The cause of infertility may be in the female partner, or in the male partner, or in both sexes, but the causes of certain infertility are not known and need to be further studied in the future (generally about 40% of male factors, 40% of female factors, and 10-20% of factors in both partners, but still 10-15% are unexplained).
Conception is a complex and coordinated physiological process, which must have three conditions.
1. The presence of normal germ cells (sperm and egg).
2. The sperm and egg can combine normally to form a fertilized egg.
3. The fertilized egg can normally deposit and develop in the endometrium. From the formation of a healthy egg in the woman and its picking by the fallopian tube, to the male sperm passing through the woman’s cervix and uterine cavity, entering the fallopian tube and uniting with the egg to form a fertilized egg, and finally the development of the fertilized egg to form an embryo, which in turn lays in the uterine cavity, any problem in any of these parts may cause infertility.
There are several things that female patients who are to be seen for infertility need to be aware of.
When do I need to seek infertility treatment?
Domestic and international studies have shown that the general chance of conceiving in each ovulatory menstrual cycle is only 20-25%, and the chance of conceiving in a couple with normal fertility and normal sexual life without contraception is 85% for one year and 93% for two years. However, the chance of conception decreases with age, and the rate of natural pregnancy decreases significantly in women over 35 years of age.
Therefore, the previous textbook considered that any married couple who lived together for ≥2 years without contraception and did not become pregnant was called infertility. However, taking into account the domestic and international situation, the Society for Reproduction now defines the new definition of infertility as any couple who have lived together for ≥1 year, have normal sexual intercourse, and do not get pregnant without contraception. The new definition of infertility is more scientific and reasonable because it does not emphasize whether the couple is “married” or not, because the time of marriage does not represent the time of “normal sexual life”; secondly, it is more reasonable to define the time as 1 year.
What are the main causes of infertility at present?
The first and foremost cause is tubal factor. Tubal disease can account for 25% of female infertility and is an important cause of infertility. Occlusion, fluid or adhesions in the fallopian tubes can prevent the movement of sperm, eggs or fertilized eggs. The following are the main factors leading to tubal disorders.
Blockage of the fallopian tubes due to multiple miscarriages or clearing of the uterus
early sex and unclean sex, abortion leading to pelvic inflammatory disease (adnexitis)
Pelvic adhesions (tubal adhesions) due to endometriosis.
Tuberculosis leading to pelvic tuberculosis.
The next factor is ovarian factor. Factors affecting follicular development or egg discharge such as ovarian hypoplasia, luteal insufficiency, premature ovarian failure, polycystic ovary syndrome, and ovarian tumors can cause infertility.
The above causes account for 50% of female infertility.
In addition there are.
Vaginal factors – congenital factors such as vaginal atresia or vaginal septum cause obstruction or difficulty in sexual intercourse, thus affecting the entry of sperm into the female reproductive tract.
Cervical factors – congenital abnormalities, atresia or narrowing of the cervical canal, polyps, erosions, tumors, adhesions, etc. can affect the passage of sperm; the presence of anti-sperm antibodies in the cervical mucus is detrimental to sperm penetration of the cervical canal or completely renders sperm inactive.
Uterine factors – congenital absence of uterus, infantile uterus and uterine malformation can affect female fertility. Uterine fibroids, endometriosis, endometrial inflammation, endometrial polyps, endometrial tuberculosis, and uterine adhesions are all causes of infertility.
Congenital factors – Severe congenital hypoplasia of the reproductive system, which is often accompanied by primary amenorrhea in such patients. Sex chromosomal abnormalities, such as Turner’s syndrome, true and false hermaphroditism, etc., and habitual abortion easily caused by chromosomal abnormalities.
What do I need to pay attention to before coming to the clinic for infertility?
1. Direct expression
Many infertility patients are too shy to talk about their problems and are embarrassed to express them directly after meeting with the doctor, which is related to our national conditions and the environment of the consultation room. To sum up the common aspects as follows: many infertility patients mostly express their problems as follows: menstrual disorders, ovarian cysts, pelvic inflammatory disease, etc. If not infertility professional physicians sometimes do not hospitalize the real purpose of the patient.
2.Choose the hospital carefully and consult the doctor persistently
There are many hospitals and clinics for infertility in China, so patients need to choose carefully, and this is not much to say.
Once you have chosen a hospital and doctor, do not change them easily because there are as many tests for female infertility as follows (of course, not all of them should be done, it depends on the doctor’s habit and specialty, the most important tests should be done first in the shortest time, and only if the cause of infertility is still not clear should you continue to investigate other items). It is difficult to diagnose the cause of infertility in a single visit. In particular, we would like to remind female patients not to rush to take medication just because they are in a hurry, as it is very important to have a clear diagnosis. Only in rare cases should we administer medication while examining the patient.
The following tests are performed for female infertility
①Rh blood group
②Anti-sperm antibodies
③Anti-cardiolipin antibodies
④Anti-endometrial antibodies
⑤ Sex hormones
⑥Chromosome
⑦White belt routine examination
⑧Cervical secretion gonococcal examination
⑨ Chlamydia examination of cervical secretion
⑩Mycoplasma examination of cervical secretion
⑪Cervical cytology examination
⑫B ultrasound of reproductive system
⑬Uterine tubal examination
⑭Laparoscopy or hysteroscopy
3. Couples together
The above-mentioned causes of male and female infertility each account for about 40% of the cases, so it is best to bring your husband along with you, or bring your recent routine semen test results.
4. Other matters
No need to come to the clinic on an empty stomach.
Choose a normal consultation time from Monday to Friday.
It is better to come to the clinic as soon as your period is over for the first time, and then come to the clinic according to the doctor’s prescription.