Infertility caused by external genitalia and vaginal diseases accounts for 1% to 5% of infertility cases. The vagina is the receptacle for sexual intercourse and semen; certain structural or functional diseases of the external genitalia and vagina can affect the entry and storage of semen or sperm in the vagina, or due to changes in its environment, impair the normal function of sperm, leading to infertility.
Vulvovaginitis
The reproductive tract of a normal woman of childbearing age has a natural defense mechanism. The vaginal microecology is dominated by vaginal bacilli. Under the influence of estrogen, the vaginal epithelium continuously proliferates and is rich in glycogen. With the help of vaginal bacilli, glycogen is broken down into lactic acid, maintaining a vaginal pH of 4-5, effectively killing pathogens or inhibiting their reproduction. Since vaginal bacilli form a biofilm on the vaginal wall that provides protection, even though different microorganisms are often seen in the vulva and vagina of normal women, clinically they do not show signs of inflammation.
In clinical practice, when examining vaginal fluid (leukorrhea), one test is for cleanliness, which is based on the proportion of dominant vaginal bacilli in the vagina. The cleanliness of vaginal discharge (examined by Gram stain microscopy) can be divided into four degrees.