1. Gamete transport disorders caused by various factors on the female side.
(1) Tubal obstruction: double tubal obstruction or severe pelvic adhesions confirmed by hysterosalpingography (HSG) or laparoscopy or open surgery or hysteroscopy; after bilateral salpingo-oophorectomy, and failed post-tubal ligation recanalization;
(2) Tubal inflammation: one tubal obstruction or bilateral tubal patency or incomplete obstruction confirmed by HSG, after conservative treatment, repeated ovulation monitoring + guided intercourse for more than 6 months without pregnancy; or after 3 cycles of IUI fertility treatment without pregnancy, considering bilateral tubal dysfunction;
(3) Those who are still infertile after more than one year of active treatment after laparoscopic or open tubal plastic surgery.
2. Ovulation disorders.
(1) Polycystic ovary syndrome (PCOS), follicular luteinization unruptured syndrome (LUFs), etc., with mature follicles developing after 3 cycles of effective ovulation promotion plus HCG application but follicles cannot be expelled normally;
(2) Those who have normal ovulation after treatment for ovulation disorders and are not pregnant after guided intercourse should first undergo IUI treatment and switch to IVF if they fail to get pregnant in 3 cycles.
3. Endometriosis.
(1) Those who are infertile after six months of drug and/or surgical treatment for severe endometriosis;
(2) Patients with mild or moderate endometriosis or recurrence of endometriosis after surgery, who refuse to undergo surgery and fail to conceive after 3 cycles of natural cycle + IUI or ovulation promotion + IUI treatment;
(3) Patients with endometriosis combined with other infertility factors who need IVF treatment.
4.Low, weak and malformed spermatozoa in male partner.
(1) Those with sperm density of 5-20×106/ml, 30% a grade >15%, normal form >5% and absolute value of sperm >10×106 after treatment should first undergo IUI treatment, and those who fail to conceive in 3 cycles can change to IVF treatment;
(2) IVF-ET treatment is considered for those with semen density of 1-5×106/ml, normal morphology >5% and absolute value of spermatozoa above 1×106 after treatment.
5. Unexplained infertility.
(1) Infertility for more than 3 years, with no obvious abnormality found in both male and female partners by routine infertility examination, meeting the following conditions.
(1) It is confirmed that the female partner has a regular ovulation cycle and the fallopian tubes are open;
②Two normal semen analyses;
(iii) normal pelvic cavity on laparoscopy;
④Post-coital test is positive. These patients can undergo IVF if they have not conceived after natural cycles or 3 cycles of ovulation promotion + IUI;
(2) If the primary infertility is more than 5 years old and meets the other conditions mentioned above but refuses to undergo laparoscopy and cannot be diagnosed with unexplained infertility, IUI treatment can be performed first and then IVF treatment can be performed for 3 cycles of infertility.
6.Immune infertility: If the primary infertility is more than 3 years old, except for other reasons, and the presence of immune infertility factors is considered, 3 cycles of IUI can be performed first, and IVF can be performed instead if the infertility is not detected.
7. Indications for donor sperm IVF
(1) The male partner is an azoospermic patient who is eligible for donor insemination, but the female partner also has the above infertility factors;
(2) The patient has not conceived after 3 to 4 cycles of AID and requests for IVF with donor sperm;
(3) The male partner can obtain sperm by testicular or epididymal puncture before the assisted conception procedure, and he intends to undergo ICSI assisted conception treatment, but the sperm retrieval fails on the day of egg collection, and he voluntarily adopts the donor sperm provided by the human sperm bank for IVF.