Interview topics: women diagnosed cause of infertility is the key
invited guests: reproductive endocrinologist Professor Chun-Xia Gu
Record interview follows:
Moderator: friends, good afternoon! Welcome to the Sohu interview between health today. We talk about female infertility, please go to the guest was the well-known reproductive endocrinologist Professor Chun-Xia Gu.
150 kinds of diseases, clinical letters can lead to women's infertility, the cause is very complicated, if not a clear cause for treatment will not be able to bring effective, or even cause physical damage to the patient, leading to lifelong infertility, therefore, to identify a clear cause, symptomatic treatment to take is an important prerequisite for a successful pregnancy, and today Professor Valley, combined with his 50 years of clinical experience to friends on the diagnosis and treatment of infertility.
1, what is the female infertility?
Moderator: Professor Gu, please give us about what users are female infertility.
Valley Chunxia: We must first understand What is infertility, infertility is not a disease, the main growth is the continuation of life, growth hampered for some reason, that is, to infertility. When the time is not on the birth caused many social problems, such as the family does not live there, and even caused the rupture in the feelings, the situation is still a lot to see. In the process of birth, from the women in terms of a complex of factors, women have menstrual cycle, usually 28 days, must be in this cycle, the ovulation sex to achieve pregnancy. we have done some research on natural birth the first couple of chances to become pregnant, about 60%, 80% second year, to 90% the third year, so we are based on the past three years, infertility is defined as the standard.
But the situation such as late marriage, living and working pressure, for various reasons can not be soon to have children, lead us to shorten the time of infertility. from the world WHO's requirements and standards is concerned, the age of couples of reproductive age, if there is a normal sex life, and no contraceptive measures, there is no growth in one year, can carry out all aspects of the inspection.
So according to this standard is more appropriate terms, over the treatment that many women want children, they usually work with some success, there are good advantages in life, want to have a child, we will conduct a comprehensive inspection .
2, the current female infertility prevalence in China, how?
Moderator: At present, women are not the incidence of infertility in China how to?
Valley Chunxia: World Health Organization in 1986, had a demographics, statistics show, in which Asia accounted for 3%, 4% of the Middle East, Europe accounted for 5.4%, U.S. 6%, Africa 10.1%, the highest in Africa, the Middle East and Asia, we are the incidence of infertility is the lowest The.
China in 1989 had a survey on the couple's first marriage, there are 5,918 pairs of couples participated in the survey, the survey shows that primary infertility in Dalian and only 1.01%, the infertility rate is 6.89%, so is very small. here as a lot of factors, the impact of a region, the environment, there are other factors, such as urban and rural differences and the impact of various aspects of age, the survey is also based on two years standard statistics do.
3, which factors may cause female infertility?
Moderator: After the concept described above, many users more concerned about following what the reasons may lead to the occurrence of female infertility?
Valley Chunxia: Infertility happened several conditions must be.
First: the couple must have a normal germ cells, germ cells is the man with a good sperm, the woman with a good egg .
Second: sperm and egg to be able to combine, to form a zygote.
Third: The fertilized egg to be able to enter into a normal uterus, and then to the uterine cavity. Meanwhile, a variety of physiological factors embryos also have a great impact.
This is essential items, the process of pregnancy, such as sexual life is not in the ovulation period of time, it is difficult to conceive.
menstrual cycle, ovulation is if 28 days, then began to develop from the follicle to mature the time of ovulation. in the ovary in a mature egg cell row out of discharged pelvic, and then get through the fallopian tube fallopian tube adsorption umbrella side, this time, if the sex life of sperm through the vagina , cervical, uterine cavity, the first sperm to reach fallopian tube into the egg cell with the egg into the zygote. This process is very delicate, very strong merit. a one-time life of the sperm there? must be at least more than 2 million sperm, This is a very low standard. Now normally, 6 10 to 100 million, this is normal.
after the sperm reach the fallopian tube is a sperm, the sperm is also very important activities, such as men's sperm activity is not strong, it could not reach the insemination, although that may have to slowly, fertilization, they also may be a problem, such as not very good penetration into the egg, there is no way to fertilization. So we still have after fertilization a few days, slowly from the oviduct into the uterine cavity, endometrial uterine cavity at this time to have adequate nutrition, in order to achieve a good pregnancy.
so that this process may encounter many problems, a If you reach the mature egg, or even after discharge to mature, but can not reach the fallopian tubes, this process can not become pregnant. If you reach the fallopian tubes, although pregnancy, but because for some reason, such as diseases, resulting in tubal narrow, so that often resulted in abnormal pregnancy. Even if the fertilized egg to the uterine cavity, uterine cavity if there are other diseases can also cause infertility. so a lot of problems, a normal child birth process is very complicated The.
