The causes of infertility are complex, of which female factors account for 40%, male factors account for 30-40%, and both male and female factors account for 10-20% [1]. Our hospital admitted a primary infertility couple, both men and women are abnormal, the woman has been corrected by several surgeries, after artificial insemination of male sperm for one time, now the mid-term pregnancy, the intrauterine development of the fetus is normal. It is reported as follows. 1. Patient Sun Mou, female, 27 years old, was initially diagnosed on July 22, 2010, after 4 years of infertility due to no contraception after marriage. She had regular menstruation, 5-6/28-30 days, medium volume, no blood clots, occasional dysmenorrhea, and complained of normal follicular development and ovulation during natural cycles at the local hospital. Her husband’s semen was found to be weak in the local hospital. She had no history of hepatitis, tuberculosis, appendicitis, or pelvic inflammatory disease, and her tubes were not clear after several tubal fluids were performed. Gynecological examination: normal vulvar development, patent vagina, smooth cervix, anterior uterus, normal size, no pressure pain, no abnormality in both adnexa. Sex hormone five were all in the normal range. Diagnosis: primary infertility, male weak spermatozoa. Uterine tubal iodine-oil angiography (HSG) was performed on July 29, 2010, 4 days after menstruation, suggesting: narrow uterine cavity, irregular morphology, double fallopian tubes were not visualized, uterine pressure was roughly the contrast agent into the pelvic lymphatic vessels. HSG diagnosis was uterine adhesions? Malformation? Double tubal incompatibility. On the same day, she went to the local tuberculosis clinic for a negative tuberculin test, and on August 24, a hysteroscopy was performed, which revealed abnormalities in the shape of the uterine cavity, with multiple polyps of varying sizes around the anterior and posterior walls of the uterus and around the openings of the fallopian tubes, with the openings of both fallopian tubes visible, and polypoid proliferation visible on the left side of the wall of the cervical canal. She was admitted to the hospital and underwent hysteroscopic endometrial polypectomy + laparoscopic pelvic adhesion release and double tubal melphalan on August 27 under general anesthesia. During the operation, multiple endometrial polyps were seen; the plasma membrane of the isthmus of the anterior wall of the uterus was adherent to the anterior peritoneum, and both fallopian tubes were adherent to the peritoneum of the pelvic side wall, so adhesion disintegration was carried out, and after disintegration of the adhesions, Mylan’s fluids were used to indicate that both fallopian tubes were patent. The first month after the resumption of menstruation monitoring follicular development is normal, the guidance of coitus is not pregnant, vaginal ultrasound suggests strong echoes in the uterine cavity, considering the residual polyps, on October 7, 3 days after menstruation, once again hysteroscopy: the uterine cavity is normal morphology, the posterior wall of the uterine cavity, the bottom of the right wall, two polyps, the cervical canal is normal, and was given to diagnostic curettage. November after menstruation, once again hysteroscopy, there is no polyp. Both patients came to the clinic together, the husband’s semen was checked for weak spermatozoa in the local hospital before coming to the clinic, and on July 22, semen routine in our hospital: volume 3.5ml, PH value 7.4, liquefaction time 30 minutes, density 39.685×106/ml, sperm viability 31.081%, class A 6.306%, class B 7.658%, deformity rate 68%. on October 6, semen routine manual counting method On October 6, semen routine manual counting: volume 4.0ml, PH value 7.0, liquefaction time 30 minutes, density 15.1×106/ml, sperm viability 21%, grade A 4%, grade B 10.5%, deformity rate of 84% are suggestive of weak spermatozoa. The patient requested intrauterine insemination (IUI), and both parties signed an informed consent form for IUI after completing auxiliary examinations to rule out contraindications to IUI. Follicular monitoring was performed in the natural cycle, and the follicle developed to 32.5px, which meant ovulation. On December 16, she was given clomiphene 50mg qd×5 days (menstrual days 3-7) and HMG 75u im qod×2 times (menstrual days 8 and 10) to stimulate follicular development. On the 13th day of menstruation, IUI was performed, and the semen was processed by gradient centrifugation, with 12.6×106 sperms of grade a+b after processing, and intrauterine injection was performed, with no intraoperative bleeding and no spillage of semen, and vaginal ultrasound suggested that the three large follicles had ruptured on the following day. Postoperatively, dextroprogesterone 10mg q8h×15 days was given to support the corpus luteum. On January 14, 2011, 18 days after ovulation, HCG 271.95 mIU/ml was checked, and progesterone 40mg im qd, dydrogesterone 