Embryo stasis

　　Embryo stasis refers to the cessation of development of the early embryo due to some reasons. Ultrasound examination shows that the fetus bud or fetus in the gestational sac is irregular, without fetal heartbeats, or the gestational sac is withered. Clinically, it belongs to the category of miscarriage or stillbirth. There are many reasons for embryo stasis.

　　Endocrine disorders

　　The implantation and continued development of the embryo depend on the complex endocrine system coordinating with each other. Any abnormality in any link can lead to miscarriage. During the early development of the embryo, three important hormone levels are required: estrogen, progesterone, and human chorionic gonadotropin. As for the mother, if her endogenous hormones are insufficient, she cannot meet the needs of the embryo, which may cause the embryo to stop developing and lead to miscarriage. The most common problem is the dysfunction of the corpus luteum, which can cause delayed development of the endometrium and a short luteal phase, thereby affecting the implantation of the fertilized egg or early pregnancy miscarriage. Patients with incomplete corpus luteum function often have other glandular dysfunction, such as hyperthyroidism or hypothyroidism, diabetes, relative increase of androgenism, and hyperprolactinemia, etc. These factors are all unfavorable for embryo development and are closely related to miscarriage.

　　Immune factors

　　The embryo or fetus in the uterine cavity during pregnancy is actually a xenograft of the same species, because the fetus is a combination of the genetic material of the parents and cannot be completely the same as the mother. The immune incompatibility between mother and fetus leads to rejection of the fetus by the mother. Common autoimmune diseases include systemic lupus erythematosus, scleroderma, mixed connective tissue disease, dermatomyositis, and others. The second issue is reproductive immunity. If we carry a certain antibody, it may affect the development of the embryo. In fact, the detection of antibodies varies from hospital to hospital, and the opinions of doctors are also different. From our research perspective, we believe that there are four influencing factors: first, anti-sperm antibodies, which may resist the combination of sperm and egg if present; second, anti-endometrial antibodies, which may affect the development of the embryo if they exist, and resist the development of the embryo; third, anti-ovarian antibodies, which may affect the quality of the egg if present; fourth, anti-chorionic gonadotropin antibodies, which are an important hormone that needs to be secreted seven days after the sperm and egg combine. However, if there is such an antibody, it may resist the secretion of the hormone, possibly causing the embryo to stop developing.

　　Uterine abnormalities

　　The internal environment and the overall environment of the uterus can both have an impact on the embryo. The internal environment refers to the endometrium, which can affect implantation if it is too thin or too thick. Abortion caused by uterine defects accounts for about 10% to 15%. Common conditions include: (1) Congenital Müllerian duct abnormalities, including unicornuate uterus, bicornuate uterus, and bicorne uterus leading to a narrow uterine cavity and restricted blood supply. Abnormal development of uterine arteries can lead to asynchronous decidualization and implantation abnormalities. (2) Uterine adhesions, mainly caused by uterine trauma, infection, or placental tissue residue leading to uterine adhesions and fibrosis. This hinders normal decidualization and placental implantation. (3) Uterine fibroids and endometriosis can lead to reduced blood supply, resulting in ischemia and venous dilation, asynchronous decidualization, abnormal implantation, and hormone changes caused by fibroids, which can also lead to pregnancy failure. (4) Congenital or traumatic cervical incompetence, as well as cervical maldevelopment caused by ethinyl estradiol treatment during fetal development often leads to mid-trimester pregnancy loss.

