Infertile couples always ask: What is the reason why we can’t get pregnant? It is true that there are many people who have been to many hospitals and have undergone various tests and have not found anything wrong. For such couples, I often spend some time talking with them. Since the tests do not find the “problem” that causes infertility, it means that there may not be any organic lesions that can cause infertility, but it does not mean that there is no “problem”. Modern medicine divides human diseases into two categories: physical and mental. Physical diseases can be organic lesions or functional abnormalities, including infectious, anatomical abnormalities of organs, superfluous and dysfunctional diseases; psychogenic diseases are caused by mental or psychological factors, i.e., what we call “heart diseases”. The most important feature of these “cardiac diseases” is that no organic lesions of the body are detected. Among the infertility population, “psychogenic infertility” is not uncommon or even common. Studies have reported that more or less mental and psychological stress is almost universal among infertile couples, and that this group is at a high risk of depression. “Psychogenic infertility is often caused by emotional instability, sadness, irritability, tension, sleep disorders, etc., due to various reasons (especially under pressure from society, work and life), and the negative impact of these psychological problems on pregnancy can be in several ways: 1. The ovulation of the menstrual cycle occurs on time under the precise regulation of the hypothalamic-pituitary-ovarian axis, and the luteal function after ovulation is the subsequent guarantee of a successful pregnancy. Their work is intertwined and highly precise, and the slightest mistake can “ruin” the “results” of the month’s pregnancy efforts. Psychological factors such as stress, irritability, anger, etc. can stimulate the adrenal glands of the human stress system to produce increased glucocorticoids, which inhibit the function of the hypothalamus, weakening the instructions issued by the hypothalamus, and decreasing the function of the subordinate pituitary-ovarian, which may cause ovulation disorders or irregular ovulation in the menstrual cycle, or poor development of the ovulated eggs, or poor luteal function after ovulation. 2, the impact on male sperm production psychological factors in men and women is the same as the impact of the hypothalamus-pituitary-gonadal axis inhibition, in men is manifested as spermatogenic function is affected, may lead to spermatozoospermia, very often manifested as a decrease in libido. 3. The effects of poor sleep Poor or insufficient sleep is quite common in infertile couples. The human body during sleep is equivalent to a machine undergoing “maintenance”, that is, the process of adjustment of the whole rest. The endocrine changes in the human body during sleep are an important activity in the body’s recuperation and adjustment. During this period, the secretion of growth hormone and melatonin increases, and these hormones not only promote the body to increase energy and repair capacity and other “recharging” processes, but also increase the function of the granulosa cells on the follicles, thus increasing the ability of follicles to grow. Studies have reported that these hormones indirectly promote follicle growth and egg quality. The lack of sleep on this process of “maintenance”, poor follicle development or poor egg quality, the efforts to get pregnant will be “fizzled out”. 4, sex life is reduced, poor mood also affects libido, “psychogenic infertility” couples tend to have a low frequency of sex, such as 1-2 times a month sex is likely to miss the precious opportunity to conceive during the days of ovulation. 5, easy spontaneous abortion As mentioned above, mental factors can cause poor luteal function in women after ovulation; in addition to this, it may also cause immune dysfunction. The immune function of the human body is like the army of a country, its function is originally to deal with foreign invasion of the “enemy”, when the immune function is disordered or abnormal, it may happen to misidentify the “enemy”, that is, to identify their own organs as When the immune function is disturbed or abnormal, it is possible to misidentify the “enemy”, i.e., to recognize one’s own organs as “enemy” and to recognize the embryo as “foreign body” and to reject it. As a result, this condition often leads to repeated failure of embryo implantation and early embryonic abortion, as well as attacking one’s own organs, such as premature ovarian failure and thyroiditis, which means that the army that was supposed to protect the country is fighting a “civil war”. The above situation is really a vicious circle for infertile couples: the more infertile they are, the more depressed they are, and the more depressed they are, the less they can conceive. If you have read this, will you be able to “take the right place”? If you are unfortunately “shot” and how to deal with it? In fact, I would like to say that if it is really only “psychogenic infertility” and there is no other organic cause of infertility, then the fertility outcome is relatively optimistic and you should be congratulated! However, it does not mean that there is no need for treatment or no way to treat it. I have the following suggestions for the treatment of “psychogenic infertility”: 1. First of all, we should face the reality and give ourselves a chance to correct our psychological and mental stress, instead of being alone and “consumed” with bitterness and negativity. Don’t be shy about talking about it, be honest with your doctor about your situation and seek medical help. As the saying goes, “the heart has to cure the heart”, as long as you are aware of the “heart cause” of the harm, but also consciously to deal with it, there is hope to find a way out. 2, adjust the status quo Analyze the biggest source of “heart cause”, such as from the family elders pressure or their own inferiority complex, husband and wife conflict? Or from work pressure, economic pressure, etc.? Targeted to resolve the pressure. As I mentioned earlier, if there is no other cause of infertility, the outcome of treatment for “psychogenic infertility” is more optimistic, so there is no need to be pessimistic and sad. You can see a psychiatrist for specialist consultation and use antidepressants for a short period of time under the guidance of a doctor to improve your mood, and for those with sleep disorders or poor sleep, a doctor can prescribe sleeping aids or melatonin to improve the quality of sleep. After interrupting the “vicious cycle” with short-term medication, you may have unexpected and surprising effects. In my office, I often observe the possibility of “heart disease” from the expressions and emotions of the patients, but not many of them take the initiative to tell me the cause of their “heart”. Often, I take the initiative to ask and guide the patients to tell what is on their mind, and these patients often burst into tears as soon as they open their mouths. Many of these patients have learned to tell me about their condition after many visits, and some of them even ask for guidance in sleeping. Many of them have been able to conceive naturally after letting go of their mental baggage and adding medical intervention, and all are happy! However, there are also patients who enter the IVF cycle with “heart problems” and even with the assistance of high cost top technology, the effect of the patient’s “heart” on follicle development and other aspects still overshadows the outcome of the assisted conception. It is clear that there is no way to avoid the “heart factor”, only to proactively deal with it.