As a clinical staff engaged in reproductive medicine, we often hear patients talk about their desire to have a child, the hardship of seeking medical treatment, and even their anger at being cheated. In addition, there is also the indifference and lack of responsibility of some individual doctors, which makes them disappointed and angry, and they even do not want to go to the clinic again. Patients’ complaints have their reasons. In fact, doctors also have difficulties: they have to see many patients every day, because infertility is different from other diseases, and the medical history to be understood is special, plus most patients do not want to reveal some private issues, and the complaints about unrelated conditions waste at least 2/3 of the doctor’s consultation time, the doctor simply does not have so much time to listen to the patient’s slow statement. Therefore, it is both the responsibility of the reproductive medicine clinician and the key to achieving the desired outcome for the patient in order to buy time, avoid or minimize detours, and fulfill the patient’s dream as soon as possible. The following specific recommendations can provide reference for infertile couples. Infertile couples should choose a hospital with a certain scale level. Because the causes of infertility are complex and often involve both men and women, the examination is extensive and cannot be completed without a hospital of a certain size to check the basic reproductive functions. If you can’t find the cause, you can’t talk about targeted treatment, how can you talk about achieving the expected results? Some hospitals advertise that they are specialist hospitals, but in reality they cannot even do some basic tests such as semen biochemistry and reproductive hormones; some do not even have the equipment and technology to support the examination and treatment such as hysteroscopy and laparoscopy, so how can we talk about comprehensive examination and effective treatment? 2, the choice of departments and doctors Some couples arrive at the hospital, embarrassed to talk about infertility, often men talk about male, urology, or prostatitis, etc.; women talk about gynecological inflammation, or menstrual disorders, etc.. As there are certain differences between male, gynecologic and reproductive medicine doctors in their specialties, many of the common diagnostic and treatment methods used in male and gynecologic medicine are not fully applicable to infertility, and some of them may cause serious consequences. The result is that the patient spent a lot of money to treat the so-called prostatitis, and finally found out that the cause of infertility is not prostatitis, but testicular sperm dysfunctional azoospermia. There are also gynecologists who do not fully examine the patient’s reproductive function and simply treat the patient for gynecological inflammation, such as cervicitis, adnexitis, pelvic inflammation, etc. If the patient is eventually found to be pregnant, the consequence is that the eager couple has to consider the toxic side effects of some drugs on the fetus and choose to have an abortion, a lesson that is commonplace. Some hospitals do not have a reproductive medicine department, and men are often seen in urology or male medicine, and women in obstetrics and gynecology. Even in hospitals with reproductive medicine departments, it is important to carefully identify whether the doctor is a doctor who specializes in reproductive medicine. In terms of training mode and professional settings, reproductive medicine specialties in China are currently given only at the master’s and doctoral degree levels. The so-called experts who are rushed to work after only a short training are in a sense indiscriminate. This is why it is more important for patients to choose a doctor than a hospital. At present, the treatment of infertility in developed countries in Europe and the United States uses the “one-to-one” model of male and female consultation and treatment, that is, a doctor is always responsible for the whole process of consultation and treatment of an infertile couple. This requires the infertility specialist to have the skills to treat both men and women, which not only facilitates the couple’s consultation, but more importantly, plays a key role in improving the pregnancy rate. At present, there is a shortage of reproductive medicine specialists who can perform the same diagnosis and treatment for couples in China. Although many hospitals have reproductive medicine departments or infertility specialists, in fact, couples are forced to be examined and treated separately by different doctors when they arrive at the hospital, which in essence is still a separate diagnosis and treatment for men and women. Therefore, it will be more helpful to find a professional doctor who can treat couples with the same diagnosis and treatment to improve the pregnancy rate. 3.The questions that may be involved in the doctor’s consultation The doctor’s consultation includes: how many years of marriage, whether the wife has ever been pregnant or given birth; for those who have been pregnant, they should specifically state how many times they have been pregnant, whether it was abortion, medical abortion or natural abortion, and whether they have cleared the uterus; if they have a history of childbirth, they should specifically answer how many children they have given birth to, whether they were born naturally or by cesarean section, whether they were boys or girls, and the health status of their children, etc.; after the last pregnancy or childbirth If you have a history of childbirth, you should tell us how many children you have had, whether they were born naturally or by cesarean section, whether they were boys or girls, and the health status of the children; how long you have not been pregnant since your last pregnancy or childbirth; what kind of contraceptive measures you take and when you started contraception, and how long you have not been pregnant since you stopped contraception; whether you live together or separately; how many times a week or month you have sex, and the time and quality of your sex life; whether you choose to have intercourse during ovulation, and whether there are any factors affecting fertility during sex; whether you have suffered from mumps, tuberculosis, hepatitis, nephritis, heart and lung diseases, and thyroid and kidney diseases. The doctor will also ask the female partner if she has had any surgeries, if her parents and siblings have had children, if she has any past drug allergies, if she has any special hobbies such as smoking, alcohol, tea and beverages, and if she has been exposed to any chemicals or radiation that may affect her fertility. For the female partner, the doctor will also focus on the age of menarche, the duration of each menstruation, the accuracy of the menstrual cycle, whether it is early or late, whether it is regular, and the time of the last menstruation. The leukorrhea should be described in most cases, the amount, color and odor of the leukorrhea. If you have been examined in another hospital, you should describe in detail what tests have been done in the