　　Chromosomal issues

　　If there is chromosomal abnormality, it can also lead to the failure of embryo development and early abortion. Chromosomal abnormalities include quantitative and structural abnormalities, and quantitative abnormalities can be divided into aneuploidy and polyploidy. The most common abnormal karyotype is trisomy, and 16 trisomy accounts for 1/3, which is often lethal. In 25-67% of trisomy 21, 4-50% of trisomy 13, and 6-33% of trisomy 18, abortion is inevitable. Other abnormalities include monosomy (4SX), and tetraploidy due to abnormal cleavage can lead to embryo non-development. Structural abnormalities include deletions, balanced translocations, inversions, and overlaps. Balanced translocation is the most common chromosomal abnormality. Current research on chromosomal issues believes that pairing, exchange, and separation of chromosomes form gametes, and gametes combine to form zygotes. If there is an abnormal zygote, it will lead to abnormal development, which can cause abortion, stillbirth, neonatal death, and malformed children. Therefore, prenatal diagnosis is necessary to prevent the birth of children with chromosomal abnormalities. For abortions and fetal arrest caused by chromosomal abnormality carriers, there is currently no effective treatment method in Western medicine, and only prenatal genetic counseling and diagnosis can be carried out. In theory, there is a chance for normal karyotype delivery and carrier infants for chromosomal abnormalities. Prenatal diagnosis for these couples ensures the birth of normal infants. Of course, current research also shows that both partners have normal chromosomes, but chromosomal abnormalities occur during gamete formation and embryo development. If the age of the female is greater than 35, the egg becomes aged, and it is easy to have chromosomal non-separation, leading to chromosomal abnormalities; seminal fluid abnormalities, such as sperms with大头畸形 are mostly diploid, which can form polyploid embryos after fertilization and lead to abortion. The influence of adverse environmental factors such as toxic chemicals, radiation, and high temperatures can also cause chromosomal abnormalities in embryos. Therefore, the key to preventing fetal arrest caused by chromosomal abnormalities is to regulate the physical condition of both partners, so that the functions of each organ are normal and coordinated, yin and yang are balanced, choose the best time for pregnancy, and stay away from adverse environments.

　　Genital tract infection

　　In addition to the above factors, early pregnancy loss caused by infection has been increasingly emphasized by Chinese and foreign scholars. Severe TDRCH infection in the early stages of pregnancy can cause embryonic death or abortion, while mild infection can also cause embryonic malformation. Studies have shown that cytomegalovirus can cause missed abortion and intrauterine fetal death. After the mother is infected, the pathogen can enter the placenta through the blood, causing damage to the chorionic and capillary endothelium, destroying the placental barrier, and leading to abortion, embryonic arrest in development, and fetal malformation. Many studies have shown that mycoplasma infection is related to embryonic arrest, and the positive rate of mycoplasma infection in cervical secretions of women with embryonic arrest is significantly higher than that of normal women, with extremely significant differences.

　　Environmental factors

　　Changes in the physiological state during pregnancy have caused significant changes in the absorption, distribution, and excretion of treatment drugs and various environmental harmful substances by the mother's body. In the early stages of development, the embryo is extremely sensitive to the effects of treatment drugs and environmental factors. At this time, various harmful factors can cause embryo injury or even loss. Many drugs and environmental factors are important factors causing early embryonic death or fetal malformation. Environmental hormones can directly act on the central nervous endocrine regulatory system, causing reproductive hormone secretion disorder, leading to a decrease in fertility and abnormal embryo development. The environmental factors causing abortion are diverse, including physical factors such as X-rays, microwave, noise, ultrasound, and high temperature, as well as heavy metals such as aluminum, lead, mercury, and zinc, which affect the implantation of the fertilized egg or directly damage the embryo, leading to abortion. Various chemical drugs such as dichloropropane, carbon disulfide, anesthetic gases, oral antidiabetic drugs, and others can interfere with and damage reproductive function, leading to embryo abortion, stillbirth, malformation, developmental delay, and dysfunction. In addition, poor living habits such as smoking, alcoholism, coffee, drugs, and certain medications all affect early embryo development.

　　If a dead fetus remains in the uterus for too long without treatment, it can have adverse effects on the mother. Usually, if the fetus remains in the abdomen for more than four weeks, the pregnant woman may develop complications such as impaired blood coagulation function.

　　If embryonic arrest occurs, all pregnancy reactions of the pregnant woman will gradually disappear. First, there will no longer be nausea and vomiting, and the feeling of breast swelling will also weaken. Then, vaginal bleeding will occur, often in dark red vaginal discharge. Finally, there may be lower abdominal pain and the expulsion of the embryo. These symptoms vary from person to person, with some experiencing no signs at all before abdominal pain occurs, followed by miscarriage, or the embryonic arrest is asymptomatic and discovered through routine B-ultrasound examination. Most pregnant women show no obvious symptoms after the fetus stops developing, while some may have spotting without abdominal pain, which is different from threatened miscarriage.

