(a) What is infertility? What is infertility?
Infertility is defined as the absence of pregnancy in couples of childbearing age who have had normal sexual intercourse for 1 year or more without contraception. Infertility is divided into primary infertility and secondary infertility. Primary infertility refers to those who have never been pregnant; secondary infertility refers to those who have been pregnant and then become infertile.
Infertility refers to infertility caused by the male partner after the couple has lived together without contraception for more than 1 year without having children.
(2) What factors can lead to female infertility?
1. tubal infertility: common ones are hydrosalpinx, tubal dysplasia, tubal adhesions, endometriosis, etc;
2. Ovulation disorders: common ones are premature ovarian failure, polycystic ovaries, endometriosis, etc;
3. Uterine infertility: common ones are uterine malformation, endometrial inflammation, endometriosis, endometrial hypersecretion, etc;
4. Cervical infertility: common ones such as cervical polyps, cervical tumors, cervical inflammation, etc;
5. Vaginal infertility: common vaginal malformations, vaginal inflammation, etc;
6. Immunological infertility: common ones such as anti-sperm antibody positivity, etc.
(3) How is oligospermia, weak and teratozoospermia diagnosed in the male partner?
Oligospermia: 3-7 days of sperm retrieval after abstinence, more than three consecutive semen analyses suggest that the sperm density is less than 20×106/ml and the total sperm count (sperm density×total sperm count) is less than 40×106/ml.
Weak spermatozoospermia: After 3-7 days of sperm retrieval after abstinence, three or more consecutive semen analyses indicated that the sperm density was greater than 20×106/ml, less than 50% of forward moving sperm (A+B) or less than 25% of fast linear moving sperm, and other parameters were normal.
Teratozoospermia: Sperm retrieved 3-7 days after abstinence, two or more consecutive semen analyses suggest sperm density >20×106/ml, >50% of forward moving sperm (A+B) or >25% of fast linear moving sperm, and <30% of sperm with normal head < span="">.
(d) What is unexplained infertility? How is it treated?
The unexplained infertility refers to the absence of abnormal physical diseases in the male partner and normal semen analysis without other causes, while the female partner has no obvious infertility.
The female partner has no obvious reasons for infertility.
If the infertility period is short (<2< span="">years) and the female partner is <32< span="">years old, expectant therapy can be used.
2. If the number of years of infertility is >2 years or the age of the female partner is >32 years, or if the expectant therapy fails, artificial insemination can be considered.
3.If 2-3 IUI cycles are not successful in conception, then IVF or ICSI is considered.
(E) What is artificial insemination? What kind of people are suitable for artificial insemination?
Artificial insemination is a technique to deliver sperm into the female reproductive tract in a non-coital manner to achieve conception.
Indications for IUI: The basic requirement is that at least one of the fallopian tubes is open.
1. Mild or moderate oligospermia, weak spermatozoa, non-severe malformed spermatozoa, abnormal liquefaction;
2. Infertility caused by abnormal cervical mucus that prevents sperm from passing through the cervix;
3. sexual dysfunction or sexual intercourse disorders caused by genital tract abnormalities;
4. Ovulation disorders and endometriosis that are not treated with drugs alone;
5. Infertility of unknown origin;
6. Immunological infertility.
(6) The cost of artificial insemination? Success rate?
The cost of artificial insemination is about 3,000-4,000 yuan, and the success rate is about 15%.
(vii) What is IVF? What is the difference between artificial insemination and IVF?
In vitro fertilization-embryo transfer, commonly known as IVF, is a technique in which the eggs and sperm of a couple with infertility are removed from the body, fertilized in an in vitro culture system and developed into embryos, which are then transferred into the uterine cavity to achieve pregnancy.
The differences between IUI and IVF.
1. Different indications.
(1) Artificial insemination is mainly suitable for patients with patent fallopian tubes on the female side and mild oligospermia on the male side.
(2) IVF is mainly suitable for patients with tubal lesions on the female side and/or little or no sperm on the male side.
2. The operation process is different.
(1) IUI means direct injection of sperm into the posterior vaginal cavity or uterine cavity through the vagina.
(2) IVF refers to the removal of both the male sperm and the female egg from the body, in vitro fertilization and the development of an embryo before sending it back to the woman’s uterine cavity.
(H) What are 1st, 2nd and 3rd generation IVF? What kind of patients are they suitable for?
The main indications for conventional in vitro fertilization-embryo transfer (IVF-ET), commonly known as first generation IVF, are
1. Gamete transport disorders caused by various factors in the female partner;
2. Ovulation disorders;
3, endometriosis;
4.Low or weak spermatozoa in male;
5. Infertility of unknown origin;
6.Immune infertility.
Intracytoplasmic sperm injection (ICSI-ET), commonly known as second-generation IVF, involves the injection of a single sperm into the oocyte plasma by microinjection, which results in the passive fertilization of sperm and oocyte, the formation of a fertilized egg and embryo transfer to achieve pregnancy. The main indications are.
1. Severe oligospermia, hypospermia and teratospermia;
2, irreversible obstructive azoospermia;
3, spermatogenic dysfunction (excluding those caused by genetic defects);
4, immune infertility;
5, in vitro fertilization failure;
6.Sperm acrosome abnormalities;
7. Pre-implantation embryo genetic examination is required.
The main indications for preimplantation genetic diagnosis, commonly known as three-generation IVF, are
1. Patients with abnormal chromosome number or structure;
2. One of the spouses is a carrier of a sex-linked genetic disorder (e.g. hemophilia, pseudohypertrophic muscular dystrophy);
3. Patients or carriers of monogenic diseases for which genetic diagnosis is available;
4. HLA (human leukocyte antigen) matching for solving difficulties in the source of donor for bone marrow transplantation.
(ix) What kind of patients are not suitable for IVF?
1.Any one of the male or female suffers from serious mental disorders, acute infection of the genitourinary system, or sexually transmitted diseases.
2.Hereditary diseases that are not suitable for childbirth as stipulated in the Maternal and Infant Health Care Law and are not currently available for pre-implantation genetic diagnosis.
3.Any party has serious bad habits such as drug addiction.
4.Any party is exposed to teratogenic amount of rays, poisons and drugs and is in the period of action.
5, the female uterus does not have pregnancy function or serious physical disease can not bear pregnancy.
(J) Can IVF be done for hydrosalpinx? What is the pregnancy rate?
IVF can be done for hydrosalpinx, but before doing IVF, the doctor needs to ligate the tubes with hydrosalpinx through laparoscopy, and IVF can only be done after the surgery, otherwise the pregnancy rate will be affected. The pregnancy rate of IVF after tubal ligation is normal.