Last year the Family Planning Office at the OBGYN (Obstetrics and Gynecology) department at the Veterans' General Hospital undertook a study of its patients. The study discovered that the incidence of infertility has gone up from ten percent in the past to 14%. Many OBGYN doctors confirm that there has been a steady increase in infertility in Taiwan.

"Naturally this is related to industrial and commercial development," Tzeng Chii-ruey, director of the In Vitro Fertilization Laboratory of the OBGYN department at the Taipei Medical College Hospital, points out, coming straight to the point. In both Orient and Occident, the increase in infertility has been seen as a "disease of civilization." He suggests that in a hectic industrial and commercial society, there are many "supermen" and "superwomen" who are still unmarried past thirty years of age. Women's fertility is strongest between the ages of 20 and 25, but this is the time when they are busiest in study or work. Even if married, because having a child requires considerable attention, they often look first to stabilizing the family economic situation or pursuit of success in personal careers, and choose to delay pregnancy. As a result there has been a sharp increase in the number using birth control pills or inserting birth control devices. The former may lead to an inability to restore ovulation in some women, while the latter can easily lead to pelvic infection or produce scars in the oviduct, creating blockages and infertility.

The medical community has also discovered that 40% of cases of infertile women are due to "endometriosis". This probably accounts for the largest group of infertile women.

National Taiwan University Hospital obstetrician Li Tse-yao calls endometriosis a "disease of civilization." This is because it was only discovered 80 years ago. Soung Yung- kuei, chairman of OBGYN at Chang Geng Memorial Hospital, explains that in an agricultural society a woman's menstrual cycle begins relatively late. Add to this relatively early marriages and frequent, closely spaced births, and these factors greatly reduced the number of menstrual periods a woman had in a lifetime, which naturally reduced the possibility for cells in the inside membrane of the uterus to shift position. Compared to this, modern people have relatively better nutrition and mature faster, working women marry later, and there has been a great decrease in frequency of births, so that the number of periods in a lifetime correspondingly increases, so it is not strange that the number of people afflicted with endometriosis increases greatly.

The problem is not confined to women. "Sperm activity also noticeably decreases in men over forty," says Taipei Medical College urologist Chang Han-sheng. In fact, according to statistics, failure to conceive is due to a problem with the woman in only one-third of cases. Both the man and woman are responsible in another one-third, and the problem is solely with the man in the final one-third.

In the living environment of modern people, the air, water, and food all have relatively more "dangerous components" than in the past. For example, studies show that when a great deal of artificial sweeteners go through the placenta, this can cause the fertilized egg to slip, leading to miscarriage, early birth, or infertility.

Further, a liberalized sexual outlook has also contributed to the avalanche of infertility in modern people.

In recent years, because of sexual freedom and use of unsanitary public bathrooms, there has been a spread of chlamydia. This has been seen as a major cause of infertility by obstetricians and gynecologists.

The main cause often cannot be found in many cases of infertility, or treatment is in effective, so that sufferers abandon hope. Yet as soon as their mood clears up or when the husband and wife can get away from work to go on vacation, it's not long before they have good news.

This type of "psychosomatic sterility" brought on by work or other psychological pressures is also increasing.

How can pressure cause infertility? There is a close relationship between ovulation activity and hormones produced by the brain. Pressure can cause irregular hormone release, which affects ovulation. Further, the oviduct and vagina are controlled by the "autonomous nervous system" so that changes in mood can indirectly lead to cramps or spasms in the two areas. In clinical studies, doctors have been able to see from films that the oviduct relaxes and contracts with changes in mood. Sometimes the oviduct closes, and sometimes returns to normal. Once a patient begins to consciously strongly desire a child, the psychological pressure increases, and there is even less chance of conception.

According to the same logic, psychological pressure can also cause irregular sperm production in men, and poor sperm quality is a major factor in inability to conceive.

In fact, following treatment for infertility or sterility, 70% to 80% of patients can successfully conceive, without the need for artificial insemination. Some doctors even say that up to one-fourth of cases of infertility are because of pressure, and that after seeing a doctor and understanding the cause, no treatment is necessary, and pregnancy can result within a couple of months.

This is a reason why many doctors advise infertile women not to be obsessed with "test-tube babies," and not to abandon natural pregnancy.

[Picture Caption]

Is the increase in the number of infertile or sterile people an indicator of modernity? How many people must wish for something like these little dolls! (photo by P u Hua-chih)