate and increases the miscarriage rate.
(2) Environmental factors: can also silently affect human fertility. The main effects on female fertility are menstrual irregularities and ovulation disorders, amenorrhea, scanty menstruation and even premature ovarian failure. Environmental effects not only lead to infertility, but can also lead to congenital malformations of the fetus, miscarriage, premature birth, stillbirth and other diseases. Research data show that the highest age of fertility for men and women to marry is 24-25 years old, and gradually declines thereafter, especially for women to 30 years old and then declines sharply. Foreign studies have shown that infertility occurs in about 10-30% of cases after abortion. A history of oral contraceptive pills in the female party within two years of stopping the use of contraceptives still not pregnant up to 15% of the unborn women, menstruating women for 7%.
(3) Social factors: the influence of the can not be ignored. With the development of society, the change of ideology also has a greater impact on fertility. After China’s reform and opening-up policy, many women postpone the age of marriage and childbearing, the age of infertility patients has a rising trend, and the incidence of infertility also has a rising trend, and many women come to the clinic only when they are over 35 years old. As fertility decreases with age, the incidence of hereditary diseases also increases with age.
Countermeasures
The reproductive health of humans themselves is a worldwide concern. Taking relevant measures to reduce the incidence of infertility requires the concerted efforts of society and health care professionals.
First of all, reduce the pollution to the environment, starting with me. Try to save energy and reduce pollution to the environment. Eat less junk food and do not use toxic and harmful cosmetics.
Secondly, we will conduct lectures on relevant health information at junior high school level and university level, and actively promote knowledge related to female menstruation and fertility, so as to strive for early medical consultation, early detection of diseases and early treatment of patients.
At the same time, we promote the hazards of premarital sex and abortion before childbirth, and reduce the incidence of premarital abortion.
Finally, we should plan our life arrangements reasonably, marry later and have children later as appropriate, and strive to complete the reproductive tasks in life at the prime reproductive age.