A lot of people say that after getting married and not getting pregnant is infertility, is that so? This statement is not completely accurate, the so-called infertility, must have several conditions, first of all, couples have a normal and regular sex life (2-3 times a week), and secondly, the two sides did not take any contraceptive measures when having sex, in addition to time requirements, that is, at least one year or more than one year without pregnancy can be called infertility. Second, pregnancy is a woman’s business, and men have much to do with it? This argument is untenable, pregnancy is a joint effort of men and women, pregnancy through fertilization, implantation and growth and development of the last to become a mature fetus, fertilization refers to the man’s sperm and the woman’s egg combined together, which requires a few basic conditions, the man should have healthy sperm, the woman needs to be mature and healthy egg and can be successfully combined, which any one of these links out of order are A successful pregnancy cannot be achieved. In other words, if you have infertility, you should have both men and women undergo the relevant examinations at the same time, and it is incorrect to simply assume that it is any one of them. Thirdly, as mentioned earlier, problems in both sexes can lead to infertility, so let’s talk about some of the common causes of infertility. The causes of infertility include female factors, male factors, both male and female factors and some unknown reasons, of which female factors account for 30-40%, male 20-30%, both sides 20-30%, unknown reasons account for 5-10%. (1) Pelvic and tubal abnormalities, including tubal obstruction, hydrosalpinx, chronic tubalitis, tubal tuberculosis, pelvic adhesions, pelvic tuberculosis and so on. (2) Anovulation or ovulation disorder, commonly including polycystic ovary syndrome, premature ovarian failure and some other endocrine disorders. (3) Endometriosis, including ovarian endometriosis (i.e. chocolate cyst), pelvic endometriosis, etc. (4) Endometrial abnormalities, such as abnormal endometrial hyperplasia, endometrial polyps, and uterine adhesions. (5) There are also some diseases, such as hyperthyroidism, congenital gonadal dysfunction, chromosomal abnormalities and so on. 2, the male side of the common reasons are: (1) sexual dysfunction, resulting in the inability to ejaculate and so on. (2) Abnormal sperm quality, including oligospermia, weak sperm, deformed sperm, azoospermia. (3) Non-obstructive azoospermia caused by chromosomal abnormalities. (3) Both sides of the cause: infertility caused by immune factors. Fourth, with infertility need to do which aspects of the examination? As mentioned earlier, both sides need to be examined, and when the examination is conducted, it usually starts from the most common causes, using simple methods first. In addition to a simple physical examination (gynecological examination, male specialist examination), both sides must do the first visit to the examination: male semen routine, the female first vaginal ultrasound, if necessary, also need to do a tubal flux, menstrual abnormalities also need to check a basic sex hormones. If after the above examination suspected tubal problems, need to do tubal imaging or laparoscopy, suspected endometrial abnormalities need to carry out hysteroscopy, suspected endometriosis need to do laparoscopy, male semen abnormalities may need to do prostate ultrasound, if azoospermia also need to do testicular or epididymal aspiration biopsy, chromosome examination, sex hormone examination. If none of the above tests find problems, you may also need to check anti-sperm antibodies, thyroid function and so on. Fifth, if the tubal imaging says that the fallopian tube is fluid or different how to deal with it? There are two sides of the fallopian tube, if only one side is abnormal, then you need to carry out other aspects of the examination, or simple symptomatic treatment to be guided by coitus and other treatments, if it is found to be bilateral abnormality, may need to resort to other means, of course, the final choice of treatment should be a combination of the patient’s age, ovary status, whether there are other abnormalities and the patient’s wishes and so on many aspects of comprehensive consideration. Generally, we suggest that young patients with fewer years of infertility can first consider laparoscopic surgery or other minimally invasive surgery. Laparoscopy is the gold standard for checking whether the tubes are open and whether there is fluid buildup, etc. We can find out some false-positive or false-negative results reported by tubal imaging, and more importantly, most of the obstructed tubes can be unblocked during laparoscopic examination to make them open up. It is worth mentioning that laparoscopy can also help us discover some other causes of infertility, such as pelvic adhesions, endometriosis, etc., and these problems can be handled accordingly while discovering them, which greatly increases the chances of pregnancy for the patients themselves. For patients who have been infertile for a longer period of time, who are older or who cannot undergo laparoscopy, they can now choose to undergo in vitro fertilization-embryo transfer (commonly known as in vitro fertilization). Of course, if the tubal hydrocele patients, especially those who have obvious to the uterine cavity reflux of fluid patients, even if they intend to do IVF, we still recommend that they in the IVF before the laparoscopic surgery to do the appropriate treatment. VI. Why do endometrial polyps cause infertility and what are the ways to solve the problem? Is it dangerous? First of all, it should be clear that not all endometrial polyps can cause infertility, but if endometrial polyps are found in infertility clinic, they must be treated. Endometrial polyps can cause infertility by altering the volume of the uterine cavity, reducing the area where the embryo can settle, and altering the endometrium’s localized risk microenvironment. Endometrial polyps are abnormal growths that cannot be made to disappear with medication and must be removed surgically. Smaller endometrial polyps can be ultrasound-guided scraping to achieve the purpose of removing polyps, for larger polyps simple scraping is difficult to work, and this method is difficult to completely scrape the polyps completely, and there is a risk of damage to other normal parts of the uterine lining. However, for larger endometrial polyps or multiple endometrial polyps, scraping is hardly effective. In recent years, hysteroscopic surgery has become an important means of treating endometrial polyps. Hysteroscopy allows