Moderator: Professor Gu has just given us a detailed description of the users, including the process of pregnancy, usually causing a major cause of female infertility what?
Valley Chunxia: from the cause is concerned, the main female infertility There are several.
one belongs to organic lesion, the other is part of the endocrine system disease, may also be multiple factors in both number of diseases, in addition to unknown reasons. It is generally speaking in general terms, each half of the general reasons, but this time with a relationship we know, such as reform and opening up, an increase of infectious diseases in our country, after which the lesions observed may be greater than the organic aspects of endocrine diseases.
mainly refers to inflammation on the organic diseases, such as we have just mentioned, like tubal inflammation, pelvic inflammation, vaginal inflammation, inflammation of the cervix, all the inflammation can cause tubal final barrier, resulting in infertility. There is TB , TB problem in the past and more. and then there is a cause of infertility is infertility uterine mucosa, the easily lead to pelvic adhesions, tubal adhesions after the issue has caused a variety of pelvic problems is not easy to make egg and sperm met, and then causing infertility.
Moderator: unreasonable as tubal infertility in women accounts for a large proportion of you?
Valley Chunxia: tubal barrier has just told a tubal inflammation, almost 30 % number of patients is due to inflammation caused by fallopian tube.
Moderator: Uterine fibroids can cause infertility do?
Valley Chunxia: Uterine fibroids can cause infertility general, but also pregnancy, pregnancy and some can cause miscarriage, the growth of this area with fibroids have a certain relationship, as well as the size of fibroids, if the fibroids larger than 4 cm after the fibroid treatment may be a little better later pregnancy, if the 4 cm below or by, the general relationship is not too likely.
Moderator: Now the more serious inflammatory gynecological What?
Valley Chunxia: the more common genital tract inflammation and the severity of inflammation. In addition and treatment is not timely, thorough incomplete, inflammation after infection, when inflammation even when more serious purulent, but also the formation of pelvic cyst, or a long time to form a pelvic cyst ruptured abdominal inflammation, very serious. If inflammation, infection must be timely and thorough treatment, but also pay attention to personal hygiene. as long as a thorough treatment, early or curable, if treated too late will result in infertility.
4, female infertility and age No relationship?
Moderator: because now may have been delayed marriage and childbearing, age, and female infertility not related to the occurrence, such as older since the reproductive process have any effect?
Valley Chunxia: influential, particularly in women, the 30 years old to 35 years of age, fertility was significantly worse than the much younger, the pregnancy rates and fertility rates to be greatly affected, over a 35-year-old even worse.
5, hormones What is the relationship level and infertility?
Moderator: hormone levels are related with infertility do?
Valley Chunxia: a relationship, the so-called hormones, estrogen in women, the progesterone, of course, a small amount of male hormone, it is normal secretion of ovarian inside. ovarian secretion of this hormone which, when pregnant, progesterone if not, the children would be affected.
6, psychological factors have any effect on pregnancy?
Moderator: Psychological factors will affect you pregnant?
Valley Chunxia: Of course there are psychological factors, such as pregnant women are like, by a lot of mental pressure, menstruation does not come often, but also in his stomach growing, but it finally to the doctor there to check, a check is not, is false pregnancy, which is greatly influenced by the spirit, causing her endocrine disorders and causing amenorrhea, so this situation is , if excessive tension, otherwise very good, this can also cause infertility.
Moderator: couples having trouble conceiving, there will be psychological pressure, how to deal with, Professor Gu has any suggestions?
Valley Chunxia: I think only better relax, to Xiangde Tong, the child's question I think a lot is entirely their own fertility, but because of her great mental stress, do not relax, the result caused by endocrine disorders , endocrine disorders that do not ovulate after the egg there, but not exclusive, once can relax after the birth. For example there have been previous examples of this are many, married for several years unable to bear children, then adopt the child, adoption was actually on the pregnant beyond their own on, and even pregnant with two, so that psychological stress and infertility is still a great relationship.
7, the main reasons for infertility in the woman's body?
Moderator: Many people now talk about to infertility, that the reason for the woman who appears in this view right?
