Infertility is a worry for many families. Some informal hospitals take advantage of this gap, with advertisements all over the place, misleading many families and wasting a lot of human and material resources. There are many causes of infertility, which can be broadly divided into male or female factors, and also into congenital or acquired factors, or into anatomical factors, immune factors, infectious factors, genetic factors and so on.
It is because the causes of infertility are complex that treatment is difficult. Therefore, before an infertile couple receives treatment, they should first know what the causes of infertility are. Both men and women should go to the hospital for examination at the same time. Scientific and systematic examination is very necessary for clear diagnosis and treatment. It is even more necessary to visit a regular hospital.
I. The main examination items for women are as follows.
1, gynecological examination and routine white belt, gonococcus, bacterial vaginosis, mycoplasma, chlamydia examination
(1) Examination purpose: To understand the development of female genitalia and the presence of vaginitis, cervicitis, etc.
Infections of pathogens in the reproductive tract can affect the success rate of fertility treatment, and even if the fertility treatment is successful, it can lead to adverse effects on fetal birth, such as miscarriage and abnormal fetal development.
(2) Examination time: Non-menstrual period.
(3) Precautions: Vaginal discharge, vaginal douching, intercourse, gynecological examination and ultrasound examination are prohibited for three days before the test, please empty the bladder before taking the specimen.
Reproductive endocrine hormone test
1.Checking purpose: To understand whether the hormone secretion of pituitary gland and ovaries is normal, to assist in diagnosing the cause of infertility and to evaluate the function of ovaries and uterus.
2.Checking time: within 2-4 days of menstruation, preferably on the second day of menstruation; if menstruation is still coming for more than 50-60 days, blood can be drawn to check sex hormones.
If you want to check prolactin (PRL) alone, you should take blood around 9-11 am, do not do strenuous exercise, do not stimulate your breasts, rest for 20 minutes before taking blood, and rest well the night before the test.
Anti-sperm antibodies, anti-endometrial antibodies, anti-cardiolipin antibodies, virus four tests
1, the purpose of the test: to draw blood to check some antibodies related to fertility in the female serum. And whether there is a virus infection.
2.Checking time: The test can be done every day, but it is usually done on the second day of menstruation together with sex hormones.
Intracavitary ultrasonography
1.Examination purpose: Intracavitary ultrasound is a scanning probe placed inside the vagina to observe the uterus and ovaries. Vaginal ultrasound has clear imaging and high resolution, and can observe very small fibroids and lesions.
2. Precautions: The bladder needs to be emptied before each ultrasound.
V. Endometrial pathology examination
1.Examination purpose: It can indirectly reflect ovarian function and directly respond to endometrial lesions; determine the degree of uterine development and the presence of cervical canal and uterine cavity adhesions, and the presence of other abnormalities such as polyps.
2.Checking time: within 24 hours of menstrual flow. It is generally recommended to come to the hospital on an empty stomach on the morning of the second day of menstruation to have blood drawn for sex hormones and then to take the endometrium.
3. Precautions: Oral antibiotics should be taken for 3-5 days after the operation to prevent infection, and it is normal to have reduced menstruation or no menstruation.
Sixth, hysterosalpingography
1.Checking purpose: to understand whether the uterus is developing normally, whether there are occupying lesions in the uterine cavity, the patency of the fallopian tubes and whether there are pelvic adhesions, etc.
2.Checking time.
(1) 3-7 days after menstruation is the best time for examination. If your menstrual period is only 3 days, it is better to come to the hospital for examination 5-7 days after your menstrual period is clean. Before the examination, sexual intercourse is forbidden and it is better to use preventive vaginal medication for 3-4 days to prevent infection.
(2) The time for imaging in our hospital is every Monday to Friday afternoon, but please come to the hospital in the morning for gynecological examination, ECG and sign the informed consent form, and come to the hospital at 12:50 pm on the same day accompanied by your family for examination. If you come to the hospital after 13:00, you will not be able to have this examination on that day.
(3) Precautions.
① Pay attention to local hygiene after the imaging. Sexual intercourse, tub bathing and swimming are prohibited for 2 weeks.
② Oral antibiotics (azithromycin + metronidazole) should be taken for 5-7 days after imaging to prevent infection.
③ Sexual intercourse is prohibited for 2 weeks after imaging, and contraception is recommended for 3 months. This is because pregnancy within 3 months after exposure to radiation may lead to an increased chance of abnormal fetal development.
④A small amount of vaginal bleeding (less than menstrual blood) and lower abdominal pain may occur after imaging; please do not worry, as the symptoms will gradually decrease or disappear on their own the next day. If there are abnormalities such as heavy bleeding, difficulty in breathing, chest tightness, choking and coughing, itchy skin and severe abdominal pain, please go to the hospital promptly.
VII. Hysteroscopy
1.Checking purpose: To understand the situation in the uterine cavity, which can detect the pathological conditions related to infertility such as uterine adhesions, submucosal fibroids, endometrial polyps, uterine malformations, etc. It is suitable for those who are suspected of having any form of intrauterine lesions or need to make diagnosis and treatment of intrauterine lesions, which can be observed, taken or positioned for scraping under direct vision to discover intrauterine lesions and improve the accuracy of diagnosis of intrauterine diseases.
2.Examination time.
A 3-7 days after clean menstruation is the best time for examination. If your menstrual period is only 3 days, please come to the hospital for examination preferably 5-7 days after your menstrual period is clean; if your menstrual period is more than 5 days, you can come to the hospital for examination 3 days after your menstrual period is clean. Before the examination, sexual intercourse is forbidden, and it is better to put prophylactic vaginal pills for 3-4 days.
