When interpreted through modern medicine, the 'uterine coldness' described in Donguibogam—namely cold coagulation in the uterus—extends beyond the sensory feeling of feeling cold, being closely tied to diminished blood circulation around the uterus and ovaries. The uterus and ovaries are key organs in intricate reproductive processes, including reproductive hormone secretion, oocyte maturation, and implantation. When blood flow here is not smooth, various problems arise.
First, decreased ovarian blood circulation can lower the quality of an ovum. An ovum must receive sufficient oxygen and nutrients during its growth process, but when blood flow decreases, the exchange of substances required for ovarian follicle growth and oocyte maturation cannot occur properly. This may increase immature oocytes or elevate the possibility of oocyte chromosomal abnormality, reducing the success rates of fertilization and implantation. Furthermore, it can affect the function of the corpus luteum formed after ovulation, potentially leading to insufficient progesterone secretion.
Second, decreased blood flow to the endometrium degrades the implantation environment. For a zygote to successfully implant in the uterus, a sufficiently thick endometrium with well-developed blood vessels is essential. If blood flow to the uterus weakens, the endometrium thins or vascular development becomes inadequate, making it difficult for the zygote to take stable root in the endometrium. Indeed, when endometrial blood flow in women with subfertility is measured using ultrasound, reports often indicate a lower blood flow volume compared to healthy women of fertile age.
Third, cold qi can also be connected to reduced immunity and inflammatory reactions. Chronic reductions in blood flow cause localized oxygen deprivation, which can accelerate the increase of reactive oxygen species (free radicals) and inflammatory responses. Such a microinflammation environment damages the health of the ovum and spermatozoon and leads to reduced endometrial receptivity, hindering implantation. In addition, under stressful conditions, the sympathetic nervous system undergoes hyperactivation and constricts blood vessels, further reducing blood supply particularly to the reproductive organs, creating a cold womb environment and potentially forming a vicious cycle contributing to subfertility.
In conclusion, uterine coldness in Donguibogam aligns with various causes of subfertility explained by modern medicine, such as ovarian hypofunction, reduced endometrial receptivity, hormonal imbalance, and chronic inflammation, suggesting that establishing a warm, healthy uterine environment is a crucial key to achieving a successful pregnancy.
