I. What are the basic conditions for human fertility?
The conditions for female fertility are: the right age for childbirth
A woman’s endocrine hormones are normal: she must have a normal menstrual cycle, with menstruation every 28-30 days
Both ovaries have ovulation function
The fallopian tubes should be soft and smooth, with the function of transporting eggs and fertilized eggs, without serious pelvic inflammatory disease, reproductive tract infections and pelvic adhesions
Cervical mucus (leucorrhoea) and blood should not contain anti-sperm antibodies, etc.
Second, the conditions for male fertility are
Semen volume: greater than 0.5 ml, usually 2-3 ml
Liquefaction time: 30~60 minutes
Activity rate: greater than 60% (generally 60-80%)
Motility: more than 50% of A+B grade sperm
Count: 20×106/ml
Inflammatory cells: less than one (+)
Deformed sperm: less than 30%
III. What is infertility?
Infertility refers to the inability of a couple of childbearing age to conceive after one year of regular sexual intercourse without contraception.
Factors of both partners may lead to infertility. In general, the female partner accounts for 60-70% of cases; the male partner for 20-30%; and 10% for unknown reasons. In addition to reproductive disorders that can affect fertility, the following are also detrimental to fertility.
Lifestyle (especially stress)
Overweight
Alcohol, coffee overdose, smoking
Psychological factors
IV. Causes of female infertility: Ovulation problems are the most common
Congenital developmental abnormalities: congenital developmental abnormalities of the reproductive system
Abnormal ovarian function: ovulation disorder, luteal insufficiency
Fallopian tube damage such as adhesions, hydrocele, obstruction, resection, tumor compression
Uterine factors such as endometriosis, fibroids, endometrial polyps, endometrial tuberculosis, infantile uterus, etc.
Cervical factors such as severe cervicitis, cervical canal stenosis, abnormal cervical mucus or presence of anti-sperm antibodies
Reproductive system infections: inflammation, tuberculosis
Other causes such as hyperprolactinemia
V. Causes of male infertility: such as retrograde ejaculation, oligospermia, azoospermia, infection obstruction, cryptorchidism, chromosomal abnormalities, varicocele, mumps, sexual intercourse difficulties, etc.
The examination and treatment of infertility will tell you five basic questions.
1. Is there any problem with ovulation of the female partner?
Is the menstrual cycle normal or disordered?
Basal body temperature (BBT) measurement in both directions, shortened follicular phase and luteal phase, and delayed menstrual cycle often indicate irregular ovulation or anovulation.
Blood hormone measurement
Ultrasound monitoring of ovulation
2.Is there any sperm problem?
Semen routine and analysis
Sperm morphological examination
Blood FSH, LH, T hormone measurement
Presence of anti-sperm antibodies
3.Can the sperm and egg combine?
Cervical mucus test
Post-coital test
Hysterosalpingography (HSG) or lumpectomy
Hysteroscopy
laparoscopy
4.Can the embryo implant or can the mother maintain the pregnancy?
Luteinizing hormone test: 7-9 days after ovulation
Endometrial biopsy: 1-3 days before menstruation
Ultrasound examination: 7-9 days after ovulation, showing the “three lines” sign
Progesterone level to maintain pregnancy
5.Other causes of infertility?
Positive reproductive immune antibodies
Polycystic ovary syndrome (PCOS)
Endometriosis
VI. Infertility consultation and treatment process
Initial consultation to understand the cause of infertility
Examination stage Identify one or several possible causes of infertility in both men and women (examination methods include chromosomes, hormones, antibodies, three cervical tests, HSG, laparoscopy, ovulation monitoring, semen examination and analysis, sperm morphology examination).
You need to understand a few things
Firstly, pregnancy is a matter for both husband and wife. Both of them should encourage each other and work together to face the disease of infertility to reduce mental stress and improve the success rate of treatment.
Second: The causes of infertility are complex and the problem may lie with both partners, so both partners need to undergo some relevant tests before determining the treatment plan.
Third: If some tests or treatments have been done in the past, it is better to bring all these information for the doctor’s reference.
Fourth: Infertility examination and treatment cannot be completed in one or several procedures, and you need to make several follow-up visits until you achieve the final pregnancy.
Seven: Treatment plan selection: Based on the diagnosis results, the best treatment plan is chosen. During the treatment of infertility, the doctor will explain to you the possible causes of infertility and propose several different examination and treatment methods for your reference according to your actual situation
1.Outpatient medication stage: Generally, the medication will be used for 3-6 months, and if it is not effective, the patient will be immediately transferred to laparoscopic surgery or direct assisted reproductive technology treatment.
2.Surgical treatment stage: Some patients can be relieved of tubal adhesions, obstruction, obstruction, ovarian cysts and other causes by surgical means.
3.Assisted reproductive technology treatment stage: For those who are ineffective in conservative treatment or 3-6 months after surgical treatment, or whose examination results suggest no possibility of the above treatment at all, they should be treated with assisted reproductive technology.
Follow-up stage After applying assisted reproductive technology treatment, such as IVF (IVF-ET), it is necessary to maintain luteal function, check blood HCG results after two weeks, determine IVF outcomes, and summarize and archive information.