Infertility is an uncompromisingly difficult condition with complex causes, and the true cause is obvious in some couples, while others are not so sure. Currently there are no quality control indicators for success rates in infertility treatment worldwide, and doctors generally do not jump to conclusions except for the absolute cause of infertility. However, empirical treatment is possible to improve the chances of conception.
Because the fertility mechanism is very complex, for a long time, there is a great misunderstanding of infertility, I would like to say to those anxious patient couples, infertility needs to be treated correctly, as far as possible to identify the causes and take targeted measures, in order not to take a detour, less detours, as soon as possible to achieve the purpose of fertility.
1, normal sexual function, does not mean normal reproductive function
Because of the peculiarities of female anatomy and physiology, many women will have more or less gynecological discomfort, coupled with the historical subordinate status of women, so many men will be the cause of infertility attributed to the female, a reason for men to cheerful is “I am very good, I have no problem”. In fact, male sexual function and reproductive function are two completely different concepts, which are two separate and completely different mechanisms. There are many men who have had children who have sexual dysfunction. Many patients with severe premature ejaculation also slowly begin to seek medical attention only after their female partner becomes pregnant and has a child. Conversely, many patients with azoospermia have a strong sexual desire, normal erections, and normal ejaculation during intercourse, but no sperm in their semen.
2. A history of pregnancy does not mean that there has been fertility
There have been couples who have been infertile for many years and have been seeking consultation and treatment from the female partner for the reason that “my husband has no problem, his past girlfriends have been pregnant many times” or “my husband had a child in his first marriage”.
Please note that infertility is divided into primary infertility and secondary infertility, and secondary infertility means that there was a history of fertility and now the woman cannot conceive. In the past, it was possible to have children normally, but after many years, azoospermia is also found in the clinic. There is such a male patient, before the age of 25, had made 3 girlfriends pregnant, after 5 years of marriage is infertile, test results, this person spermatogenesis gene has a deficiency, has a serious weak spermatozoa.
Although such patients have spermatogenesis in the early stage, some hereditary diseases are late, and the compensatory function of sperm in the body is lost after a certain age, so there is no sperm in the later stage, and it is naturally impossible to have children.
3. Routine semen examination, which cannot fully reflect the fertility function
Many women, when seeking treatment for infertility, often indicate that all the tests on the male side are normal and it must be my problem. And the normal in the mouth of many patients is only the normal semen routine analysis. Since most hospitals do not have a specialized male establishment or the corresponding examination equipment, they are only able to carry out routine semen examinations. In fact, there are many indicators that affect male fertility. In addition to semen routine, sperm function, sex hormone level, immune factors (mainly specific antibodies), karyotype, Y chromosome microdeletion, etc. are all important influencing factors, and if any one of them is wrong, even if the semen routine examination is completely normal, it is also impossible to have children.
4, less, weak sperm is not absolute infertility
Theoretically, as long as there is a morphologically intact and active sperm, it is possible to get pregnant, only the chances are extremely small. However, for the average patient with low or weak spermatozoa, it is possible to relax and increase the chances of pregnancy by chance. The chances of pregnancy will of course be greatly increased by improving the sperm condition through medication. However, the disease must not be seen and treated, and further examination of the female partner is neglected.
One patient, 9 years after marriage, had been treated for mild oligospermia and weak spermatozoa for 7 years, covering almost all of China, with little improvement in sperm condition. At the initial consultation, the woman agreed to the examination only after a strong request from the specialist. The results showed that the female partner had bilateral fallopian tube incompetence. The man not only wasted 7 years of time and money, but the mental stress almost broke him. So when the expert gave him a full analysis, the man bawled his eyes out.
5, fully consider the woman’s fertility status, choose the right way to have children
According to the latest research data, a normal couple, the monthly chance of pregnancy is only 20-25%, the annual chance of pregnancy is about 85%, and for women at the age of 35, the chance of pregnancy than 25-year-old women fell by half, to the age of 38 fell by another half. The misconception is that a woman has the possibility of getting pregnant as long as she has normal menstruation. In fact, in most women, the eggs begin to gradually decrease or lose their fertility 7 to 8 years before menopause. It is very important for male physicians to master the fertility pattern of women to establish treatment strategies for different infertility couples. In the couple mentioned above, the male partner had mild oligospermia and weak spermatozoa and the female partner had bilateral proximal incompetence of the fallopian tubes. Although interventional tubal unblocking may allow the tubes to reopen, the female partner was 37 years old and her ovarian function was diminished. In view of this situation, the specialist recommended direct IVF, which turned out to be a success.
6. Azoospermia is not necessarily childless
Since the world’s first IVF case was born in 1978, assisted reproduction techniques have been widely carried out, enabling many patients with severe oligospermia, weak spermia, and even azoospermia to have the opportunity to have their own offspring. However, not all patients with azoospermia have this opportunity. First, further tests should be performed to determine if there are chromosomal abnormalities? Is there a deletion of the spermatogenesis gene? Is it obstructive azoospermia? After it is determined that a man has active sperm in his epididymis or testes for IVF treatment, he should also be treated aggressively with the aim of obtaining more and more qualified sperm through epididymal or testicular puncture for maximum success rate of IVF. There is an advanced technique to search for sperm or possible spermatogenic tissues from within the testes under a high magnification microscope, especially in patients with small testes or chromosomal abnormalities, with a high success rate, to finally complete IVF.
7. Unknown cause is not incurable
As we all know, the treatment of any disease should be clear about the cause of the disease, and then we can take targeted treatment to achieve satisfactory results. However, due to the late development of male science, the lack of basic research, and even disconnected from the clinical, many male infertility can not find the absolute cause, which brings great inconvenience to the treatment, but also to the community to chase the interests of some bad hospitals and doctors to take advantage of the opportunity. The World Health Organization has so far been unable to come up with a guiding program, relying entirely on the experience of clinicians in the use of drugs.
Zheng reminds: for patients with unexplained infertility, they should neither give up on treatment nor blindly turn to doctors, and the combination of Chinese and Western medicine has better clinical efficacy.