Benefits of simultaneous consultation for both husband and wife Infertility is often the result of multiple factors affecting both husband and wife, and the cause must be found out through a comprehensive and careful examination of both sides, which is the key to treating infertility, and women account for about two-thirds of the factors of infertility, and it is preferable for both husband and wife to go to the clinic at the same time during the first consultation of infertility patients, which has the following benefits This is to facilitate the understanding of various conditions of both parties, including the results of the examination and treatment of both parties, so as to further focus on the examination according to the specific situation. ② Easy to teach and guide the two sides. ③ Establish a good doctor-patient relationship and maintain confidentiality for the patient, which is conducive to treatment. How to initially screen for infertility? Infertility is often the result of a variety of factors affecting the couple, must be through the two sides of a comprehensive and careful examination to find out the reasons, which is the key to the treatment of infertility. First of all, the infertile couple’s general history taking, physical examination, various assessments. Secondly, routine semen analysis of the male partner is the first and foremost test for infertility, which is performed in the hospital within 3-7 days of abstinence. According to the WHO 5th edition standard, the test of various indexes will be conducted, and if the result is abnormal, 2-3 times of review will be conducted to confirm the result. Those with secondary infertility also need to be examined. Related examinations: including general physical examination, gynecological examination, vaginal ultrasound and special infertility examination. (A) general examination The doctor will pay attention to the mental state, general development and nutritional status of the friends who come to the clinic, the development of secondary sexual characteristics, including breast development, the presence of breast milk, fat distribution, hair growth, the presence of masculinization phenomenon; due to endocrine disorders of the pituitary gland, adrenal glands, thyroid gland, and other organs of the body caused by endocrine disorders, or skin pigmentation abnormalities, and so on. 1, body mass index (BMI): is the world recognized is the world recognized a rating method of assessing the degree of obesity, the formula is BMI = weight (kg) / (height) 2 (m), the normal range of 18.5-25kg/m2, due to the existence of error, so BMI can only be used as a number of standards to assess the weight of the individual and the health status of one of the standards. 2.Waist-Hip Ratio (WHR): the ratio of waist/hip circumference, the normal range should be <0.85, which is an important indicator for determining < span="">central obesity. Because excessive waist fat can destroy the insulin system, leading to diabetes, hypertension, hyperlipidemia and other diseases, but also can lead to liver hypertrophy, affecting the function of the liver, therefore, patients should be encouraged to lose weight before treatment, to be treated after weight loss of 15%, which can improve the therapeutic effect. 3, history of tuberculosis: most patients lack clear symptoms, positive signs, so when there is primary infertility, scanty menstruation or amenorrhea; unmarried women have low-grade fever, night sweats, pelvic inflammatory diseases or ascites; previous history of tuberculosis contact or I have suffered from pulmonary tuberculosis, pleurisy, intestinal tuberculosis should be considered to have a possibility of tuberculosis of the reproductive system, routinely perform the following tests: ① PPD test: is a highly sensitive, highly specific test method. PPD test: is a very sensitive and specific examination method, the test reaction is positive for the diagnosis of tuberculosis infection is of great value, but it can not diagnose the lungs with or without tuberculosis or determine the nature of the lesion. ② Serum-interferon: used for the diagnosis of latent tuberculosis infection. ③ Frontal and lateral chest radiographs or CT scanning: ④ Pelvic X-ray or CT scanning: finding isolated calcified spots suggests that there have been pelvic lymphatic tuberculosis foci. ⑤ Blood sedimentation and anti-tuberculosis antibody: poor sensitivity and specificity, although widely used in clinical practice, it has little diagnostic significance. (4) Thyroid examination: to check whether the thyroid gland is enlarged or not, and to assess the thyroid function, the main reason is that some thyroid diseases will interfere with the normal ovarian function. (B) gynecological examination Gynecological examination must be performed in the first visit, which can detect some obvious congenital genital malformations, such as congenital absence of vagina, vaginal mediastinum, double cervix and double uterus. (C) Vaginal ultrasound is a commonly used clinical examination method in reproductive medicine to observe the endometrium and ovaries, especially for endometrial cancer, uterine fibroids, pelvic masses, follicle monitoring, early ectopic pregnancy, etc. The images are more clearly displayed. (D) infertility special examination 1, serum sex hormone measurement: under normal circumstances in the menstrual cycle on the 2nd-5th day of fasting to determine the level of various hormones in the serum, can obtain the functional status of the ovary and its impact on the link and other aspects of the information, and at the same time, can identify ovarian or pituitary ovulation disorders and amenorrhea. 2.Hysterosalpingography: Infertility caused by tubal disease accounts for 1/3 of female infertility, therefore, normal structure and function of the fallopian tube is a necessary condition for normal pregnancy, and accurate evaluation of the structure and function of the fallopian tube is the key link in the diagnosis and treatment of female infertility. Hysterosalpingography is the most commonly used examination method to know whether the fallopian tubes are smooth, the degree of smoothness and the specific obstruction site, and it is usually carried out within 3-7 days after menstruation without acute inflammation of the reproductive system. 3, endometrial diagnostic scraping: its purpose is to scrape the contents of the uterine cavity for pathological examination to assist in diagnosis. 4.Immunological examination: some patients with primary infertility are found to produce anti-sperm antibody, anti-ovarian antibody, anti-hyaline band antibody and other adverse immune reactions through testing, which will kill sperm or inhibit sperm and egg combination, resulting in infertility, in addition to indirectly through the post-coital test, in-vitro sperm penetration test and so on. 5, hysteroscopy: hysteroscopy can not only determine the location, size, appearance and scope of the presence of lesions, and can be on the surface of the lesions of the tissue structure of the meticulous observation, and under direct vision to take or positioning scraping, greatly improving the accuracy of the diagnosis of diseases in the uterine cavity, updating, development and make up for the shortcomings of the traditional diagnostic and therapeutic methods. It is usually performed within 3-7 days after menstruation is clean. What are the treatments to help infertility friends? Symptomatic treatment is based on the results of the initial infertility screening. What are the common treatment methods? 1.Expectation therapy Adjustment of mood, lifestyle improvement, psychological guidance and other non-medical behavioral interventions. 2, symptomatic treatment General medication, physical therapy, combined traditional Chinese and Western medicine treatment, ovulation promotion treatment. 3.Luminal surgery diagnosis and treatment Uterine and laparoscopic surgery is targeted selection, under the premise of considering complications, pelvic cavity exploration, adhesion decomposition and so on. The premise is to maximize the protection of ovarian function, to prevent the re-formation of adhesions and ovarian hypoplasia and other complications. 4. Assisted Reproductive Technology Assisted Reproductive Technology refers to the use of medical technology and methods of artificial manipulation of sperm and eggs, fertilized eggs, embryos, in order to achieve the purpose of conception, divided into artificial insemination and in vitro fertilization-embryo transplantation technology and its various derivative technologies. Since 2006, the implementation of this technique has been subject to strict access by the local health and family planning commissions, which have organized the evaluation of experts from the National Health and Family Planning Commission.