Many women have a misunderstanding: as long as they menstruate normally, they can successfully get pregnant and give birth.
In fact, a woman's "fertility" is related to many aspects, and the menstrual situation can only reflect part of the fertility conditions, and the following 5 aspects need to be comprehensively assessed together.
In general, the optimal age for women to have children is 25-35 years old, and over 35 years old is an advanced maternal age.
This is because:
After the age of 35, as the age increases, the fertility of women gradually declines, the proportion of infertility increases, and the risk of fetal chromosomal abnormalities increases.
Complications during pregnancy and childbirth may increase in advanced-age pregnant women, such as gestational hypertension syndrome, gestational diabetes, and preterm birth, which are more common than those of women of appropriate age [1].
Ideally, at the optimal reproductive age, a woman is fully mature, has good egg quality, pelvic floor muscle elasticity, and recovers faster after childbirth.
The incidence of miscarriage, preterm birth, stillbirth, malformations and dementia is also lowest during this period.
But pregnancy and childbirth are not just medical matters, and many women have missed the optimal age when they are ready to give birth.
Don't worry too much, after all, there are only a few problems, and most of the situations are safe under the escort of medical staff.
If you want to get pregnant, you must first have "seeds". For women, whether the ovarian function is good or not, whether there are mature follicles, and whether they can discharge high-quality and healthy eggs are very important.
(Source: extendfertility.com)
To know whether ovarian function and the quality and quantity of follicles are up to standard, look at these three items: sex hormone six, anti-mullerian hormone (AMH), and number of basal sinus follicles (AFC).
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1. Six items of sex hormones
Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estrogen (E2) in the sex six hormones can all reflect the "age" of the ovaries to some extent [2], and it is recommended to check on the second day of menstruation.
● An increase in FSH can reflect a decrease in ovarian reserve function, and if the FSH > 10 to 15 IU/L on the 2nd to 3rd day of menstruation, it indicates a decrease in ovarian function; FSH > 25 IU/L indicates occult ovarian failure; if FSH is higher than 40 IU/L, it indicates a severe decline or failure of ovarian function;
● Combining FSH and LH, if FSH/LH ≥2, it indicates that there may be poor ovarian reserve function, especially infertile patients in women aged ≥ 35 years, indicating that ovarian function may decline;
● The base value of estrogen E2 is 25 to 45 pg/mL. If basal estradiol (the predominantly estrogen) level > 80 pg/mL, it may indicate decreased ovarian function, which in combination with FSH can improve predictability.
2. Anti-Mullerian hormone (AMH)
In recent years, AMH has been recognized as closely related to the reserve function of the ovaries [2].
Some young women have decreased ovarian reserve, which is manifested by a decrease in AMH (
3. Number of basal sinus follicles (AFC)
Sinus follicles develop from the basal follicles in the ovaries during each menstrual cycle.
At the beginning of menstruation, the number of sinus follicles in the ovaries can be clearly observed by ultrasound, and if ultrasound on the 2nd or 3rd day of menstruation shows that there are fewer than 5 sinus follicles on the ovaries, or even less, it means that the reserve function of the ovaries has decreased significantly.
The fallopian tubes are the site of fertilization and the conduit for transporting "seeds".
Normally, the egg binds to the sperm in the fallopian tubes to form a fertilized egg, which is then transported to the uterine cavity. Therefore, the fallopian tubes play a very important role in pregnancy.
(Source: make a gif.com)
If the fallopian tubes are blocked or not smooth, it is easy to lead to infertility or ectopic pregnancy. Tubal infertility has been reported to account for 30% to 50% of infertile women [3].
These are the following reasons that are most likely to cause blockage of the fallopian tubes:
1. Inflammation of the lower genital tract
For example, Neisseria gonorrhoeae cervicitis, Chlamydia trachomatis cervicitis, etc. spread upwards to the fallopian tubes, causing adhesions to the mucosa of the fallopian tubes.
2. Infection after intrauterine surgery
Multiple abortion curettage surgery, hysterostomy, etc., may cause postoperative infection or blockage of fallopian tubes.
3. Gynecological diseases
Endometriosis, chocolate cysts, and ovarian cysts may also cause the fallopian tubes to stick or be compressed.
The "seed" of the fertilized egg comes to the uterine cavity, and it also needs "soil" to grow well, which is the tolerance of the endometrium to the embryo.
(Source: chataboutit.org)
The main influences on uterine receptivity are:
1. Endometrial thickness
At present, it is believed that when the endometrium thickness is 8 to 14 mm and the form is three-line, the endometrium has good tolerance, strong acceptance of embryo implantation, and the success rate of embryo implantation is high [4].
2. Uterine morphology
Structural abnormalities of the uterus include endometrial polyps, submucosal fibroids, intermuscular fibroids, uterine cavity adhesions, or uterine malformations, such as bicornal uterus, uncornuated uterus, mediastinum uterus, etc.
Uterine fibroids cause changes in the morphology of the uterine cavity
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(Source: CAST PHARMA)
These abnormal uterine morphologies are like "houses" of strange shapes or structures. The growth of the fertilized egg in the abnormal uterus may also be affected.
Physical factors in pregnant women can also affect fertility, such as endocrine disorders leading to non-ovulation or affecting embryonic development, and some congenital hereditary conditions may also be passed on to children.
There are also some bad habits such as smoking, drinking, exposure to chemicals, etc., which also affect the normal development of the fetus.
postscript
Naked marriage is OK, but not "naked". Pregnancy is a psychological and physical battle, a big deal for the whole family.
Before preparing for pregnancy, both husband and wife must do a good job under the guidance of the doctor, after all, fertility is a comprehensive "strength" competition.
bibliography
Chen Yan,Xing Jun. Outcome analysis of perinatal pregnancy in advanced maternal age[J].Journal of Practical Obstetrics and Gynecology,2009,25(02):97-99.
[2] Li Man,Wen Dongmei,Wang Weijia,Xu Shengnan,Zhao Jin,Zhong Wanting. Predictive value of combined AMH, FSH, LH and E2 detection in ovarian reserve function in infertile patients[J].Laboratory Medicine and Clinical,2017,14(12):1729-1731.
Yang Dan,Lei Zhenwu. Causes of tubal infertility[J].Journal of Practical Obstetrics and Gynecology,1996(06):282-283.
Xu Huiying,Li Na,Zhang Yunshan. Embryo implantation—endometrial receptivity is key[J].Journal of Reproductive Medicine,2014,23(03):198-202.
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