　　1. Chromosomal abnormalities.Before pregnancy, pre-pregnancy examination and medical diagnosis should be carried out. If there is a family history of hereditary diseases, consider not becoming pregnant or taking effective care measures.

　　2. Abstain from harmful substances.If engaged in related industries, it is advisable to change to other departments a few months before conception. For newly decorated homes, it is recommended not to move in too early and only move in after the detection is qualified. Choose clean and non-polluted food for diet.

　　3. Radioactive light.Avoid pre-pregnancy X-ray examination. When the microwave oven is operating, it should be kept at a certain distance, about one meter or more. Do not carry a mobile phone for a long time, and use it only when necessary.

　　4. Drug effects.If there is no intention to conceive, proper contraception should be taken. When preparing for pregnancy, if symptoms occur, the first thing to confirm is whether pregnancy has already occurred. If so, medication should be taken cautiously. It is best to consult a doctor and choose medication that is beneficial to the patient's condition and has no impact on the fetus.

　　5. Smoking and drinking.Both partners should quit smoking and drinking before and during pregnancy to avoid the impact of smoking and drinking on the fetus inside the abdomen.

　　6. Viral infection.Pregnant women should be vaccinated against rubella in advance. In the first three months of pregnancy, avoid staying in public places for too long and do appropriate physical exercise to enhance physical fitness and self-satisfaction. Maintain a balanced diet.

　　7. Chronic severe diseases.Medications for treating chronic diseases can have a significant impact on the fetus. If the patient needs to become pregnant, they should discontinue medication for a period of time, and pregnancy is suitable only when the condition is stable.

　　8. Immune system abnormalities.For women with immune system abnormalities, pregnancy should be postponed until the condition is completely recovered. In daily life, they need to exercise more, maintain a balanced diet, and enhance immunity.

　　Ultrasound examination should be performed in the early pregnancy to avoid missed diagnosis of fetal pregnancy failure. Ultrasound monitoring of embryo and fetal development, if ≥6 weeks without gestational sac, or although there is a gestational sac but deformed and shrunken, when the gestational sac has reached ≥4cm but the fetal bud is not visible, and the head and arm length of the fetal bud is ≥1.5cm but there is no fetal heartbeat, it can be determined that the embryo or fetus has abnormal development. The latter three conditions can be diagnosed as fetal pregnancy failure.

　　In addition, blood β-hcG determination is also helpful for the diagnosis of fetal pregnancy failure. If ≥5 weeks, blood β-hcG

　　Male examination items

　　1. Semen cytopathology examination: Determine sperm viability and the presence of malformed sperm.

　　2. Male prostate examination: Prostatitis can lead to abnormal seminal fluid.

　　3. Karyotype examination: Chromosomal abnormalities are an important cause of fetal pregnancy failure.

　　Female examination items

　　1. Six tests of female sex hormones: female hormone levels determine the quality of follicle development, and the quality of the follicle directly affects the quality of the embryo. When the quality of the embryo is poor, it is easy to cause fetal pregnancy arrest. The test of the six hormones (i.e., ovarian reserve function) is usually performed on the third day of the menstrual period.

　　2. Four major female reproductive health tests: including rubella virus, cytomegalovirus, toxoplasma, and herpes simplex virus. Due to low immunity, pregnant women and women planning to become pregnant have a high chance of infection in the fetus. These infections not only lead to fetal pregnancy arrest but can also cause birth defects in infants.

　　3. Immune antibody test: including tests for anti-sperm antibody, blocking antibody, anti-embryo antibody, anti-ovary antibody, anti-nuclear antibody, anti-endometrial antibody, anti-human chorionic gonadotropin antibody, and anti-cardiolipin antibody, etc. The clinical manifestation of immune infertility is fetal pregnancy arrest.