10mg bid, and estradiol valerate 2mg qd were given to supplement estrogen and progesterone. On January 17, 2011, she repeated the blood test for HCG 740.65mIU/ml, E2 1876pmol/ml, P 139.90nmol/ml, and continued the previous treatment for 3 weeks. On the 53rd day of amenorrhea, she underwent a vaginal ultrasound: the size of the gestational sac in the uterus was 4.2×67.5px, and the top of the rump of the fetus was 30px long, with a fetal heartbeat visible. Progesterone and estradiol valerate were discontinued, and dextroprogesterone was continued to support the corpus luteum. Vaginal ultrasound was performed on the 73rd day of menopause: a viable fetus was found in the uterus with a biparietal diameter of 40px, a parietal-rump length of 102.4999999999999999px, and a good fetal heartbeat. Fertility-preserving drugs were discontinued, and regular prenatal checkups in the obstetrics department were instructed after 1 month. 2.Discussion Due to the postponement of marriage and childbearing age, environmental pollution, sexually transmitted diseases, pelvic inflammatory diseases continue to increase, infertility in recent years has been on the rise year by year. Its etiology is complex, and the latest data show [2] that the findings of the main etiologic factors associated with infertility are: tubal and pelvic diseases 41.4%, male factors (including azoospermia, oligo-, weak-, dead-, and teratogenic spermatozoa, and sexual dysfunction) 36.4%, and ovulatory abnormalities 12.2%. In this paper, the patient had primary infertility for 4 years, and both partners were examined for causes of infertility. The female HSG showed uterine cavity morphology disorder, narrow uterine cavity, double tubal proximal obstruction, suspected of uterine adhesion, due to primary infertility, tuberculin test ruled out tuberculosis due to tuberculosis, there is no history of acute pelvic infections, and is considered to be associated with repeated repeated tubal lysis, uterine operation led to subclinical infection. Hysteroscopy was performed and found that the uterine cavity was morphologically abnormal, the uterine cavity was occupied by endometrial polyps, which could explain the narrowness and irregularity of the uterine cavity during HSG, so hysteroscopic electrosurgery + laparoscopy was performed, pelvic adhesions were found during the operation, separation was given, Melan fluid suggested that both tubes were patent, it was hypothesized that the tubes did not show up because of polyps blocking the opening of the fallopian tubes. Because of the multiple polyps in the uterine cavity, the polyp could not be completely removed at one time, and postoperative ultrasound still suggested strong echoes in the uterine cavity, so hysteroscopy was performed again, and there were still a small number of polyps, and diagnostic scraping was given. Endometrial polyps are benign lesions in which endometrium undergoes focal hyperplasia by the continuous action of estrogen [3, 4], Zhang Xubin et al. reported that tubal obstruction factor accounted for 167 cases (33.27%) in 502 cases of infertility hysteroscopy, in addition to endometritis (24.90%), endometrial polyp (10.76%), uterine cavity adhesion (5.18%), cervical canal mass ( 3.98%) and congenital uterine abnormalities (3.19%) were also common causes. Hysteroscopy found that the proportion of endometrial polyps and cervical tube masses in primary infertility was significantly higher than that of secondary infertility group [5]; therefore, for primary infertility patients with longer infertility time, timely hysteroscopy should be performed to exclude infertility caused by intrauterine pathology, and hysteroscopy can only visualize the surface of the endometrium, but not the tubes, and can not completely replace the HSG examination, which is more accurate and perfect when complementing each other. The two complement each other to be more accurate and perfect. For some uterine development abnormality, or the existence of pelvic factors, purely relying on hysteroscopy can not be clearly diagnosed, if necessary, need to be combined with laparoscopy to further clarify the diagnosis and treatment, this patient HSG suggests that the uterine cavity is obvious abnormalities, due to the existence of tubal obstruction at the same time, timely hysterolaparoscopic examination and treatment, laying the foundation for the further success of the treatment. Due to the husband’s weak spermatozoa, he was eligible for artificial insemination. Timely intrauterine insemination (IUI) shortened the treatment time and saved medical costs. The natural cycle of small follicle ovulation, so the use of clomiphene + urotropin to promote follicle development and maturation after IUI, after ovulation to support the corpus luteum and then successful fertilization. To summarize, in infertility treatment, both sides at the same time systematic examination, in accordance with the diagnosis and treatment pathway [6], will get twice the result with half the effort.