you to see the entire uterine cavity under direct vision, which has the advantages of visualization, clean removal of diseased tissue, and no damage to other parts of the lining of the uterus. Considering that endometrial polyps are very prone to recurrence, we suggest that patients who are infertile due to endometrial polyps should be instructed to have intercourse or undergo in vitro fertilization as soon as possible after the surgery and normal menstruation is resumed, and if recurrence occurs, the surgery should be repeated in time to remove the endometrial polyps. As for the safety of hysteroscopy, there are risks of water intoxication and secondary uterine adhesions, but the technique has been used successfully for nearly 40 years. Seven, because of endometriosis caused by infertility and how to deal with it? Endometriosis is an extremely common gynecological disease and an important cause of female infertility, reportedly accounting for about 20-30% of female infertility, as mentioned earlier, endometriosis can occur in the ovaries, pelvis, uterine myometrium, and various organs of the body. If ultrasound or the patient’s symptoms suggest endometriosis, laparoscopic surgery should be performed as soon as possible. This safe, minimally invasive procedure not only helps to confirm the diagnosis of endometriosis, but also treats the type of endometriosis needed, making it the best treatment for endometriosis. After endometriosis surgery, for younger patients with better ovarian function can first use medication (such as Norethindr) to prevent its recurrence for 2-3 months, and then use medication to promote ovulation to guide coitus, and strive to get pregnant in less than 6 months, if older or poor ovarian function can be guided to coitus as soon as possible after the recovery of menstruation after surgery. The prime time for all patients to get pregnant after surgery is within one year after the operation, especially six months is particularly important. If you still can’t get pregnant after the above treatment, you can repeat the laparoscopic surgery while excluding other reasons for not getting pregnant, and you can also get pregnant as soon as possible with the help of assisted reproduction technology (in vitro fertilization). Polycystic ovary syndrome is also very common, if so how should it be handled? Polycystic ovary syndrome is an endocrine syndrome characterized by prolonged anovulation and hyperandrogenism, and is the most common cause of menstrual disorders in fertile women. The main clinical manifestations include hyperandrogenic changes, menstrual abnormalities, ovulation disorders and infertility. This disease is the most common cause of anovulatory infertility. After the diagnosis of this disease, the treatment of this disease requires a combination of several aspects such as the changes in the patient’s ultrasound, the characteristics of the hormone levels and the patient’s hospital. Here we focus on the treatment of patients with polycystic ovary syndrome who come to the hospital for infertility. For patients with polycystic ovary syndrome who have normal hormone levels and no clinical manifestations of hyperandrogenism, we can directly treat the patients with ovulation stimulation. Generally speaking, the preferred drug is clomiphene, which needs to be used under the guidance of a doctor, and needs to be monitored regularly during the process of its use (the methods of monitoring include regular vaginal ultrasound, hormone measurements, or urinary LH panels, etc.), and the follicles will be given or given to a doctor when the doctor determines that they are mature. The doctor will determine the maturity of the follicles and give or not give drugs to promote follicular discharge, and strictly in accordance with the doctor’s instructions on the time of coitus. If there is no ovulation or pregnancy after 3-6 consecutive cycles of Clomiphene, we can also use other ovulation drugs, such as letrozole, urogonadotropin, follicle-stimulating hormone and so on. For patients with polycystic ovary syndrome with hyperandrogenism or hyperandrogenism, we need to use androgen-lowering drugs for treatment, we are more familiar with drugs such as Daying 35, the main androgen-lowering component of this drug is cyproterone acetate, and there are also some newer drugs that have androgen-lowering effects, such as Yusmin, which has drospirenone as an androgen-lowering component. If the above drugs are used continuously for 3-6 months and still can not be reduced to normal, we can also use dexamethasone and other hormones or traditional Chinese medicine. After the patient’s androgen level is reduced to normal or improved, we can carry out ovulation induction treatment according to the above mentioned methods. In addition, some patients with insulin resistance, especially those who are fat, can try to control their diet and lose weight, and if necessary, they can also use some insulin sensitizers, such as metformin, etc. After improvement or after these treatments, we can also use dexamethasone and other hormones or Chinese medicines. After the improvement or at the same time when these treatments are carried out, ovulation induction treatment can be carried out according to the above methods. If the above patients do not get pregnant after 3-6 cycles of regular ovulation guidance intercourse, we can consider resorting to assisted reproductive technologies (including IVF and artificial insemination, etc.). There are also options, mainly for those patients who are not in a position to undergo IVF or who have failed after IVF, there are TCM treatments and laparoscopic surgeries, including laparoscopic ovarian perforation and laparoscopic ovarian wedge resection. After our systematic and regular treatment, more than 90% of the patients can eventually get pregnant. Nine, the male problems have should be how to deal with it? For male problems we also have male professors to help us answer in detail, I’m here to simply say that there are several ways: 1, on the less weak malformed sperm can improve lifestyle, drug therapy, if, if not effective, according to the sperm specifics of the line of assisted reproduction therapy, including artificial insemination, in vitro fertilization, IVF, IVF, micro fertilization, etc.. 2, for sexual dysfunction, the first choice to improve sexual function, if not effective, then switch to the above mentioned methods of assisted reproduction. 3, for azoospermia, should do testicular and epididymal puncture, puncture out of sperm can do micro fertilization in vitro fertilization, if there is no sperm can only do sperm artificial insemination or sperm in vitro fertilization.