The doctor named the reasons that prevent women from getting pregnant

According to statistics, every sixth couple in Russia cannot have children. What medical reasons prevent representatives of the fair half of humanity from realizing their reproductive potential? Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology of the Sechenov University of the Ministry of Health of Russia, Honored Doctor of the Russian Federation Inna Apolikhina told the MK observer about this on the sidelines of the First Sechenov International Forum of Motherhood and Childhood.

— The topic of reproductive health is comprehensive, and there are many reasons that can prevent you from realizing your reproductive potential. Often a woman is unable to get pregnant not because of problems with her own health, but because of problems with the health of her husband – therefore, at the first stage, we note the factor of male infertility. However, if everything is fine with the man, you need to carefully examine the woman’s health for various disorders.

— Inna Anatolyevna, what are the main diseases that prevent a woman from getting pregnant?

— One of the main reasons is a disease that is called the mystery of the 21st century — endometriosis. Endometriosis is the growth of cells in the inner layer of the uterus (tissue similar to the endometrium) beyond its boundaries. That is, on the peritoneum, fallopian tubes, ovaries. Today it is known that approximately every tenth woman of reproductive age suffers from severe endometriosis. The most unpleasant thing is that this disease is accompanied by severe pain, which is more often associated with the menstrual cycle. This requires treatment, usually surgical and then, without fail, hormonal. What’s sad is that endometriosis is often accompanied by adhesions and obstruction of the fallopian tubes, all of which prevent conception.

The next reason why the joy of motherhood may become inaccessible to a woman is a dishormonal disorder in the female body, in which ovulation is blocked, and this condition is called “polycystic ovary syndrome.”

Another reason why pregnancy may not occur is uterine fibroids, especially if the fibroid node grows directly in the uterine cavity. Today, fibroids are the most common chronic disease in women. It is more common than chronic bronchitis, cholecystitis or colitis. On average, every second representative of the fair sex during reproductive age is diagnosed with fibroids – a benign tumor-like formation. Or maybe even more often.

A huge problem is inflammatory diseases that cause pronounced adhesions in the pelvis and obstruction of the fallopian tubes. Often such inflammations develop after sexually transmitted infections. Previously, gonorrhea, trichomoniasis, and chlamydia manifested themselves with a clear clinical picture. But now we are seeing more subtle forms of these diseases, and therefore women do not see a doctor on time, when treatment is most effective. Also among the reasons for ineffective treatment is the increasing antibiotic resistance. This leads to the fact that often a woman does not even know that she has suffered from a sexually transmitted disease, and as a result she ends up with infertility.

Unfortunately, recently cancer of the female reproductive system (including cancer of the breast, uterus, cervix, ovaries) has become younger. Women who encounter this disease during their reproductive years may subsequently have problems with pregnancy and childbirth.

But modern medicine offers a way out of this situation. Today, doctors treat cancer even during pregnancy and subsequently enable the patient to find the happiness of motherhood. It is important to remember that after 35 years a woman’s ovulatory potential decreases, so we recommend freezing eggs for both cancer patients and women in general, especially after 35 but before 40 years of age.

Today we are actively introducing modern diagnostic methods into clinical practice, which allows us to diagnose many diseases at an early stage, including those that have a hidden course. This allows them to be treated quickly and significantly increases the chances of women becoming mothers.

— We talked about what medical reasons prevent a woman from getting pregnant. However, sometimes it happens that a woman becomes pregnant but cannot carry the child to term. What are the main reasons?

— Yes, sometimes a woman does not have the opportunity to carry her pregnancy to the optimal period, when the child is already viable. Miscarriage is a multifactorial problem. It may be related to characteristics of the body, such as bleeding disorders, inflammation, cervical problems and genetic factors. And there are many purely obstetric conditions such as preeclampsia, fetal growth restriction, gestational diabetes mellitus and breech, placenta accreta and abruption.

– There is a belief that if a woman becomes pregnant, the fibroids will resolve…

– It is not right. The pregnant uterus requires improved blood supply, but against the background of good blood supply, myomatous nodes can also grow during this period.

— What measures need to be taken to improve a woman’s reproductive health?

— To maintain her women’s health, a woman needs to regularly see doctors and undergo a medical examination. During the medical examination, the doctor may suspect problems in her health. And at the stage of prenatal preparation, we are waiting not only for the woman, but also for her husband. It is advisable for my husband to visit a urologist. And we should not forget that the course of pregnancy can be disrupted by alcohol and smoking. So a healthy lifestyle and regular examinations are the basis of reproductive health.

Published in the newspaper “Moskovsky Komsomolets” No. 29225 dated February 28, 2024

Newspaper headline:
Motherhood: Mission Impossible