“I really didn’t expect that I would become a mother so soon!” Ms. Liao, 32 years old this year, was so excited that her eyes were red when she was checked to be 3 months pregnant at the hospital. Ms. Liao has been preparing for pregnancy since she was 28 years old, and all indicators are normal, but her belly has not moved at all for several years, “I was found to have celiac disease during the preconception checkup a few years ago, but a friend told me that celiac disease is not a disease and does not need to be treated at all, and I never thought that this is the problem that has kept me from getting pregnant for 4 years.” What should be checked for cervical infertility? 1. Examination of the cervical canal for organic lesions (1) Vaginal examination: observe the position, shape and size of the external opening of the cervix, the amount and nature of secretions and the presence of cervical erosion and redundancy, etc. Pay attention to the presence of cervical lifting pain and parametrial pressure pain. Bacteriological examination of the cervical canal mucus is also done. If necessary, scraping or colposcopy should be done. (2) Probe examination: It is simple and practical to detect the direction and length of the cervical canal and its ratio to the cervix, the presence of stenosis, adhesions and the tightness of the endocervical opening. If abnormalities are suspected, further contrast examination should be considered. (3) Imaging: Hysterosalpingography can not only detect uterine and fallopian tube lesions, but cervical imaging is also beneficial for the study of infertility treatment. When oil is applied and the contrast apparatus is developed, it can show the length and shape of the cervical canal very well. (2) Cervical mucus examination (1) Cervical mucus characterization: observe the amount, transparency, viscosity and extensibility of cervical mucus secretion. (2) Sperm-cervical mucus compatibility test: post-coital test (PCT): the PCT can determine whether the compatibility between sperm and cervical mucus is normal. 3. Common symptoms of cervical infertility (1) Atresia and stenosis of the cervical canal Congenital cervical atresia or stenosis is mostly due to incomplete formation and fusion of the lower segment of the bilateral Mullerian canal. It is rare clinically and is often accompanied by uterine hypoplasia with mostly normal development of secondary sexual characteristics. If the patient has good endometrial function, periodic lower abdominal pain may occur during puberty due to accumulation of blood in the uterine cavity, or menorrhagia with dysmenorrhea, and menstrual blood may also reflux into the abdominal cavity via the fallopian tubes, causing pelvic endometriosis. (2) Cervical duct dysplasia may be accompanied by uterine dysplasia. In severe dysplasia, the cervix is elongated. In moderate dysplasia, the ratio of the length of the cervix to the body of the uterus is 1:1, which is called “youthful uterus”. Hypoplastic cervix can lead to inadequate cervical glandular secretion. (3) Abnormal position of the cervical canal is often accompanied by abnormal position of the uterine body. Chronic pelvic inflammatory disease or endometriosis can cause extreme posterior tilt, retroflexion or anterior flexion of the uterus, so that the cervical ectocervix is attached to the fornix, resulting in the fornix becoming shallow and losing the role of the sperm storage pool, which is not conducive to the upward movement of sperm. In addition, cervical lengthening, too short or cervical prolapse may also change the normal position of the relationship between the ectocervix and the posterior fornix, preventing sperm from moving up. (4) Cervical fibroids Cervical fibroids cause infertility mainly because of deformation and narrowing of the cervical canal, which affects the passage of sperm. The clinical manifestations are mainly irregular menstruation, increased amount of menstrual blood and increased leucorrhea. Some patients are asymptomatic. Gynecological examination may reveal a prominent fibroid nodule or a change in the shape of the cervix, with enlargement of the cervix on the side where the fibroid is located and thinning of the opposite side by pressure, and a twist-shaped elongation of the external cervical opening. Cervical disease can kill sperm halfway and lead to infertility, so cervical disease needs to be taken seriously by all women.