past. For women, you should focus on the results of routine leukorrhea, colposcopy, ultrasound examination of uterine adnexa, hysterosalpingography or iodine oil imaging, follicle monitoring, luteal function, etc. In some cases, you also need to do reproductive hormones, reproductive immune antibodies, eugenic programs, pathogenic microorganisms (such as mycoplasma, chlamydia, etc.) and other related tests. For the male partner, the focus should be on sexual function and semen examination results. For example, whether the penis can be erected, the strength of the erection and the duration of the erection, whether the couple can penetrate the vagina during sex, whether ejaculation can be completed in the vagina or ejaculated, the amount of semen, whether it is milky white, gray or other colors, whether semen flows out of the vaginal opening after the couple has sex, whether there is that special smell of semen (heather smell), etc. All of these are important clues for the doctor to assess their reproductive function and analyze the cause of infertility. For those who have been treated in other hospitals, the couple should focus on the time, method, and examination results before and after treatment, as well as any adverse reactions to the treatment. For repeat patients, the couple should understand what examination or treatment should be done in this follow-up visit to the hospital, and tell what happened in the last examination and treatment, and whether there is any discomfort or adverse reaction. Couples should prepare the above before the consultation, and try to use the shortest time and the most concise language to present their condition and treatment in a focused and concise manner during the consultation. This is very important for infertility couples, not only to save clinic time, reduce repeated tests and save money, but also to reduce the negative impact caused by emotion, which is very beneficial to treatment. 4, see infertility should not be ignored other issues No matter how long you have been married without pregnancy, you must have a good mood. Unlike looking at other diseases, infertility requires couples to be seen together. Systematic screening of infertility causes takes a long time, especially for women, and it usually takes 1 to 2 months of the cycle to complete the examination. The growth cycle of male sperm is about 74 days, so the treatment cycle of sperm takes 3 months as a course of treatment and 3 courses of treatment before the efficacy can be evaluated. Some friends are anxious to ask why when they don’t get pregnant after 1~2 months of treatment. In fact, it is unrealistic to be anxious and the anxiety itself may also affect conception. Some friends have been seeking medical treatment for many years, but they cannot tell what tests and treatments they have done in the past, and the materials or records of their previous visits are lost, so the doctor has to re-examine them; some of them take out thick stacks of medical records and reports of their previous visits, which are disorganized, and there is not much information that is really useful. Patients should put the same tests together in chronological order before the visit. For example, the reports of multiple hydroentanglement or iodine oil imaging can be grouped together by examination time to help the doctor determine the evolution of the tubal condition before and after; the reports of follicle testing of the same menstrual cycle can be grouped together to help the doctor understand the growth process of the follicle at a glance; the reports of multiple semen analyses stored in chronological order can help the doctor understand the changes before and after multiple treatments, etc. The examination for the first time male is relatively simple, only the full set of semen analysis and other factors that may affect sperm quality must be checked, but you need to wait for the report. If there is no problem, the man can leave it for now; if there is a problem, there are more items to continue the examination, but further tests will be chosen based on the semen analysis. The examination for first-time women is relatively more complicated, and usually requires checking 1 to 2 menstrual cycles. The menstrual cycle is often divided into 4 phases: menstrual period, late menstrual period, ovulation period and luteal phase, and in each period there are different examination contents, just like the chain of a bicycle, with one ring interlocking with another, and each ring is important. Only with this careful search can the cause of infertility or infertility be identified, but these examinations or treatments require time and money, and more importantly, patience. A very common clinical situation is that “the treatment is lighter than the investigation”, that is, many friends to the hospital, rather than spend money to buy drugs for treatment, rather than willing to do the examination, as if to the hospital is not prescribed drugs is not to see the doctor. I do not know, the cause of the disease is unknown, no target treatment is undoubtedly a waste of money and time. Some friends for various reasons do not follow up on the time required, resulting in a prolonged period of time to investigate the cause of the disease, or miss the timing of treatment. If you miss the time, you will have to wait for the next menstrual period to be checked or treated at the same time, thus prolonging the course of the disease and artificially causing unnecessary financial waste. It is important to listen carefully to the doctor’s instructions, remember the medical advice, and strictly implement them. A truly responsible doctor will inform the patient of the treatment plan. Initial patients will be informed of the general examination plan and follow-up patients will be informed of the stage plan. Before leaving the hospital, the patient should listen carefully to the doctor’s instructions and understand what tests or treatments are being done, what the next steps are, and what to pay attention to during treatment. After returning home, you should remember the doctor’s instructions and follow them. Especially for out-of-town patients, they should ask the doctor in person before leaving the hospital about matters that are unclear, so that human errors do not occur when they go home and then telephone to describe them. The role of the doctor is to help the patient find the cause of the disease, propose treatment advice and implement a treatment plan. But to implement the treatment plan for a good outcome, it also depends on the patient’s own active cooperation. As the saying goes, “a long illness becomes a doctor”. After years of seeking medical treatment and spending huge amounts of money on “tuition”, patients are more familiar with the treatment of their own infertility, and under the guidance of doctors, they should be aware of their own reproductive physiological deficiencies or defects and should try to Under the guidance of the doctor, the patient should try to find out the advantages that are beneficial to their fertility and actively cooperate with the treatment. If they do so, their wish to have a baby may be realized soon.