【Medical Q&A】I have not been able to conceive after taking the ring? What causes infertility?

Since the official implementation of China's three-child policy, many families can't wait to meet their third baby. However, many women don't get pregnant for a year after taking off their IUDs.

The principles of IUD contraception are:

1. Due to the long-term stimulation of the endometrium by foreign bodies, a sterile inflammatory response is caused, and the number of white blood cells and macrophages is increased, which hinders the implantation of the fertilized egg;

2. Foreign body reaction can also damage the endometrium and produce prostaglandins, which in turn can change the peristalsis of the fallopian tubes, so that the speed of the fertilized egg is not synchronized with the endometrium, thus affecting implantation;

3. Endometrial compression, ischemia, activation of plasminogen, local fibrinolytic activity enhanced, resulting in blastocyst lysis and absorption;

4. IUDS with copper can interfere with endometrial cell metabolism;

5. Progestogen-containing IUD can cause endometrial gland atrophy and interstitial degeneration, which are not conducive to implantation of fertilized eggs, thus playing a contraceptive role.

How do IUD cause infertility?

After the IUD is removed, the above mechanism ceases to exist. The endometrium returns to normal after a 1-month menstrual cycle, and fertility functions are restored. However, if the sterile operation is not strict, the technique is not skilled, the placement is improper, the movement is rough or the genital tract itself has a foci of infection when the IUD is placed, which can cause complications, commonly chronic endometritis and salpingitis, uterine damage and IUD incarceration and other complications, resulting in infertility consequences.

Therefore, for women who are infertile after loop retrieval, if the menstrual cycle is normal and there is no change in menstrual flow, salpingogram or hysteroscopy can be confirmed, and then different treatment methods are used according to the location and severity of tubal obstruction.