Examinations Indications Vaginal Examine the vagina and urethra for inflammation and infection, etc. Inflammatory cells and pathogens can directly or indirectly affect or stifle sperm motility. The cervical os (cervical canal) is the first point of entry for sperm into the uterus. A tumor, inflammation, erosion or other infection at the cervical os can lead to blockage or deformation of the cervical os, which can eventually lead to failure of conception. The uterus is the cradle of life, where the fertilized egg lays and develops. Inflammation or adhesions of the endometrium, endometriosis, uterine dysplasia, fibroids and other lesions can reduce the fertility function of the uterus and lead to infertility. The fallopian tubes are the only channel for transporting eggs and the place where sperm and eggs are united. Inflammation, adhesions and obstruction of the fallopian tubes will lead to infertility. The ovaries are the place where eggs are produced and released. Ovarian dysplasia, inflammatory infections and ovarian cysts can affect egg production and development, leading to infertility. The pelvic cavity is the gathering place of female internal genital organs. Chronic diseases such as inflammation, infection and adhesions from the pelvic cavity can cause lesions and malfunction of reproductive organs and accessories, such as fallopian tubes and ovaries, and eventually affect the ability to conceive. Endocrine Abnormal functions of female gonads, thyroid and adrenal glands, and endocrine disorders can cause menstrual irregularities, ovulation disorders, amenorrhea, etc., resulting in infertility. Sex hormones Abnormal sex hormone levels can cause uterine dysplasia, ovulation disorders, and impaired egg production resulting in infertility. Immunological factors When all tests are normal but you have not been able to conceive, the presence of adverse immune reactions such as anti-sperm antibodies, anti-ovarian antibodies, anti-hyaluronic antibodies, and absence of sealing antibodies are found, which in turn kill sperm or inhibit sperm-egg binding, resulting in the inability to conceive. Ovulation disorders: Dysfunction of the hypothalamus-pituitary-ovarian axis, inflammation or other causes such as polycystic ovaries and cystic adhesions can cause abnormal ovulation, resulting in failure to conceive or ectopic pregnancy. Treatment process Type of treatment Method of treatment Implementation details General indications Treatment of tubal infertility Treatment of bilateral tubal obstruction ① For obstruction of the umbilical end of the fallopian tube, pelvic adhesion release and tubal umbilicoplasty should be performed. ② Surgical recanalization of interstitial tubal obstruction is difficult and the recanalization rate is low, so direct IVF-ET is recommended. ③ For simple post-tubal ligation isthmus obstruction, end-to-end tubal isthmus anastomosis after ligation site removal can be considered. Different treatment options are available depending on the site and degree of tubal obstruction. Treatment of patent fallopian tubes: Treatment of bilateral tubal obstruction by hysteroscopic tubal cannulation. If patency is caused by partial obstruction of the umbilical end and unilateral tubal isthmus; laparoscopic findings may not be positive in patients with partial obstruction of the interstitial and isthmus portions of the fallopian tubes. Treatment of chronic inflammation of the fallopian tubes Oral administration of herbs to invigorate blood circulation and remove blood stasis, herbal reserved enemas and acupuncture point injections, together with ultrashort wave physiotherapy to promote local blood circulation and facilitate the elimination of inflammation. It is only suitable for those with mild tubal adhesions and obstruction and short duration of lesions. In vitro fertilization-embryo transfer (IVF-ET) In vitro fertilization-embryo transfer Patients who cannot obtain a natural pregnancy even after 6 months to one year of tubal and pelvic plastic surgery have very low chances of obtaining a natural pregnancy, and it is generally not recommended to perform the plastic surgery again, but to use in vitro fertilization (IVF-ET) directly. Treatment of ovulation disorders Ovulation induction Patients with ovulation disorders are treated with drugs or surgical methods to induce ovulation. The aim is usually to induce the development of a single follicle or a few follicles. It is mainly used in the treatment of ovulatory disorders and/or in combination with the application of intrauterine insemination techniques. Treatment of immune infertility AsAb production – isolation therapy The use of condom contraception for a period of 6 months or more reduces or disappears the potency of the original antibodies in the body, and prevents the semen antigens from entering the female reproductive tract to produce new antibodies. Inhibition of AsAb production – drug therapy ① Appropriate antibacterial drugs are used for the causes of immune infertility, such as germline infections, prostatitis, seminal vesiculitis, epididymitis, etc. ② Immunosuppressive therapy, mainly applying corticosteroids, such as prednisone, methylprednisolone, betamethasone, dexamethasone, etc., with a general course of treatment of about six months. Treatment of immune infertility Overcoming AsAb interference – assisted reproductivetechnology (ART) Intrauterine insemination for fertility treatment Conservative treatment is ineffective, unexplained infertility is unexplained, and immune problems are highly suspected, and the aforementioned treatment methods are ineffective. Treatment of unexplained infertility Treatment of unexplained infertility Expected treatment Treatment of unexplained infertility Medication Induction of ovulation, intrauterine insemination, in vitro fertilization-embryo transfer, use of clomiphene (CC) and prohormone application in ovulation treatment. Treatment of unexplained infertility.