1. What is infertility and infertility? Before understanding infertility, let’s first understand the process of conception. In layman’s terms, conception is when the sperm travels up the fallopian tube, meets the egg and fuses with it to form a fertilized egg, which develops and descends to the uterine cavity where it is “planted” in the endometrium and then gradually develops and eventually forms a fetus. The whole process of conception is very delicate and only when all the steps are normal can the overall success be guaranteed, and any mistake in one step can cause infertility. In a woman with a normal menstrual cycle, fertilization occurs once a month, around 14 days before the next menstrual period. Clinical definition: Infertility is defined as a couple of childbearing age who are sexually normal, cohabiting, and have never had a pregnancy (excluding biochemical pregnancies) for 1 year without contraception; it is also said to be called infertility in women and sterility in men. Female infertility means that the woman has had a pregnancy but actually failed to have a child, all ending in miscarriage, premature birth, stillbirth or stillbirth. Why 1 year? Several foreign surveys have shown that the pregnancy rate for couples with normal fertility without contraception is 80-90% in 1 year and 93-95% in 2 years. for women over 35 years old, especially after 37 years old, the ovarian reserve declines rapidly. Therefore, for women over 35 years old, it is recommended that six months without contraception without pregnancy can be examined for infertility-related causes. 2. Prevalence Due to environmental pollution, work and life stress, lifestyle (staying up late, smoking and drinking, diet structure), fertility concept (delaying childbirth, multiple abortions) and other problems in modern society, the proportion of couples with infertility/infertility is as high as 15%, with one in six couples suffering from infertility/infertility. And with the postponement of the age of childbirth, this proportion has a rising trend. 3, etiology Problems in any part of the conception process can cause infertility causing infertility. ① tubal and pelvic factors such as inflammation, tuberculosis, endometriosis, congenital developmental abnormalities, etc.; ② ovulation factors such as polycystic ovary syndrome, luteal insufficiency, etc.; ③ uncommon factors include uterine or cervical abnormalities, immune resistance, etc.; ④ unexplained infertility i.e. infertility where all known tests suggest normal; ⑤ male infertility factors are mainly semen abnormalities, such as abnormal development, pathogenic infections Other causes include immune factors, erectile abnormalities, etc.; ⑥ Factors of both partners include lack of basic knowledge of sexual life, mental factors, immune factors, etc. Those who have never been pregnant are called primary infertility, and those who have been pregnant for more than one year are called secondary infertility. It is worth mentioning that multiple abortions after pregnancy (clamping abortion or curettage) may cause irreparable damage to the endometrium and eventually lead to infertility, which is one of the important causes of secondary infertility, so men and women of childbearing age must do a good job of contraception before they plan to have children. The earlier the contraceptive measure is taken, the less harm it will do to women. The common examination and diagnosis of infertility is to exclude the normal aspects of the conception process one by one by using the exclusion method to find out where the problem lies and then carry out symptomatic treatment. The female side examination mainly includes gynecological internal and external genital examination, ovarian function examination, tubal patency examination, hysteroscopic laparoscopic examination, immunological examination, ultrasonic imaging examination and genetic examination, etc. The male examination includes external genital examination, semen examination, immunological examination, endocrine examination, pathological examination, genetic examination and ultrasonic imaging examination, etc. Relevant examinations within one year from a tertiary care hospital or above have a certain reference value, so please try to bring the report card of previous examinations when you come to the clinic, and you should also bring the hospitalization case of previous surgery regardless of the time limit (if any). 5. Treatment Having said all these, the most important and most concerned question is: What should be done for infertility? Among the principles of infertility treatment, the first is to improve lifestyle, reduce weight by at least 5-10% for those who are overweight; correct malnutrition and anemia for those who are physically weak; quit smoking, drug addiction and alcohol abuse; master sexual knowledge, understand your ovulation pattern and have intercourse with moderate frequency to increase the chance of conception. Then treatment is carried out according to the diagnosed cause. The following treatments are commonly used: ①Medication: mainly used in infertility with impaired development and maturation of sperm or eggs due to endocrine disorders to improve fertility through endocrine regulation. ②Surgical treatment: mainly used for infertility caused by organic lesions. In women, such as pelvic adhesions, tubal adhesions, uterine adhesions, endometriosis or abnormal development of the reproductive tract, and in men, such as varicocele, cryptorchidism and obstruction of the vas deferens. ③Assisted reproductive technology (ART): For patients who cannot be treated with conventional drugs or surgery or whose treatment has failed, they can be treated with assisted reproductive technology (ART), which includes artificial insemination (IUI), in vitro fertilization-embryo transfer (IVF-ET), intracytoplasmic single sperm injection (ICSI) and preimplantation genetic diagnosis (PGD). As the last killer app for fertility doctors, ART has helped countless families realize their dream of having children, and this technology is being improved and advanced by medical practitioners all over the world, and it is believed that the success rate of ART will be higher and higher in the future. Since infertility is closely related to age, treatment options are chosen with due consideration to the physiological age of the female ovaries, the rationality and effectiveness of the treatment options, as well as their performance to price ratio, and natural, safe and reasonable options are adopted as much as possible. However, in clinical practice, every time we meet one or two patients whose doctors recommend IVF but do not want to do it and want to “try again by themselves”, and one or two patients whose doctors recommend trying again for natural pregnancy or IUI but are clamoring “I want to do IVF”. Every time, I feel the urge to introduce you to each other and persuade each other. All the previous efforts are for the final treatment, each treatment method is not good or bad, there are no advantages or disadvantages, each person’s situation is different, the right treatment, can cure the disease is a good method, your doctor will choose for you the most beneficial method.