Valley Chunxia: This view is wrong, in a sense, the reasons for men than women because more than we had on 10,000 pairs of infertile couples to check, in which the factors of female infertility, 25%, 33% male factors, another is that both men and women for some reason, if one may not be a problem, but both sides have a little problem This will result in infertility, the causes of women 20%, 25% unknown reasons, the reason for men than these. not as long as the woman check-ups, and also be sure to also check the man, so often, sometimes over treatment of couples, one should check the man, the man said no problem, and finally check the results on the contrary, the woman is no problem, the man in question, this has a lot.
8, the main check which aspects of infertility?
Moderator: users are more concerned about major investigations to the hospital after what does?
Valley Chunxia: mainly do is to check the body, in addition to reproductive function test, the man, the woman must be considered, there is no serious in some cases, there is no organ abnormalities, if there are any organic lesion, of course, also need the determination of hormones, but the determination of hormones in the woman can not be entirely in terms of hormones as a very important factor, because the organic lesions are To find out, the key is to find out a comprehensive real cause, not to say made a determination will be able to determine how hormone therapy, which is still not complete.
9, how do ovulation monitor?
Moderator: just talking about a very important part of the female is ovulating, and now more people are self-determination by temperature measurement, this method is accurate and up?
Valley Chunxia: This is a good basis for the determination of body temperature, because the very simple. to monitor ovulation, the first to know when ovulation, the menstrual cycle is 30 days if it is almost 16 days, 15 days of ovulation. If the backward extension of the time if the correct statement should come before menstruation 14 days, this time on a cycle of ovulation is the time, so we are not very accurate projections, many people want the rhythm, rhythm of projections about what her time. She said that menstrual clean for a week, That is just ovulation, but not the rhythm.
So in the absence of ovulation, basal body temperature is relatively low body temperature before, after ovulation, pregnancy hormones in the body temperature, resulting in a hot performance of the body, higher than normal for 0.4 to 0.6 degrees, so you see the body temperature, if sustained increase of 12-14 days, no pregnancy, then the temperature drops began to menstruation, so this will be able to more accurate to understand the specific time of ovulation, how can see that there is no ovulation. Some people think that menstruation is ovulation, it is not right, because there can be no ovulation period, so the determination of basal body temperature is very good.
10, infertility Treatment
Moderator: talk in front of so many reasons, for the treatment of concern to many Internet users, as described earlier, Professor Gu, female infertility may be mainly for two reasons, the treatment is also a corresponding?
Valley Chunxia: Yes, we are mainly according to his real reasons, according to targeted treatment for this reason, of course, not just for this reason sometimes the inspection tube, and needs to be done hysteroscopy, laparoscopy, laparoscopic uterine ectopic examination is very important, foreign to this very seriously, laparoscopic examination must be done to make the treatment and diagnosis, so hysteroscopy and laparoscopy in the diagnosis of infertility plays an important role. only by hysteroscopy and laparoscopy can be treated clearly, this is very crucial.
of course, because after checking out how what therapy, if indeed the reason oviduct, such as fully closed, and the top tube is OK, is a water, when to do angiography, the distal fallopian tube to see the state of the formation of water, that is blocking the state, in which case no problem if the husband, that is pure water, ovulation Ye Hao, Ye Hao endometrial conditions can be considered to be the treatment of tubal water, after ostomy surgery. In other respects normal circumstances, making eloquence likely to succeed, or is a loss. If other conditions are not good, it can not choose This can be considered IVF, in vitro fertilization. If the husband is not good, there is no need for the woman so strenuous, so that by a lot of pain, and finally get a good child.
Moderator: Now, as this Clinical results of infertility how to?
Valley Chunxia: Generally speaking, the way we are treated almost 30%, 40% of the way.
11, Chinese medicine treatment for infertility how effective?
Moderator: Many users are more concerned about this issue, which is on TCM treatment of infertility in the end how to?
Valley Chunxia: When checking the cause of the disease clear, for example, there is no inflammation or ovulation and the function The problem can be treated using traditional Chinese medicine, Chinese medicine effect is still good, you can achieve the purpose of ovulation, but ovulation situation, TCM treatment slightly slower, if a relatively light inflammation, such as early disease caused by acute inflammation, or slightly After a stage, then the traditional Chinese medicine is good, so that inflammation can be completely alleviated, if developed into chronic inflammation, the effect have sent.
