1. Clinical diagnosis and treatment: The patient Wang, 30 years old, complained of being infertile for 4 years after marriage without contraception in July 2010 when she was first diagnosed. The couple lived together and had a normal sex life. Menstrual history: menstruation at the age of 16, 35-40 days once, lasting 5 days, the amount of medium, no dysmenorrhea; outside the hospital diagnosed as “primary infertility, polycystic ovary syndrome”, given metformin, daing-35 treatment, clomiphene (CC) + urotropin (HMG) to promote ovulation for 6 cycles, with dominant follicle development, only 1 cycle follicle rupture, the rest of the cycle dominant follicle rupture, the rest of the cycle dominant follicle rupture. The follicle ruptured in one cycle, and the dominant follicle did not rupture in the remaining cycles, and she was infertile at the time of coitus. In November 2009, a hysterosalpingogram was performed in our hospital, which showed that the uterus was normal in shape, and the fallopian tubes were patent bilaterally. Because the male partner’s semen was poorly liquefied for several times, and the effect of medication was unsatisfactory, AIH was performed.Past history, personal history, family history were not special, and in May 2006, he had undergone surgery for intestinal obstruction. Physical examination: T: 36.4℃, P: 80 beats/min, R: 20 beats/min, BP: 120/80mmHg General condition was OK, clear, spirit was OK, heart and lungs (-), abdomen was soft, liver and spleen were not found; gynecological examination: vulva was developed normally, vagina was smooth, cervix was smooth, uterus was anteriorly positioned, and there were no obvious abnormalities in the double adnexa. Auxiliary examination: routine AIH auxiliary examination was basically normal, female basic endocrine: basic endocrine results: FSH: 6.39mIU/ml, LH: 7.39mIU/ml, E2: 302.30pmol/ml, PRL: 8.78ng/ml, T: 0.61nmol/l. Vaginal secretion examination was normal. Routine semen examination of the male partner on October 27, 2010 showed the following: volume 3.5 ml, PH: 7.3, liquefaction time: 60 minutes without liquefaction, density 27.56 ml/ml, sperm motility 43.11%, grade A 23.56%, grade B 17.90%. Serum ASAB(-),UU,CT(-). Treatment: the patient’s first cycle program: CC + HMG ovulation treatment, the patient’s menstrual day 3-7 CC50mgqd, menstrual day 8, day 10 each injection (75iu), on the 12th day of menstruation, vaginal ultrasound showed: EM: 1.2cm, type B, the right follicle: 1.75cm1, the left follicle: did not see the dominant follicle; urinary LH semiquantitative 45mIU/ml The operation went smoothly, postoperative review of the dominant follicle was 3.5×2.7cm with good tension and translucency, there was no fluid accumulation in the pelvis and around the ovaries, suggesting that the follicle was not discharged, progesterone gelatin pill 0.1 ,bid, half a month of review and no pregnancy. Second cycle: CC+HMG was given again to promote ovulation with the same dosage as before, and the dosage of HMG was increased to 150IU. On the 8th day of menstruation, the male partner ovulated once, and on the 13th day of menstruation, vaginal ultrasound showed that EM was 1.0cm, type A, right follicle was 1.75cm1; left follicle was 1.9cm1, 1.4cm1, and the mouth of the uterus was slightly open, and chorionic villus stimulant was given 10,000u, which was injected intramuscularly at 8:00pm on the 15th day of menstruation. Intramuscular injection, the morning of the 15th day of menstruation, artificial egg breaking + intrauterine insemination, 10 a.m. ultrasound examination of bilateral dominant follicles are not broken, first of all, the processed spermatozoa A + B 52.7 × 10 ^ 6, injected into the uterine cavity, and then in the vaginal ultrasound guidance of bilateral large follicle puncture, the operation went smoothly, after the operation was given to the progesterone 40 mg intramuscular injection qd × 15 days, after six months, check the urine HCG positive, blood β-HCG: 2099IUG, blood β-HCG: 2099IUG. HCG: 2099IU/L, 35 days after IUI, vaginal ultrasound: intrauterine pregnancy, single fetus, gestational sac size 2.7×2.8cm, yolk sac via 0.45cm, visible buds and fetal heartbeat. She was still pregnant. 2, Discussion LUFS refers to the follicle is not ruptured after maturation, the oocyte is not discharged and the granulosa cell luteinization, and secretion of progesterone leads to a series of changes in the effect organs of the body similar to the ovulation cycle, such as the basal body temperature is a biphasic change, the endometrium is a secretory change, the cervical mucus is a change in the normal ovulation period, etc., and the proportion of the infertility patients reaches 25% to 30%. The incidence of LUFS has been reported to be 10.1% in natural cycles, 31.8% in ovulation-inducing cycles, and 63.6% in repeat incidence. The application of ovulation-promoting drugs increases the incidence of LUFS, and because the oocytes are not discharged, the patient has no possibility of pregnancy; the pathogenesis of LUFS is still unclear, and it is believed that it is the result of a combination of endocrine factors and mechanical factors. Endocrine factors include a weakening of the luteinizing hormone peak during the peri-ovulatory period, insufficient secretion of progesterone in the middle of the menstrual period, changes in local hemodynamics in the ovary…, and dysfunction or defects in local hydrolases, collagenases, and prostaglandins in the ovary. Mechanical factors are pelvic adhesions, endometriosis, polycystic ovary syndrome, etc. which cause changes in the local histomorphology of the ovary, and thickening of the ovarian leukomalacia, which prevents follicular rupture and egg expulsion. Currently, the diagnosis of LUFS relies mainly on ultrasound monitoring. Despite the simplicity of LUFS ultrasonography, a true diagnosis is still difficult to make, and sometimes a blood-filled corpus luteum may be mistaken for a persistently growing luteinized non-ruptured follicle. Ultrasound-guided transvaginal follicular puncture can mechanically rupture the follicle to achieve ovulation; at the same time, it can make the blood androgen level drop, so that the original excessive androgen inhibition of follicle maturation can be relieved; make the follicle produce less inhibitory hormone, reduce the level of inhibitory hormone in the blood circulation, lift the inhibition of hypothalamus pituitary, and the synthesis and release of FSH increase, which will promote the follicle to mature and ovulate. The release of FSH synthesis increases, promoting follicular maturation and ovulation. This patient had combined polycystic ovaries and a history of pelvic surgery, and there were endocrine and mechanical factors that contributed to the development of her LUFS. Due to abnormal semen liquefaction in the male partner, artificial insemination immediately after ovulation increased her chances of conception. In conclusion, transvaginal ultrasound-guided follicular puncture for the treatment of LUFS is accurate in localization, simple and effective, with little pain and trauma to the patient, and a high success rate of postoperative conception, but care should be taken to avoid injury to the surrounding organs and abdominal bleeding during the procedure.