Cervical canal during pregnancy and infertility
Pregnancy is a special state of the female body when it switches to a new mode of operation and everything that happens in it is aimed at preserving and developing the unborn child. This applies to all internal organs, closely interconnected with each other, including the cervical canal.
What is the cervical canal and what is it for? This is a 7-8 mm wide area of the cervix with two fauces (holes) connecting the vagina with the uterine cavity. It is through him during menstruation that blood comes out and through it after intercourse sperm pass. In the cervical canal, they interact with the secretions of the female reproductive tract, as a result of which the reactions necessary for the fertilization of the egg are triggered.
A feature of the cervical canal is that at conception it changes its color (usually bright pink or whitish) to a bluish tint, and on this basis, the doctor can establish pregnancy in the early stages.
From the inside, the canal is covered with epithelial cells that secrete mucus (secretion), which during pregnancy forms a dense mucous plug. Such a plug reliably protects the placenta and the fetus in the uterus from the penetration of unwanted microorganisms from the vagina over the next 9 months. The mucous plug leaves shortly before childbirth - in someone for 1-2 weeks, in someone for 2-3 hours, and then a woman can observe the release of yellowish or colorless mucus, sometimes streaked with blood.
Cervical mucus is a complex biological substance, 50% composed of water, as well as electrolytes, proteins, polysaccharides, mucin and lysozyme. Its formation directly depends on the ratio of the amount of hormones - estrogen and progesterone. Estrogens, the hormones of the first phase of the menstrual cycle, stimulate the production of abundant cervical mucus, while progesterone, the hormone of the second phase of the cycle, suppresses the secretory activity of the cervical glands.
In addition, just before childbirth, the lumen of the cervical canal expands to 10 centimeters. By nature, such a function was laid in the woman's body so that the process of the birth of a little man into the world would not be complicated for the woman in labor.
But not always during pregnancy everything goes well and smoothly, in some cases, a woman has ischemic-cervical insufficiency (PPI). It manifests itself in the inability of the cervix to hold the rapidly growing fertilized egg. Most often, PPI develops by 16-18 weeks of gestation, when the embryo begins to quickly increase in size and push in the abdomen. The provoking moment for premature termination of pregnancy at this stage can be just coughing, sneezing, lifting weights and even simple fetal movements.
Another reason for the development of PPIs can be a high concentration of male hormones androgens in a woman's blood, which in large quantities causes a softening of the cervix.
In all these cases, a woman should be under the supervision of a doctor, sometimes a surgical operation may be prescribed, after which the cervix will not be able to open until a certain period (before delivery). For this, special sutures are applied or after 24 weeks, obstetric devices in the form of rings and a pessary are used.
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It is also known that the great misfortune of many married couples is the inability of women of reproductive age to have a child, i.e. infertility. It is believed that in some cases it is also associated with disorders localized in the cervix, namely, in the cervical canal. The percentage of infertile married couples today reaches 15%.
In recent years, for many women, the development of a professional career has been a priority, so the birth of a baby is most often planned after 30 years. As a result, various difficulties arise with pregnancy and bearing a child. For example, the infertility of women over 35 is expressed in the inability to become pregnant during six months of open sexual relations. This is due to the fact that women of this age group have a reduced reserve of oocytes capable of fertilization.
To this can also be added the cervical (cervical) factor of female infertility, manifested in two types of disorders: narrowing of the uterine canal and violation of the composition of cervical mucus (the latter is much more common). Violations localized in the cervix are the cause of 5-10% of all cases of infertility.
The mucus produced by the cervix plays a leading role in the transport of sperm. During the entire menstrual cycle, its composition changes, which occurs under the influence of the female sex hormones estrogen. At the beginning of the cycle, the mucus is dense, viscous and poorly permeable, by the time the ovum matures, it becomes less viscous, transparent and acquires an alkaline reaction. Microchannels are formed in it, along which sperm move, while simultaneously being exposed to the stimulating effect of cervical mucus.
The functional role of mucus is to screen out non-viable sperm and various impurities in the semen. When the properties of cervical mucus change, for example, with a lack of estrogen or as a result of taking certain medications, it thickens, its production decreases and sperm (even viable ones) cannot move freely in it.
The transport of spermatozoa into the uterine cavity is also difficult when the cervical canal is narrowed. This pathology can be congenital, acquired as a result of infection or inflammation, or surgery.
Treatment of infertility in case of violations in the cervical canal is a difficult, lengthy process, but not hopeless, just a woman needs to strictly adhere to all the doctor's recommendations.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
