For every family with a baby-hungry heart
Miscarriage is undoubtedly a nightmare
And repeated miscarriages again and again
It is even more devastating to expectant mothers
All the time
We are all accustomed to thinking
Miscarriage after pregnancy is a factor for the woman
As a matter of fact
There are some miscarriages, especially recurrent miscarriages
It also has a lot to do with the man
This pot is not always
Throw it to the woman!
In the past, it was believed that as long as pregnancy was possible, the question of whether or not to have a miscarriage or fetal arrest was only related to the woman. Current studies have found that about 10% of women have recurrent miscarriages or fetal arrest with male factors.
It mainly includes the following factors:
01
Chromosomal problems
These include abnormalities in autosomal and Y-staining body color. For example, the number of chromosomes and structural abnormalities are the clear reasons for many miscarriages and embryonic arrests, which is why our reproductive medicine center often needs to check chromosomes.
Human somatic cells contain a total of 23 pairs of chromosomes, chromosomes 1~22 are called autosomes, the difference of X or Y in chromosome 23 determines the sex of males and females, and sperm contains half of the genetic material in somatic cells, such as 23X, 23Y, etc., and the chromosomes of sperm may change with somatic chromosomal abnormalities.
According to relevant reports, 20%~55% of aborted embryos have chromosomal abnormalities.
01
Abnormalities in the number of autosomes
One is chromosomal euploidy abnormality, for example, after the combination of sperm and egg, it should be diploid, that is, 23 chromosomes from the woman's egg and 23 chromosomes from the father's sperm, but in a few cases, the fertilized egg triploidy, in this case, the embryo is more likely to have spontaneous abortion, and there are few surviving fetuses, but serious malformations may occur.
The other is chromosomal aneuploidy abnormalities including monosomy, trisomy and polysomy, and most of the surviving offspring have obvious abnormal clinical manifestations, including trisomy 21, Klinefelter syndrome (47XXY), etc. These men are more likely to have poor sperm quality, low fertility, or infertility.
02
Autosomal structural abnormalities
This is caused by breakage, loss, and improper recombination of chromosomes during the process of inheritance. Translocation is the most common, followed by inversion. Carriers of chromosomal balanced translocation, whose germ cells produce unbalanced gametes during meiosis, can lead to adverse outcomes such as miscarriage and teratogenesis.
The high miscarriage rate was related to the abnormal karyotype carried by males, the probability of miscarriage caused by males with mutual translocation was 61.1%, the probability of miscarriage caused by inversion was about 28%~42.9%, and the abnormal rate of chromosomal karyotype was 5.22%, of which autosomal abnormalities accounted for 14.6%.
03
Y chromosome
The Y chromosome is a male-specific sex chromosome, and its length variation has a genetic effect and is associated with miscarriage and embryonic arrest. Y chromosome integrity plays an important role in embryonic development and maintaining pregnancy.
There are two cases of this: a large Y chromosome, which refers to chromosome 18 > length of the Y chromosome in the same karyotype. In patients with serial miscarriages, the detection rate of large Y chromosomes can be as high as 40%, and the other is small Y chromosomes, which refer to the length of Y chromosomes < chromosome 21 in the same karyotype. The incidence of RAS due to small Y chromosomes was 3.26%~26.32%, which was quite different.
There is a gene on the long arm of the Y chromosome that regulates spermatogenesis, called the AZF gene. Its deletion, which we call the microdeletion of the Y chromosome, affects not only spermatogenesis, but also the continuation of the pregnancy of the spouse.
02
Semen infection factors
Many studies have found that Chlamydia trachomatis and Ureaplasma urealyticum infection are important pathogens that cause recurrent miscarriage, these tiny pathogens attach to the surface of sperm, can secrete neuroaminolipases, enter the egg cell with sperm, form a fertilized egg, and cause the death of the embryo that destroys the development for a long time and abortion; it can also cause endometrial inflammation, affect the regulatory mechanism of the mother's own immune system to protect the embryo, interfere with embryo implantation or damage the growing embryo and induce miscarriage; the infection destroys the natural blood-testicular barrier in the male testicular structure, and the sperm surface antigen is in contact with the blood, and an immune response occurs, producing anti-sperm antibodies, induce the autoimmune system to destroy sperm, which in turn affects the development of early embryos and leads to miscarriage.
In addition, studies have shown that the rate of DNA damage in the sperm of infected patients is more than 3 times higher than that of the control group, but the rate of DNA damage can be reduced after antibiotic treatment. This reduces the risk of miscarriage and fetal arrest.
03
High rate of sperm DNA fragmentation
The integrity of the DNA of the genetic material inside the sperm is extremely important for sperm-egg interaction, fertilization, and early fertilization cleavage. Studies have shown that people with sperm DNA damage higher than 30% have a significantly higher probability of infertility or spontaneous abortion in the first trimester.
04
Sperm morphology
Most previous studies have suggested that there is no significant correlation between sperm malformation rate and the probability of malformation in offspring, but sperm morphological abnormalities are related to abnormal nucleoproteomic transition, chromatin structure abnormalities, sperm nucleoprotein defects, and increased DNA fragmentation.
Among them, abnormal chromatin sperm is mostly manifested as abnormal head morphology (such as big-headed sperm), which will significantly increase the possibility of miscarriage when such sperm is combined with the egg to conceive, and the acrosome abnormality of the sperm head can make the sperm unable to penetrate the egg and lose the ability to fertilize, resulting in infertility and even miscarriage.
05
Sperm vitality
In the past, it was generally believed that sperm motility was poor, and could not swim into the cervix, uterus, and fallopian tubes by itself, and the egg was conceived, but more and more studies have been conducted on patients with poor sperm motility on the surface, and it is also possible to impregnate the woman, but the probability of miscarriage after conception is significantly higher than that of the normal population, which may be related to the quality of sperm itself, and low sperm motility is only a manifestation of poor sperm quality.
06
Unknown cause
The female factor was ruled out, and the male examination showed no obvious abnormalities, but still had recurrent miscarriages, which is not uncommon in clinical practice, and such people may be related to age, living environment, smoking, drinking and other unhealthy lifestyles.
Therefore, couples who are planning to have children should quit smoking and drinking as soon as possible, develop good living habits, and actively seek to go to the hospital for examination in case of repeated miscarriages and fetal growth stoppage, and do not neglect the man
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