1. What conditions should be present for normal conception?
v Normal semen
v normal ovulation
v open and normal functioning fallopian tubes
v endometrium and uterine cavity suitable for embryo implantation
2. Who needs early infertility testing?
v unable to conceive after one year of trying
v Menstrual cycle shorter than three weeks or longer than six weeks
v History of pelvic inflammatory disease, adnexitis, appendicitis and tuberculosis
v History of miscarriage
v The woman is over 30 years old
v History of mumps, epididymitis, prostatitis in the male partner
v Male partner with post-vasectomy reanastomosis
v male partner with high temperature operation
3.What are the common methods of tubal examination? What are the advantages and disadvantages of each? Which is the most classic method of examination?
v Uterine tubal lavage
v Uterine tubal lavage with ultrasound
v Hysterosalpingography with iodine oil: preferred
v Laparoscopic tubal lavage: the gold standard
4. Can I get pregnant naturally if my fallopian tubes are open? Why?
Not necessarily
v A patent fallopian tube does not necessarily mean normal peristalsis and “egg collection” function
v The function of the fallopian tubes is more important
5.How is azoospermia diagnosed?
v Semen was examined 3 times, and no sperm was found after high speed centrifugation and microscopic examination of sediment drops.
6.What is obstructive azoospermia and how to treat it?
v Semen examination more than 3 times, and no sperm is seen in the sedimentation examination after centrifugation, but the patient has normal spermatogenic function, and there are mature sperm in the epididymis or testicular puncture biopsy for various reasons
Treatment
v ICSI (2nd generation IVF) using epididymal sperm or testicular sperm after genetic diagnosis and counseling
7. What are the diagnostic criteria for polycystic ovary syndrome?
v Sporadic ovulation or anovulation
v polycystic ovarian changes detected by ultrasound (preferably negative ultrasound), with ≥12 sinus follicles in one ovary
v Signs or biochemical indicators of hyperandrogenism
v Exclusion (pituitary prolactinoma, congenital adrenal hyperplasia, androgen-secreting tumors, etc.)
v with the above 2 can be diagnosed
8.Who is suitable for artificial insemination for pregnancy?
v Low or weak spermatozoa in male partner
v Inability of semen to enter the vagina
v Cervical factors
v Immunological factors
v Unexplained infertility
v Other reasons: before radiation therapy or chemotherapy for tumor of the male partner, or if the male partner travels abroad for a long time, the semen can be cryopreserved beforehand for AIH.
9.Who are suitable for in vitro fertilization-embryo transfer (IVF) to assist pregnancy?
v Fallopian tube factor
v Ovulation disorders (PCOS, LUFS)
v Endometriosis
v Hypospermia in the male partner
v Immunological infertility
v Unexplained infertility
v Repeated failure of AIH or AID
v Failed to reopen the fallopian tubes after sterilization or infertile for more than 2 years although the fallopian tubes are open
10.What are the specific considerations before semen examination?
v It is recommended that the patient is in good physical condition, with no recent fever and good rest
v Abstain from sexual intercourse for 3-7 days and come to the hospital for examination
v Try to collect all specimens in the sperm collection cup, pay attention to keeping warm in winter, and deliver them to the laboratory within half an hour.
11.What is the difference between artificial insemination and in vitro fertilization?
v Artificial insemination is in vivo fertilization, the egg and sperm are still united in the fallopian tube, therefore, the prerequisite for artificial insemination is that at least one of the fallopian tubes is open.
v In vitro fertilization is the union of sperm and egg in an in vitro laboratory environment to form an embryo.
12.What are the normal reference values for male semen analysis?
v Sperm density ≥20×106/ml
v sperm activity rate, A-level motility sperm ≥ 25% or A + B-level motility sperm ≥ 50%
v sperm morphology: normal sperm morphology ≥ 30%
v active sperm with antibody wrapping ≤ 10%
v no sperm agglutination
13.Which infertility patients are suitable for laparoscopic exploration?
v patients with history of abortion, pelvic inflammatory disease, or infertility for many years despite previous fluids indicating patency of the fallopian tubes
v patients whose tubes are patent by HSG, but the film shows that the tubes are tortuous, uplifted, downward moving, rigid and still infertile after 6 months of ovulation treatment
v Incomplete obstruction of the fallopian tubes
v suspected endometriosis
v Unexplained infertility
v Pantopamine, iodine oil test (+)