Experts interpret the core information of infertility prevention and treatment: marriage and childbearing at the right age are more likely to conceive Scientific pregnancy preparation has a good idea

Source: People's Daily News

People's Daily Beijing, January 20 (Reporter Sun Hongli) Infertility is a fertility disorder state caused by a variety of factors, and in the mainland, the incidence of infertility is 7%-10%. In November 2021, the National Health Commission issued the "Core Information on Health Education on the Prevention and Treatment of Infertility" (hereinafter referred to as the "Core Information").

Recently, around the content of the "Core Information", Li Rong, chief physician of Peking University Third Hospital, Jiang Hui, chief physician of Peking University Third Hospital, and Huang Guoning, chief physician of Chongqing Maternal and Child Health Hospital, made relevant interpretations for the public and introduced the knowledge and skills of infertility prevention and control.

Marriage and childbearing at the right age are more likely to conceive

Age is a key factor affecting fertility, and marriage and childbearing at the right age are more likely to conceive.

The "Core Information" pointed out that the fertility of women after the age of 30 showed a downward trend, after the age of 35, fertility declined rapidly, and the fertility of men began to decline after the age of 40.

Li Rong said that with the increase of age, the functions of all aspects of the human body are gradually declining, which is an irreversible process, and the reproductive system is no exception. Pregnant women of advanced age (35 years of age and older) are at significantly increased risk of developing chromosomal abnormalities in their embryos (e.g., Down syndrome), leading to adverse outcomes such as embryos stopping development or spontaneous abortion. In addition, pregnant women of advanced age are prone to a series of complications such as hypertension and diabetes during pregnancy, which may lead to poor maternal and child outcomes when severe.

Li Rong pointed out that the best age for women to have children is 22 to 28 years old, or no more than 35 years old at most. Although men have longer fertility cycles than women, giving birth to older men also increases the risk of chromosomal abnormalities in embryos. The average human life expectancy has been significantly extended, but the age of menopause in women has not changed much, suggesting that women of childbearing age should have children at the right age.

How to prepare for pregnancy scientifically?

How to prepare for pregnancy scientifically? The "Core Information" pointed out that both men and women who are preparing to get married or planning to become pregnant should take the initiative to go to medical institutions to receive premarital medical examinations, pre-pregnancy eugenic health examinations, fertility consultation and guidance and other services. Maintaining an appropriate frequency of sex, monitoring ovulation through medical methods, and choosing intercourse during ovulation period can help with pregnancy.

Jiang Hui said that for prospective couples who plan to get married, especially expectant fathers and mothers who plan to become pregnant, it is recommended to conduct relevant medical examinations to pay attention to the physical health of both parties, especially to detect problems affecting the reproductive health of both parties as soon as possible.

Expectant fathers and expectant mothers during pregnancy should understand the basic common sense of improving the probability of pregnancy, the core problem is to grasp the time of ovulation of the woman, and ovulation can be monitored under the guidance of the doctor by calculating the woman's menstrual cycle, measuring the basal body temperature and ultrasonography. The best time to have intercourse is generally the day before the woman ovulates, and before that, the man is best abstinent for 2 to 5 days, so that the quantity and quality of semen can reach the best state. Couples with irregular menstruation and difficult to accurately grasp the day of ovulation can adopt the strategy of having sex once every other day.

Smoking and alcohol abuse affect fertility

A healthy lifestyle is essential for pregnancy preparations. The Core Message notes that smoking and alcohol abuse can affect sexual and fertility, as well as embryonic and fetal development.

Jiang Hui suggested that expectant parents who are preparing for pregnancy must prepare for pregnancy in advance, and men should generally prepare at least 3 months in advance. First of all, we must quit smoking and limit alcohol, because a large number of harmful substances such as nicotine, tar, arsenic, cadmium and so on in tobacco will seriously affect the spermatogenic function of the testicles. At the same time a reasonable diet, sperm production process requires a large number of vitamins and zinc, selenium and other trace elements, during pregnancy should eat vegetables, fruits and seafood and other foods rich in vitamins and trace elements, while paying attention to the appropriate amount of exercise and regular work and rest.

The Core Information also states that exposure to toxic and harmful substances such as lead, mercury, benzene, pesticides and radiation may lead to infertility, fetal abortation or miscarriage. Prolonged exposure to high temperatures, saunas, and hot baths can cause a decrease in sperm quality.

Jiang Hui pointed out that in the preparation for pregnancy and pregnancy, you should try to avoid contact with these harmful substances, such as not perming and dyeing your hair, and do not decorate your home for the time being. If you have to touch at work, be sure to minimize the time and dose of contact, and take protective measures, such as wearing a mask, gloves or gas mask. Radiation has teratogenic and mutagenic effects, and during pregnancy, try not to do chest X-ray, CT and other radioactive examinations.

For men, the high temperature environment will also affect the spermatogenic function of the testicles. The suitable temperature of the testicles in the scrotum is about 35 degrees, while the human body is about 37 degrees, so high-temperature environments such as saunas and hot springs, including fever when colds, will directly damage the spermatogenic function of the testicles, reduce the quantity and quality of sperm, and affect male fertility. Therefore, during pregnancy preparation, we should pay attention to cold protection and warmth, especially to avoid colds, and try to take less sauna and less hot springs during pregnancy preparation, and it is not suitable for taking hot baths for a long time.

