Do you understand infertility?

Author: Dai Wei, deputy chief physician of Reproductive Medicine Center, First Affiliated Hospital of Zhengzhou University

Reviewer: Hu Linli, Chief Physician, Reproductive Medicine Center, First Affiliated Hospital of Zhengzhou University

This is an era of rapid social development. With the improvement of education level and the pursuit of career development, more and more people choose to marry and have children later. At the same time, changes in people's lifestyles and environmental pollution have also increased the incidence of infertility. A survey by the World Health Organization shows that the prevalence of infertility varies from country to region, ranging from 5% to 30%; about 5% to 8% of couples in developed countries are affected by infertility; in 2017, a survey of seven provinces, municipalities and autonomous regions in my country found that the incidence of infertility in the community population reached 10% to 15%, and it is estimated that more than 50 million people. From 2007 to 2020, the incidence of infertility in my country has risen from 12% to 18%.

It can be seen that infertility is already a common problem, but there are still many misunderstandings surrounding it. These misunderstandings may have a negative impact on patients and hinder them from seeking effective help and treatment. Today, let's unveil the mystery of infertility and break the traditional concepts and misunderstandings that bind us.

First, let’s take a look at the normal process of pregnancy:

For a normal pregnancy process, we need: normal ovaries and ovulation; strong and sufficient sperm; unobstructed fallopian tubes; "fertile" endometrium; and a healthy uterine cavity.

Figure 1 Original copyright image, no permission to reprint

Secondly, what is "infertility"?

Infertility is defined as a condition in which a woman has normal sex life and has not gotten pregnant after living together for 12 months without taking any contraceptive measures. In general, women only ovulate one egg in one menstrual cycle, and the highest probability of pregnancy is often the very short few days around the ovulation period. Therefore, many couples who have tried to conceive for 3 or 4 months without any results, or couples who have been living apart for a long time and have tried to conceive for a long time but have rarely seen each other, may mistakenly think that they are "infertile" and come to the hospital for examination. However, the real reason is that the sperm and the egg have not met each other many times, which has caused temporary "infertility".

Then, who are the high-risk groups for infertility?

Abnormalities in either or both spouses can lead to infertility. Relatively speaking, female factors account for a larger proportion of infertility. The main causes of infertility are ovarian factors and fallopian tube factors, and others include uterine factors, etc. Male factors are mainly reflected in problems such as semen quality and sexual dysfunction. In addition, some physical conditions, age, psychological factors, etc. are also common causes of infertility.

Figure 2 Original copyright image, no permission to reprint

Blockage of the fallopian tubes prevents the egg and sperm from meeting and combining.

Figure 3 and Figure 4 are original copyrighted images and are not authorized for reproduction.

As women age, their fertility declines

Figure 5 Original copyright image, no permission to reprint

Semen abnormalities: azoospermia, oligospermia, asthenospermia, teratozoospermia and sexual dysfunction, etc., make the sperm unable to reach the egg.

Finally, is infertility untreatable?

Many people mistakenly believe that once they are diagnosed with infertility, they will never be able to have their own children. In fact, many infertile patients are able to successfully become pregnant after receiving appropriate treatment. The progress of modern medicine, especially the development of assisted reproductive technology, has provided many infertile patients with hope of having children.

In short, the diagnosis and treatment of the cause of infertility is a very tedious process, and it is not a problem that can be easily solved by a "secret recipe handed down from ancestors" or a few pills. If the couple has a normal sexual life after marriage and has not conceived for one year without taking contraceptives, they should go to a regular hospital for treatment as soon as possible. Do not rush to seek medical treatment in a hurry to have a child, so as not to delay the treatment opportunity, and do not lose confidence in treatment because of long-term treatment but still unable to conceive.