Moderator: brief introduction of a number of previous treatment methods, like this types of infertility treatment of the disease usually takes many courses?
Valley Chunxia: I do not know what is meant by the treatment of patients, because menstrual cycle is a period checked the time, to know that she has not ovulate this cycle, To understand ovulation is good also for a minimum two months, a number of treatment or tubal problems based on her cycle, menstrual clean after the inspection, if there is inflammation, then even if the bad to say.
12, now treatment of infertility of new technologies and methods
Moderator: Now in the treatment of infertility has not some new techniques and methods?
Valley Chunxia: refers to the treatment of assisted reproduction technology, there are many treatments, that is, we are talking about IVF treatment in 1978, the world's first test-tube baby was born, the world's reproductive health from a very large effect, this technology is a great development, our domestic cases from the first test-tube After the birth of the baby, have been generally carried out over such a bit of treatment, and the results are also growing. was the first generation test-tube baby, is currently the second and third-generation, in the past can not imagine some of the results can well compensated, so the whole inside of reproductive health, in the treatment of infertility is made great progress.
13, asked to have the fertility of women living habits in place recommendations?
Moderator: If couples want to have children in their daily lives should pay attention to what?
Valley Chunxia: mainly reproductive health, women during menstruation to prevent infection must be very good, for example, menstruation is not clean can not be sexually active In the time period can not bath, padding must be good, must be sterilized, good hygiene, this is a very critical situation. If you will not find a little time to treatment of menstrual resistance force is weak, prone to a variety of other issues which need proper rest, do not jump around. as well as in excessive menstrual dance or do vigorous exercise, it is easy to cause other diseases.
12, experts answer to the question
User User: follicular development is not the main reason?
Valley Chunxia: follicular development, there are many bad factors, such as their sex hormones, because the ovarian hormones is affected by the pituitary gland above secretion of hormones, pituitary secretion of a hormone to follicle growth, and if not, the follicle will grow slowly, but the follicle is not only a factor, as well as prolactin, if it is not normal, but not ovulation, have affected the growth of the follicle, where there are other factors.
friends: I am 28 years old, made a 3 flow, and 02 once, in 2005 made a beginning, the end did once, after the physical flow also returned pretty well, I intend to have children next year, will not affect the pregnancy? Or so say it another year?
Valley Chunxia: because in the past history of pregnancy, and termination of the pregnancy, with age growth, ovulation is good, to understand the situation of ovulation, the other fallopian tube inspection is still very important. There is usually tubal examination, there are tubal contrast, with contrast agent, just a clean three or four days in the menstrual, uterine endometrium has not yet fully grown, relatively thin, the endometrium has been repaired, so that imaging can be done at this time the uterine cavity appears normal circumstances, the other fallopian tube will understand the situation more clearly. so the liquid flow tube and fallopian tubes are a better way of contrast.
Moderator: people who are doing more abortions, as abortion itself will not affect pregnant women?
friends: medical abortion will not lead to infertility?
Valley Chunxia: It should be no effect, but due to time, this time there will be other problems will not interfere with her next birth, for example infection inflammation. abortion later if very smooth, it should be is not a big issue, but if she was bleeding after abortion continued a long time, so it is easy to ascending infection into the uterine cavity, fallopian tubes, and finally to annex inflammation caused by fallopian tube, pelvic inflammatory disease, which would leave after-effects, easily lead to future infertility .
users: 27 years old, 28-day menstrual cycle, a year ago, there is a polyp inside the uterus, had surgery, intimal hyperplasia after that, for 3 months of progesterone, resulting in misdiagnosis, drug withdrawal endocrine investigations, now 28-day menstrual cycle, 35 meters high, such as hormone, blood black after a few days, six months of infertility, seen many doctors stopped eating olfactory hidden, the result of infertility, may I ask how can I do?
Valley Chunxia: Sometimes the search is often the real reasons, if indeed the high prolactin can affect menstruation, or even result in amenorrhea, even if the reasons for this are looking for, for example, there is no pituitary tumor, it will also result in elevated prolactin causes amenorrhea, If no organic problem of the reproductive system, generally will not affect the pregnancy. Do not rely solely on this test, the test can not fully describe the problem. In addition to your situation is more complex, you need to know the exact diagnosis. dysplasia is cancer itself is before a lesion, prone to miscarriage, so this must be treated, and which importantly, what areas should be treated.