　　4. Thyroid function test: thyroid dysfunction is a factor that can lead to fetal pregnancy arrest.

　　5. Routine screening of vaginal discharge: to check for infections such as trichomoniasis, candidiasis, mycoplasma, chlamydia, and bacterial vaginosis.

　　6. Detection of sexually transmitted diseases such as gonorrhea and syphilis.

　　7. Determination of cervical mycoplasma and chlamydia.

　　8. Hysteroscopy: to determine whether there is adhesion in the uterine cavity, uterine fibroids, uterine malformations, and other issues.

　　9. Ultrasound of the uterus and adnexa.

　　10. ABO hemolytic disease, Rh blood group antigen system examination. Examination subjects: women with blood type O, husbands with blood type A or B, or those with a history of unexplained abortion.

　　11. Chromosome examination.

　　Hawthorn can stimulate uterine contraction, and pregnant women with a history of spontaneous abortion or symptoms of threatened abortion should not eat too much during pregnancy; however, they can eat more after delivery to help the uterus recover.

　　The alkaloids in potatoes belong to the class of steroid glycoside alkaloids, mainly solanine and chaconine. Their structure is similar to human steroid hormones, such as androgens, estrogens, and progesterone. If pregnant women consume potatoes with a high content of alkaloids for a long time in large quantities, it can accumulate in the body and lead to fetal malformation. It is better for pregnant women not to eat or eat less potatoes, especially not to eat long-stored, sprouted, or moldy potatoes.

　　Canned foodPreservatives and additives are dangerous factors that can lead to fetal malformation and abortion.

　　Warm and nourishing tonicsPregnant women have a significantly increased blood flow in the circulatory system, which increases the burden on the heart. The blood vessels in the cervix, vaginal wall, fallopian tubes, and other parts are also in a state of expansion and congestion. In addition, due to the vigorous endocrine function of pregnant women, the secretion of aldosterone increases, which is prone to water and sodium retention, leading to edema and hypertension and other diseases. Moreover, due to the decrease in gastric acid secretion, the gastrointestinal function is weakened, and symptoms such as anorexia, abdominal bloating, and constipation may occur. In this situation, if pregnant women often take warm and nourishing herbal medicines and tonics, such as ginseng, deer antler, deer placenta glue, deer horn glue, longan, lychee, and walnut meat, it is bound to lead to Yin deficiency and Yang excess, imbalance of Qi, excessive Qi consumption, and blood heat, exacerbating symptoms such as morning sickness, edema, hypertension, and constipation, and even causing abortion or stillbirth.

　　Moldy Food: If pregnant women consume agricultural and food products or food contaminated with mycotoxins, not only will acute or chronic food poisoning occur, but it can even affect the fetus. Because in the first 2-3 months of pregnancy, the embryo implants and develops, and the embryonic body cells are in a highly proliferative and differentiated stage. The invasion of mycotoxins can cause chromosome breakage or deformation, leading to genetic diseases or fetal malformations, such as congenital heart disease, congenital idiocy, and so on. Some may even cause fetal arrest and stillbirth or miscarriage. On the other hand, in the middle and late stages of pregnancy, due to the incomplete function of the fetal organs, especially the fragile functions of the liver and kidney, mycotoxins can also produce toxic effects on the fetus. A large amount of medical research data has confirmed that mycotoxins are a strong carcinogen, which can cause maternal and fetal liver cancer, stomach cancer, and so on. In addition, if the mother is in a coma or vomiting due to food poisoning, it is extremely harmful to the growth and development of the fetus.

　　When pregnant mothers unfortunately are diagnosed with fetal demise, do not panic. Usually, it is necessary to undergo abortion treatment under the guidance of a doctor. Fetal demise is different from early pregnancy, and medical abortion is not easy to completely remove, and if it remains in the uterus for a long time, it can cause intrauterine infection, damage the endometrium, and subsequently lead to fallopian tube obstruction, resulting in infertility.

　　For women who have experienced fetal demise, considering the perspective of eugenics, it is at least necessary to wait for more than half a year before getting pregnant again. This is because the recovery of ovarian function in humans takes at least two to three months, and the recovery of the endometrium takes at least about half a year.