Definition of infertility: Infertility is a condition in which a person has a normal sexual life and has not had a pregnancy for one year without contraception. Primary infertility: those who have never had a pregnancy without contraception Secondary infertility: those who have had a pregnancy and have been infertile for one year without contraception There are national, ethnic and regional differences in the incidence of infertility in China: 7%-10% of infertility is due to repeated miscarriage and ectopic pregnancy without a live baby. Causes of infertility: female factor 40%, male factor 40%, male and female factors 20% 1. Female infertility factors a ovulation disorder: polycystic ovary syndrome b fallopian tube factor: tubal obstruction c uterine factor: post-abortion cervical adhesion d cervical factor: endocervical stenosis 2. Male infertility factors: a semen abnormalities: oligo-weak teratozoospermia, azoospermia b sexual function abnormalities: penile erectile dysfunction, infertility a abnormal semen: oligospermia, azoospermia b abnormal sexual function: penile erectile dysfunction, non-ejaculation c immune factors: sperm, seminal plasma producing antisperm antibody (AsAb) 3. male and female factors: a abnormal sexual life, sexual inability b immune factors: alloimmunity, autoimmunity c unexplained infertility: both male and female examination did not find abnormalities III. Finding out the cause of infertility is the key to diagnose infertility. 1. Male examination: The first step of examination for infertile couples: Semen analysis of abstinence for 2–7 days (preferably abstinence for 4 days) Volume: 2.0 ml or more PH: 7.2 or higher Sperm density: 20×106/ml or more Total sperm count: ≥ 40×106 sperm count/one ejaculation Vitality: within 60 minutes after ejaculation ≥ 50% of sperm with forward motion (class a+b) or ≥ 25% of sperm with rapid forward motion (class a) Morphology: reduced in vitro fertilization rate if the number of sperm with normal morphology is less than 15% Survival rate: 50% or more survived, i.e., not colored Leukocytes: less than 1×106/ml Immuno-bead test: less than 50% motile sperm on attached beads MAR test: motile sperm on attached Female examination: (1) history taking (2) physical examination (3) special female infertility examination a. Ovarian function examination: including ovulation detection and luteal function examination; basal hormone measurement from day 3 to day 5 of menstruation: follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), testosterone (T), progesterone (P) measurement 7 days after ovulation (i.e. day 21 of menstruation); progesterone (P) measurement. Progesterone (P) was measured 7 days after ovulation (i.e. day 21 of menstruation); follicle monitoring was started on day 12 of menstruation to observe follicle development and ovulation. b tubal patency test: tubal lavage, hysterosalpingogram and hysterosalpingogram. cHysteroscopy: to understand the situation in the uterus and to detect uterine adhesions, submucosal fibroids, endometrial polyps, uterine malformations, etc. d Laparoscopy: direct observation of the uterus, fallopian tubes, ovaries for lesions, adhesions, endometriosis lesions, tubal passage with methylene blue fluid to determine whether the tubes are patent under direct vision. e other: post-coital test with 20 active sperm per high magnification field, MRI magnetic resonance imaging. Treatment of female infertility 1. Treatment of organic lesions of the reproductive tract 1) Treatment of chronic inflammation and obstruction of the fallopian tubes: general treatment, tubalplasty, intra-tubal injection 2) Ovarian tumors: regular review of ovarian tumors less than 5 cm every 3-6 months, surgical treatment of ovarian tumors greater than 5 cm 3) Uterine lesions: submucosal fibroids, endometrial polyps, uterine longitudinal septum, uterine adhesions, hysteroscopy or laparoscopy (4) Vaginitis: treatment of pathogenic bacteria (5) Endometriosis: laparoscopic diagnosis and treatment, postoperative assisted reproductive treatment (6) Reproductive tuberculosis: anti-tuberculosis treatment, some assisted reproductive treatment. 2. Ovulation induction (1) clomiphene (2) chorionic gonadotropin (HCG) (3) urinary sex hormone (HMG) (4) luteinizing hormone-releasing hormone (LHRH) (5) bromocriptine. 3. Treatment of immune infertility 4. Assisted reproductive techniques (artificial insemination, in vitro fertilization – embryo transfer, intracytoplasmic single sperm microinjection, preimplantation genetic diagnosis) V. Treatment of male infertility 1. General adjuvant therapy Diet: eat more fish bladders, carrots, leeks, beef, lamb Lifestyle: quit smoking and drinking, avoid wearing tight pants, less sauna, etc. 2, drug treatment (Chinese medicine, Western medicine) a specific drug treatment bacterial infection caused by inflammation: according to the results of bacterial culture, according to drug sensitivity medication, treatment should be thorough anti-tuberculosis treatment caused by tuberculosis bacteria, mycoplasma, chlamydia according to the results of drug sensitivity treatment, treatment time of two weeks oligospermia: available chorionic gonadotropin, urinary gonadotropin combined treatment, a minimum of 74 days needed weak spermatozoa: available levocanidine oral solution Treatment of seminal fluid indigestion: Prostate Bexi capsule treatment b Non-specific drug treatment Western medicine: Vitamin E, Vitamin C, adenosine triphosphate, coenzyme Q, testosterone undecanoate capsule, clomiphene, tamoxifen Chinese medicine: Liu Wei Di Huang Wan, Wu Zi Yan Zong Wan, Right Guei Wan, Sheng Sheng Sheng capsule, Jin Shui Bao capsule, Fu Fang Xuan Ju capsule, Qilin Wan, also young capsule, etc. 3.Surgical treatment for cryptorchidism: surgery before 1 year old to correct varicocele: surgery can be performed to treat vas deferens obstruction: vas deferens anastomosis can be performed according to the obstruction condition and location. 4. Assisted reproductive technology (1) Artificial insemination: artificial insemination of husband’s semen (AIH), artificial insemination of donor’s semen (AID) (2) In vitro fertilization and embryo transfer (IVF-ET) (3) Intracytoplasmic single sperm microinjection (ICSI) (4) Preimplantation genetic diagnosis (PGD) (6) Some experiences of infertility treatment –The principle of treating from simple to complex and from non-traumatic to possibly traumatic is the principle of combining Chinese and Western medicine, the principle of combining primary and secondary diagnosis and treatment, the principle of comprehensive examination and diagnosis first, followed by targeted treatment. The principle of combining traditional diagnosis and treatment technology with modern diagnosis and treatment technology, the principle of combining auxiliary examination (testing, imaging) with clinical diagnosis and treatment, the principle of all convenient patient consultation, the principle of informed consent of patients for diagnosis and treatment technology, the principle of all conducive to the safety of the offspring