The reasons women cannot get pregnant are not limited to ovarian hypofunction or oviductal obstructions — sometimes the uterine environment can cause infertility, a gynecologist said.
Fertility Society of the Republic of China chairman and clinical gynecologist Chang Fan (張帆) said the nation’s fertility rate was lower than all 193 countries listed on the UN’s World Fertility Patterns in 2013.
The Health Promotion Administration’s statistics also show that the prevalence of infertility in Taiwan was about 10 to 15 percent — approximately one in seven couples is infertile, he said.
Chang said a 29-year-old woman surnamed Hung (洪) suffered severe menstrual pain and after trying for two years, was unable to become pregnant. A doctor diagnosed her with endometriosis — endometrial tissue that normally lines the uterus grows outside the uterus — and adenomyosis — endometrial tissue that exists within and grows into the muscular wall of the uterus — and recommended that she have her uterus removed.
Hung sought further medical advice from Chang, as she wanted to have a baby.
Chang suggested modified surgery to remove most of the endometrial tissue and ovarian cysts. Hung conceived one month after the surgery.
Chang said adenomyosis is similar to endometriosis, but the endometrial tissue grows inside the muscular wall of the uterus, making the uterine muscle wall relatively thick and inelastic, which can cause heavy or prolonged menstrual bleeding, severe cramping or sharp pelvic pain during menstruation.
Traditional treatments include a hysterectomy or temporary injections, but these methods can affect a patient’s ability to conceive, he said.
Chang said in vitro fertilization is often the most effective treatment for infertility, but if the uterus is inhospitable, a fertilized ovum cannot survive.
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