Why is the male partner examined first?
When a couple with infertility problems arrives at the hospital, after the doctor has ruled out the obvious controllable factors (such as frequency of sex life), the first step is to start with the male partner.
If the semen test is also OK, the male partner is basically excluded and the female partner can be investigated.
Infertility is not always the fault of the woman!
Many people are restricted by traditional concepts and think that the inability to conceive or have children is the woman’s problem, so their first reaction is to ask the woman to come to the hospital for a checkup. In fact, it is not, the problem is also likely to be with the male partner.
Among the causes of infertility, the female factor accounts for 40% to 55%, the male factor accounts for 25% to 40%, and the factors of both spouses account for 20%, while the causes are difficult to define (including immune factors, abnormal egg quality and other reasons that are difficult to diagnose) about 10%, so both spouses need to be examined together.
What tests should the female partner undergo?
In infertility, the main causes of female infertility are abnormalities of the reproductive tract, inflammation, tumors, endometriosis and ovulation disorders. If the male semen test is normal, the female partner should undergo the following tests.
Routine gynecological examination: such as white belt examination, which can exclude vaginal abnormalities, vaginal inflammation and cervical lesions.
Ultrasound examination: It can roughly check whether there are lesions in the uterus, ovaries and fallopian tubes and exclude myometrium A, uterine malformation, ovarian cysts or tumors, polycystic ovaries or hydrocele in the fallopian tubes.
Ovulation test: follicle development can be monitored under ultrasound to see if ovulation is normal. If you don’t ovulate, how can you get pregnant?
Endocrine examination: including various hormone examinations to understand the ovarian reserve capacity (how normal ovulation functions) and to exclude hyperprolactinemia, hyperandrogenemia, abnormal thyroid function, etc.
Fallopian tube patency test: to detect whether the fallopian tubes are patent, to identify the site of tubal obstruction, and to determine whether there are uterine malformations, submucosal myomas and tubal tuberculosis.
Antibody or chromosome examination: to check for chromosomal abnormalities, anti-endometrial antibodies, anti-sperm antibodies and anti-hyaline antibodies.
Lumpectomy: If no cause can be found in the above tests, hysteroscopy or laparoscopy can be considered to directly observe the pelvis, uterus, fallopian tubes and ovaries for any lesions or adhesions.
What should I do if everything is normal?
In about 10% to 20% of cases, the examination of both partners is normal and the cause cannot be determined.
In this case, we usually recommend to use “artificial insemination” to assist the pregnancy first.
Of course, treatment options vary from person to person and specific problems need to be analyzed. For patients over 38 years old with unexplained infertility, once the IUI has failed after 3 times, they can directly switch to IVF.
If the patient has a disease, such as anemia, abnormal liver function or acute infectious disease, and the physical condition is not suitable for pregnancy, we suggest to suspend the infertility treatment until the physical quality has recovered in all aspects, and then proceed with the infertility treatment.
Artificial insemination or IVF?
If the female partner is the cause of the infertility, then we should treat the specific cause directly and then try to conceive naturally or undergo the following assisted reproduction methods.
If the test shows that the cause is the male partner, what should I do? Usually, the method of assisted reproduction is used directly: artificial insemination or in vitro fertilization.
The fundamental difference between IUI and IVF is that the site of fertilization in the former is still inside the body, while in the latter the site of fertilization is outside the body. If the woman’s fallopian tubes are open, she usually chooses IUI, and if they are not open, she usually chooses IVF.
1. Artificial insemination
”Artificial insemination” refers to the artificial injection of treated semen into the woman’s reproductive tract during her ovulation period to help her become pregnant. There are two types of artificial insemination: insemination with the husband’s semen or insemination with the sperm of a donor.
Both types of insemination require that the woman’s fallopian tubes are open and ovulation is normal.
If the woman’s fallopian tubes are not open, hysteroscopic lavage can be used to open the fallopian tubes. However, if the fallopian tubes are still not open after treatment, couples are advised to choose IVF.
2.In vitro fertilization
”In vitro fertilization and embryo transfer” is the common name for IVF in China. The eggs and sperm are removed from the couple’s bodies and then fertilized by an embryologist in a laboratory.
IVF can be divided into the first, second and third generations, depending on its application, corresponding to in vitro fertilization-embryo transfer (IVF-ET), intracytoplasmic single sperm injection (ICSI) and pre-implantation genetic diagnosis techniques, respectively.
How can genetic disorders be prevented from being inherited?
If one of the spouses has chromosomal disorders or certain diseases with high genetic potential, such as hemophilia, thalassemia, progressive muscular dystrophy, congenital adrenocortical hyperplasia, or patients with unexplained recurrent miscarriages, they can opt for third-generation IVF, in which the egg and sperm are combined in vitro to form an embryo, and then a healthy embryo is selected using advanced genetic testing technology and then This can prevent the birth of children with genetic diseases, reduce the risk of miscarriage, and increase the birth rate of healthy babies.
It is important to remember that even with this pre-implantation screening, routine prenatal checkups should not be ignored.
No emergency treatment
With the full opening of the second-child policy, many older couples are excited to have a baby, and it is conceivable that many more couples who want to have a baby but cannot do so will join the ranks of those seeking infertility treatment.
However, infertility tests are complicated, some of them are invasive, and some are closely related to the experience and level of the operating doctor, so if you need to seek treatment, you must find a regular hospital, preferably a specialized reproductive medicine center, to follow the process of step-by-step screening and make an accurate assessment before doing the right test.
Seriously, the traditional Chinese concept of marriage and children is very important, infertility is a “fat”, many small informal hospitals are mainly related projects, after going to the most likely to be fooled, starting with the most painful and expensive examination.
The last thing you need to do is not to believe in any prescriptions, but to make a clear diagnosis before you can treat the problem, or else you will waste your money, delay your fertility or even hurt your body, which is really more than worth it.