In addition, Li Rong pointed out that long-term anxiety, depression or fear and anxiety and other bad emotions will affect fertility willingness and harmony of sexual life, and will also affect women's hormone secretion and even normal ovulation of the ovaries, resulting in infertility. Couples with birth plans should maintain a good mental and healthy state.

'External environment, mental factors, etc. can affect a woman's menstrual cycle. Disorders in the cerebral cortex, hypothalamus, pituitary gland and ovaries can cause ovarian dysfunction, leading to ovulation disorders and menstrual disorders. A long-term poor mental state may exacerbate this disorder, leading to the occurrence of infertility. Li Rong further explained.

How to avoid unintended pregnancies?

Abortion can cause some harm to a woman's body. Li Rong pointed out that whether it is a medical abortion or surgical curettage, it is possible to secondary chronic inflammation of the pelvic cavity or adhesions to the uterine cavity. Pelvic inflammation can lead to tubal adhesions, obstruction, hydrops, and a poor pelvic environment, which can cause sperm and oocytes to fail to meet, resulting in infertility. There may be a decrease in menstrual flow after abortion, and it is not possible to get pregnant when you want to have a child, or if you are pregnant and miscarriage easily, and repeated abortions increase this risk. Even if no miscarriage occurs, there is an increased risk of preterm birth or intrauterine growth restriction of the fetus.

So, how to avoid unintended pregnancies when there is no birth plan?

Li Rong said that in the short term, couples who do not have a birth plan can use tool contraception (that is, condom contraception), and can also consider the use of oral contraceptives, and young women without contraindications to take oral contraceptives are actually a very safe and effective contraceptive, do not have to worry too much about the so-called "side effects" of the drug, and can quickly resume ovulation after stopping the drug, and do not affect the subsequent birth plan. Emergency contraception is not a conventional contraceptive method, and the success rate of contraception is not high, so it is not recommended to routinely use emergency contraception for post-sexual contraception. Couples of childbearing age should reasonably arrange their birth plans according to their own needs, choose appropriate and efficient contraceptive methods, and escort their health and future healthy births.

Abuse such as ovulation-promoting drugs is harmful to health

Infertility is a fertility disorder state caused by a variety of factors, women of childbearing age who have a normal sexual life without contraception for at least 12 months without pregnancy are called infertility, and in men it is called infertility. What causes infertility?

Huang Guoning said that the cause of infertility is more complex, involving common problems between men and women, it is necessary to select further targeted auxiliary examination and treatment through routine analysis of male semen, ultrasound monitoring of ovulation by women, basic endocrine measurement and tubal patency, etc. The preliminary assessment is clearly female factors, male factors, bilateral factors or unexplained infertility, etc., combined with the couple's medical history and clinical manifestations, to select further targeted auxiliary examination and treatment.

Huang Guoning stressed that female ovulation disorder is one of the main causes of infertility. Irregular use of ovulation-stimulating drugs often leads to the development of multiple follicles, posing many potential risks, such as a significantly increased incidence of multiple pregnancies and ovarian hyperstimulation syndrome, and in severe cases life-threatening. Therefore, these drugs must be used under the guidance of a specialist to reduce or avoid complications and ensure the safety of mothers and babies. Oligospermia, weak spermatozoa and azoospermia are important causes of male infertility, but the abuse of sperm-promoting drugs can also lead to harm to health and must be applied under the guidance of a specialist.

Acts such as egg trading and surrogacy seriously damage women's health rights

Human assisted reproductive technology refers to the use of medical techniques and methods to manually manipulate gametes (sperm, eggs), zygotes (fertilized eggs) and embryos to achieve the purpose of conception.

Huang Guoning said that only a small number of infertile patients need to be treated with human assisted reproductive technology to obtain pregnancy. Infertile couples to receive assisted reproductive technology fertility need to have clear indications, there are some contraindications to the restrictions, must be approved by the state in the formal medical institutions to receive fertility treatment, the list of institutions information can be found on the official website of the National Health Commission.

In recent years, human assisted reproductive technology has continuously poured into the public eye, and the Core Information emphasizes the rational application of human assisted reproductive technology and prohibits the sale of eggs and surrogacy.

Huang Guoning said that the trade in eggs, sperm and embryos not only undermines human ethics and social order, but also may cause the abuse of germ cells and genetic confusion due to the lack of effective supervision, threatening the country's reproductive health and security. Once an egg becomes a commodity, it may induce the use of overdose of ovulation-stimulating drugs in donors, increasing ovarian hyperstimulation syndrome, and the risk of surgical bleeding, infection, and even life-threatening in severe cases. For economic purposes, egg donors may deliberately conceal their family history of genetic diseases and infectious diseases, resulting in the birth of unhealthy offspring.

Huang Guoning pointed out that the surrogacy behavior is actually the woman's uterus for commercial leasing, this process will seriously affect the mental health of the surrogate, and bring medical risks such as obstetric complications, the current surrogacy is underground, which will undoubtedly increase the psychological and physiological safety risks of the surrogate, post-pregnancy hypertension, diabetes and postpartum bleeding and other obstetric complications will also increase the safety risks of the surrogate's body, but also can not be guaranteed. In addition, a fetus born through the sale and purchase of eggs and surrogacy may face ethical and legal disputes over the ownership of the fetus.

"Acts such as buying and selling eggs and surrogacy not only seriously damage women's health rights and interests, but also violate social order and good customs and trample on the bottom line of ethics and morality." The majority of women, especially adolescent women, should enhance their awareness of self-protection and consciously resist illegal acts such as buying and selling eggs and surrogacy. Huang Guoning stressed.