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0SOCIAL SIGNIFICANCE OF FEMALE INFERTILITY
Jalilova Gulchehra Azamovna
Tashkent Pediatric Medical Institute https://doi.org/10.5281/zenodo.10854317
Abstract. The article describes that female infertility is an urgent problem in all countries of the world. According to the world data the reproductive potential of female population is decreasing, increasing the number of infertile couples. Nowadays the state of reproductive health of the population is a subject of interest not only for medicine, but also for the public and stands out by its social and political significance.
Keywords: female infertility, problems offemale infertility, modern state of the problem of female infertility
Relevance. Health is a key medical and social area associated with the development of human resources in society. Reproductive health is considered one of the main elements of general health. Health, fertility and safe motherhood among people of reproductive age are important aspects of public health [1].
Infertility in marriage is not only a personal and family tragedy, but also represents a significant and pressing social problem for modern society. Infertile couples form a part of society that can affect the demographic balance, and the costs of helping such couples are minimal compared to families who can give birth without medical support. The 15-20% of infertile couples of reproductive age represent significant potential for increased fertility. This group is statistically significant and requires prompt, effective, timely and specialized intervention [3].
Infertility plays an important role in both clinical, medical and socio-psychological practice. Infertility often leads to socio-psychological discomfort of spouses, conflict situations in the family and an increase in the number of divorces [4].
According to the WHO definition (2010), infertility is the inability of a sexually active, unprotected couple to conceive a child within one year [5].
In most cases, infertility is due to factors such as abortion, sexually transmitted diseases, gynecological problems, unsuccessful births and social conditions [6]. Despite progress in the field of reproductive technologies, the problem of infertility remains relevant.
The materials and methods of the study included an analysis of domestic and foreign literature on female infertility in the world and in Uzbekistan.
Research results. According to WHO, approximately 5% of the population suffers from infertility, where the causes are genetic, immunological, anatomical and endocrinological problems [5].
The demographics and prevalence of infertility vary from country to country, and research has shown that secondary infertility is more common than primary infertility.
The level of secondary infertility in the countries of Central Asia and Eastern Europe is high. In addition, the incidence of secondary infertility increases with age. Countries such as the USA, Finland and Norway are facing the problem of secondary infertility. Primary infertility is most common in North Africa and the Middle East. Latin American countries have the least difficulty with primary infertility. It should be noted that countries with lower fertility rates have a lower prevalence of infertility [7].
Despite significant medical advances in the treatment of infertility, the global prevalence of this problem has remained unchanged over the past 20 years.
According to international researches conducted in developed countries in recent years, at least 70 million couples in the world cannot have their own children. In addition, approximately one billion people have already been diagnosed with infertility. In the United States, according to the Center for Assisted Reproductive Health at the University of Maryland, about 10% of couples are infertile [3].
In 2014, 1.9% of women aged 20 years and older who wanted to have children experienced primary infertility, unable to get pregnant within five years. Another 10.5% of women who had children in the past were unable to become pregnant again after five years of trying, which is characterized as secondary infertility. A total of 4.85 million couples worldwide experience problems conceiving despite their desire to have children.
The global prevalence of infertility remained virtually unchanged between 1990 and 2010, with a slight decline of 0.1% in primary infertility over the two decades, with larger declines in sub-Saharan Africa and South Asia.
However, secondary infertility increased slightly by 0.4%. The proportion of primary infertility among women desiring children varies by region: by 2014, it ranged from 1.5% in Latin America and the Caribbean to 2.6% in North Africa and the Middle East. In the UK, 9% of couples are considered infertile, and only half of them seek help [3,9].
The problem of infertility is widespread throughout the world. Infertility rates in various regions have remained stable at between 8 and 18% for many years, with no downward trend.
Today, it is estimated that more than 80 million people suffer from infertility. According to the European Society for Reproductive Medicine, about 10% of married couples have problems conceiving, and in the United States this figure is 14.2%, which means that 6.1 million people in the United States experience reproductive difficulties [9].
In China, where the majority of the population lives, 40 million couples face infertility problems. The infertility rate 20 years ago was only 3%, but this figure has now risen to 15%, with 70% of female infertility cases associated with pelvic inflammatory disease. In many countries, including China, there is a problem of incomplete and insufficient screening of couples suffering from infertility. Almost all (98.9%) infertile couples did not undergo a complete examination to determine the causes of infertility.
In Japan, one in ten couples experience infertility, and 1.2 million couples are unable to have children despite their desire. In South Korea, about 1.4 million women are considered infertile, according to government data, meaning one in seven women of childbearing age will experience infertility.
Previously, infertility was considered a problem only in women, but it has now been proven that 40% of infertility cases are caused by male factors, 15% of which are unexplained [3,8]. In Uzbekistan, the female population is 18 million. More than 25,000 women and 7,000 men in Uzbekistan have been diagnosed with infertility. According to research, the proportion of married women suffering from primary infertility ranges from 4.9% to 5.3%. Recent studies have shown that infertility occurs in both men and women. Endocrine disorders and tubal diseases are the causes of infertility in women in 35-40% and 20-30% of cases, respectively. In 15-30% of cases, infertility is caused by gynecological diseases, and 20% by immunological problems [3].
The population in Uzbekistan is growing rapidly, but reproductive health and infertility problems are affecting the demographic situation. Among the factors influencing the demographic crisis, the reproductive health of the population and the increase in cases of infertility are of particular importance. Maintaining and restoring reproductive health are key tasks of the state, the correct solution of which determines the possibility of preserving the population and gene pool [3,5].
In 2019, Uzbekistan adopted Law No. 528 "On the protection of reproductive health of citizens," which provides women with access to infertility treatment and social support from the state. Infertility is a serious medical and social problem that requires immediate solutions. Approximately 20% of marriages in Uzbekistan face the problem of infertility, and some experts claim that this number could reach 24-25%.
According to WHO, the frequency of infertile marriages in Uzbekistan exceeds crisis levels and is a problem of national importance [5].
Conclusion. Thus, over the past decades, many problems of female infertility have been solved with the improvement of diagnostic and therapeutic approaches to this problem. The continuing high percentage of infertility among the population of developed countries speaks in favor of the relevance of the problem and the need for its further study and implementation of scientific results, both in medicine and practical healthcare.
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