Please come to the outpatient clinic of the Reproductive Center on the same day for gynecological examination, blood sampling for routine blood count, blood coagulation, infectious diseases and electrocardiogram if there is no abnormality, then you can be admitted to the hospital.
Note: After hysteroscopy, you should take oral antibiotics for 5-7 days to prevent infection and abstain from sexual intercourse for one week; there may be a small amount of vaginal bleeding (less than menstrual blood) and lower abdominal discomfort, please do not worry, the symptoms will gradually reduce or disappear on their own the next day. If there are abnormal conditions such as heavy bleeding and severe abdominal pain, please go to the hospital in time.
VIII. Laparoscopy
To understand the pelvic cavity, directly observe the uterus, ovaries and fallopian tubes for any lesions or adhesions, discover endometriosis lesions, and feasibly pass methylene blue fluid through the fallopian tubes to see directly whether the tubes are open. Laparoscopy requires hospitalization.
IX. Chromosome examination
To help determine if there are genetic defects. It is suitable for those who have a history of multiple spontaneous abortions, history of failure to have normal pregnancy, primary amenorrhea, secondary amenorrhea, premature ovarian failure, multiple artificial insemination, many years of infertility, and multiple failed pregnancy assistance.
1. The main examination items for the male side are as follows.
Male examination
The main examination items are: male examination, male examination, male examination, male examination, male examination, male examination, male examination, male examination.
The examination of male fertility, infertility, sexual function, male reproductive organ diseases, sexual dysfunction and sexually transmitted diseases, etc.
2.Semen routine analysis
It is the most important, practical and simple test to assess male fertility.
Precautions.
(1) When diagnosing infertile couples, at least one semen analysis must be performed. If the first semen analysis results are normal, a second analysis is not necessary. In cases of azoospermia and bilateral vas deferens, there is also no need for re-testing. If other semen abnormalities are encountered, two semen analyses are required, with an interval of approximately 2 weeks between analyses. If there is a significant difference in the results between the two analyses, a third semen analysis should be performed after an interval before treatment.
(2) The specimen should be collected at a time of abstinence of at least 48 hours but not more than 7 days.
(3) Specimen collection should be performed in the designated sperm collection room of the Fertility Center. For rare patients who have difficulty in obtaining semen, they may be allowed to keep the specimen in a room other than the fertility center, but the time from specimen removal to delivery should not exceed 30 minutes, and the temperature of the delivery needs to be guaranteed.
(4) Semen specimens prepared for assisted reproduction are required to be retained in the designated sperm collection room of the reproduction center.
(5) Semen should be retained by masturbation and ejaculated into a clean semen collection container. The container should be pre-marked with the patient’s name and the time of specimen collection. If circumstances prevent the specimen from being obtained by masturbation, a special penile sleeve may be used for semen collection. If microbiological examination is to be done, the patient should first urinate and wash his hands and penis, and then discharge semen in a sterile container.
(6) The staff should emphasize to the subject the importance of maintaining the integrity of the collected specimen.
(7) Patients with difficulties in sperm retrieval should be put in contact with the clinician at the earliest possible time and follow his or her advice.
Sperm morphological analysis
The morphology and structure of spermatozoa are closely related to their function. The sperm head is the acrosome and the sperm nucleus, of which the acrosome contains hydrolytic enzymes that play an important role in the process of dissolving the zona pellucida; the sperm nucleus is the carrier of paternal genetic material; the sperm midsection is where the mitochondria are located, providing energy for sperm movement; and the sperm tail is the device for sperm movement. Studies have concluded that sperm morphology is a strong indicator for evaluating male fertility and plays an important role in the prediction of assisted reproductive outcomes.
IV. Anti-sperm antibody test
Blood is drawn to check some antibodies related to fertility in male serum.
V. Reproductive hormone measurement
The endocrine examination of male infertility patients can help determine the cause of infertility and thus provide a basis for treatment. Commonly used indicators include FSH, LH, E2, PRL, T, etc. It is suitable for male azoospermia, retrograde ejaculation, severe oligospermia, male genital dysplasia, hypogonadism or sexual dysfunction, etc.
VI. Serum inhibin B
Inhibin is a heterodimeric protein hormone secreted by female ovarian granulosa cells and male testicular support cells. It selectively inhibits the secretion of follicle-stimulating hormone (FSH) and has a local paracrine effect on the gonads. The main role of inhibin B is to regulate gamete development through a negative feedback effect on FSH. Inhibin B can be used as an endocrine marker, and its detection allows monitoring gonadal function in men or women. Therefore, inhibin B is also very important in male infertility testing.
VII. Mycoplasma
In male infertility, mycoplasma infections in the male reproductive tract cause local inflammatory reactions, making the local environment unfavorable for sperm survival, mycoplasma can also adsorb on sperm, leading to sperm membrane damage, resulting in reduced sperm runnability, deformed sperm, dead sperm, etc. causing sperm deformities, so mycoplasma solium infection in infertility, miscarriage, stillbirth detection has become a routine item.
Eight, chlamydia
Chlamydia is a common pathogen causing reproductive tract infections and has become one of the most common sexually transmitted diseases in Western countries in the last 20 years. In women it can cause vestibular adenitis, cervicitis, endometritis, tubitis, pelvic inflammatory disease, infertility, etc. In men, it can cause non-gonococcal urethritis, prostatitis, epididymitis and other diseases of the genitourinary system.
IX. Sperm nuclear DNA integrity test
Sperm nuclear DNA integrity is essential for natural conception, artificial fertilization, embryo, fetus, infant and even adult development. Studies have shown that sperm DNA integrity is an independent parameter superior to conventional semen analysis and has a high correlation with assisted reproductive technology outcomes. Therefore, sperm DNA integrity testing is important for eugenics, and in assisted reproductive technologies.