User: polycystic ovary must be through Komi chelating pregnant? now eat Liuweidihuang pills, will help it?
Valley Chunxia: polycystic ovary is more complicated, largely because of her relatively high androgen the body and the people are fat, the problem of endocrine more appear, that may amenorrhea, ovulation may not be blood or a house, so to achieve the real purpose of ovulation, other conditions are good, can get ovulation to be able to get pregnant, this is still possible, the male hormones to control some cases, further ovulation induction treatment. can help with clomiphene ovulation, but this should be determined by the specific circumstances, such as her base case, the ratio of weight and height must be wrong, there are relatively poor weight gain that effect. Some Chinese also have a certain effect, but it also needs to be based on individual circumstances, after a medical examination after the last to develop an optimal treatment plan.
friends: I am a serious uterus backward, monitoring ovulation, ovulation does not find the left ovary, right ovulation, menstruation is very accurate, had been diagnosed as Hashimoto's disease, a long-term use excellent music, and now want a baby, how do?
Valley Chunxia: what would happen to her situation of ovulation, tubal really good, Check the man is not the normal situation, it is recommended to conduct a comprehensive examination, not a pure backward will cause infertility, tubal situation is the main, there is no pelvic adhesions, adhesions, then if there is the possibility of infertility caused by relatively big.
friends: I am 33 years old, married for 13 years, 5 habitual abortion, induction of labor time, resulting in endometriosis and did a stripping operation, has been 4 years, and now there is no pregnancy, check is the fallopian tube blocked, there is hope you like this?
Valley Chunxia: a simple barrier can cause tubal infertility, coupled with other factors, then ovulation is not good, the man is not good, the possibility of infertility to a little more.
friends: I 41 years old, blood type 0, the husband is B, three times a child has died, the first 5 months, the second 4 months, and the third 3 months, the last time No Qing, 32, has 9 years of age not pregnant and do all the tests were normal, there are a number of severe cervical erosion, often check, but not treated, will also be possible for the mother?
Valley Chunxia: If blood group incompatibility is caused by infertility problem, your blood type RH how, if the RH negative if the husband is positive, then this is the problem of blood, blood group incompatibility, it will cause hemolysis after death, can also cause bleeding, obstetrics problems to more complex and more specific questions need to be with the doctors of these made clear, many probably will appear, probably a child to grow up. Do you have diabetes, genetic, immune and other issues, which need further examination you, I suggest that you can go to the professional medical bodies to examine in detail.
users: Last year, with stops this year in child education twice, in two months, the test results are normal, love is a genetic mutation that species can not have children?
Valley Chunxia: I would like to have children should not be, because the great impact of genetic factors on the pregnancy.
User: menstruation has been allowed for several years, have time to, and sometimes do not come, good to have to check the endocrine not very good, a few days ago to do B-is polycystic ovary, polycystic ovary if the cure is not to normal after the endocrine, and menstruation to normal, cured can be pregnant? < br> Valley Chunxia: This is also often a misunderstanding, because the oocysts are affected by many factors of ovarian influence, if relatively light, the general period may be able to adjust ovulation, pregnancy, ovulation can solve the problem, but we generally treatment of this cycle is good, does not mean that the next cycle to the good nature, so there is no permanent problems, because reproductive function is cyclical, so the idea that she is pregnant again until after cure, I think it is not practical.
13, specialist visits time
Moderator: Professor Gu, please tell us about the last time and place of visits.
Valley Chunxia: I am now Wednesday and Friday all-day, Monday morning a half-day, held in Beijing No. 24 West Da Wang Road, Beijing Continental Women's Hospital.
Moderator: This concludes today's interview, thank you friends concerns of Professor Xie Xiegu the visit.
experts
Valley Chunxia Professor, Chief Physician, Master Instructor
under the tutelage of renowned experts, Professor Lin Qiaozhi obstetrics and gynecology. Chinese Academy of Medical Sciences in Beijing Union Medical College Hospital, more than 50 years of work. In the field of obstetrics and gynecology has accumulated rich clinical experience, particularly the field of reproductive endocrinology in gynecology outstanding achievements in the country to carry out the first female reproductive endocrinology and female infertility clinic. infertile women conducted in-depth study, the first use of laparoscopy in the valuation of the domestic female gonadal function, and transvaginal ultrasonography in the domestic first technology to monitor treatment of infertility ovulation follicle development, have won National Merit Achievement Award.
