According to the World Health Organization, about 8%-12% of the world's population of childbearing age faces infertility. Infertility caused by women accounts for 50 to 60%, and male causes of infertility account for 40-50%.
Once you can't conceive for 1 year of pregnancy, you have to suspect infertility, and you have to go through a long and arduous diagnosis and treatment process from then on, which is not too much to describe with ninety-nine eighty-one difficulties.
However, it is recommended that the majority of infertility patients friends do not blindly go to the treatment, do not worry too much, in fact, relax the mentality will help improve the probability of pregnancy, the key to the treatment of infertility is to first find out the cause, symptomatic treatment, the following to carefully talk about how to do the examination.
Three major factors in successful pregnancy demand:
Simply put, successfully conceiving a child, like planting a crop, requires good seeds: good sperm and eggs; good channels: a smooth fallopian tube; good soil: endometrium and uterine tolerance.
Good seeds, including good eggs and high-quality sperm (sperm not only need a sufficient number, fast forward movement athletes, but also need to be rich and handsome), any reason that affects the development of sperm and eggs, or affects their release, is equivalent to no good seeds, can not be sown smoothly, resulting in the inability to conceive children.
The road should be smooth, the seed should be good, and it must be able to reach the destination, although the ovary ovulation, the end of the fallopian tube umbrella is adhesion, lifting, and water, and the egg cannot be picked up and transported to the tubal ampullament, and it is impossible to meet the sperm. Although the sperm quality is passed, the proximal end of the fallopian tube is blocked, and the sperm cannot reach the tubal ampullament.
Therefore, the woman's fallopian tube patency is very critical. However, if the fallopian tubes are blocked, stagnant, or unsmooth, infertility is caused by a large proportion of infertility factors.
In addition, the soil is good, sperm and eggs go through countless hardships to cross the mountains and mountains in the tubal ampullary abdomen, combine, form a fertilized egg, and then reach the uterus, at this time need fertile soil, in order to allow the fertilized egg to plant and grow. If the uterine soil is poor, or the uterine cavity adhesions, polyps, etc., will affect the implantation of fertilized eggs and the development of embryos.
So, what do you want to look up when you are pregnant for 1 year? Does the man have to check first?
In the traditional view, having children is a woman's business, no, and a man's seed responsibility is not small. If you can't get pregnant for 1 year, you must go to the hospital for both husband and wife, what do you check?
What does the man want to look up?
1. Andrology examination
This is the most basic examination, the doctor through the physical examination to understand the penis development, bilateral testicular volume, whether the vas deferens can be reached, the presence or absence of varicocele.
2. Routine analysis of semen
A semen examination is a "mirror" that reflects male fertility, only to check the dynamic analysis of sperm can not do an assessment of fertility, some sperm although running very fast, but headless sperm or no parietal enzyme is useless, can not make the woman pregnant.
03. Sperm morphological analysis
Sperm morphology is the assessment of male fertility, only healthy, high-value, rapid forward movement of sperm, in order to reach the tubal ampullature and meet the egg, fertilization "create man". Simple semen routine examination can no longer meet the needs of clinical development, nor can it fully and objectively reflect the true situation of patients, let alone evaluate testicular function.
Sperm morphological classification has undergone an evolutionary process from the 1st edition in 1980 to the 5th edition in 2010 through the evaluation criteria of free methods and strict methods. From 80% of normal sperm in 1980 (first edition) to 15% in 1999 (fourth edition) and 4% in 2010 (fifth edition).
04. Sperm DNA fragmentation rate detection
Refers to the proportion of sperm that have a single or double strand break of DNA in all sperm. Sperm DNA, as a carrier of genetic material, is not only closely related to the quality and function of sperm, but may also affect the binding of subsequent sperm and eggs and the normal development of embryos. Therefore, male friends with serious sperm DNA damage will not only affect the quality of sperm, reduce the probability of pregnancy, but also affect the quality of embryos, even if the eggs can be fertilized and split normally, but it is often easy to cause fetal stoppage and miscarriage due to embryonic dysplasia.
05. Sperm parietal enzyme activity detection
Sperm can be divided into four parts: the apical body, head, neck and tail, and the head is mainly composed of nuclei and apical bodies. The frontmost apical body is responsible for releasing the apical enzyme, an important proteolytic enzyme in the process of fertilization, which is related to the motility of the sperm and is closely related to the binding of sperm and egg.
Therefore, it is not enough to be pregnant for 1 year without a simple semen routine examination, it can not represent male fertility, assess male fertility is sperm morphology and sperm function, so be sure to check sperm morphology analysis, sperm DNA, sperm parietal enzymes.
What does the woman want to look up?
01. Gynecological examination
This is the most basic examination, first of all, do vaginal discharge and cervical exfoliation cells examination, if necessary, do a pathogen culture of cervical secretions, you can understand whether there is vaginal inflammation, vaginal deformities, cervical inflammation and so on. If there are large uterine fibroids or ovarian cysts, the doctor can touch them.
02, B ultrasound inspection
B Super energy can test for more infertility-related diseases, and can more accurately find uterine fibroids, adenomyosis, uterine cavity mass, ovarian cysts, polycystic ovaries, thick endometrium, uterine mediastinum, uterine adhesions, or hydrosalpinx, and assess female ovarian reserve function.
At the first visit, as long as it is not just the right time to menstruate, you can do a ultrasound; if there is an ovarian cyst, you need to repeat it on the 5th to 6th day of menstruation; if there is a uterine malformation, you may need to do ultrasound B when the menstruation comes.
But the B super can only check the relatively large morphological problems, too small or the function of the organ problem, B super can not do anything.
3. Detect ovulation
There are many ways to detect ovulation, common ones are basal body temperature method and ovulation test strip method, which can be done at home by yourself, and then show the results to the doctor. However, these two methods are not accurate, the ovulation period speculated by basal body temperature has an error of 2 to 3 days, and if the ovulation test strip is positive, it may also be only a manifestation of polycystic ovary syndrome or unruptured follicular flavinyl syndrome, and there is actually no ovulation.
Therefore, if you want to accurately understand the ovulation situation, you must go to the hospital to do B ultrasound monitoring of ovulation. Ultrasound ovulation testing is usually done on the 10th to 11th day of menstruation (10-11 days from the first day of bleeding) and is done every other day until the follicle is detected.
04. Check six sex hormones
It is a reproductive hormone test, the basic sex hormone test is 2 to 4 days after menstruation, preferably in the morning; if you want to understand the function of the luteal body, then check progesterone about a week before the next menstrual period is expected.
Some sex hormones, such as anti-Mullerian hormone (AMH) and thyroid hormone, have no special requirements for blood draw time, and generally go whenever they want;
05. Check the patency of the fallopian tubes
This is an important examination of the patency of the "channel", it is recommended to use the method of salpingogram, the traditional fluid examination, the error is relatively large, basically has not been used.
In addition to understanding tubal patency, salpingogram can also find tubal adhesions, lifting, hydrops, blockages, uterine adhesions, hysterical mass or caesarean section incision diverticulum, which can assist in diagnosis.
06. Immune infertility examination
This test also requires blood to be drawn, and the main items include anti-endometrial antibodies, anti-sperm antibodies, anti-cardiolipin antibodies, anti-zona pellica antibodies, etc.
07. Chromosomal examination
If you suspect that there is a congenital problem, you can check the chromosomes of the couple, but this test is relatively expensive and time-consuming, and the doctor checks according to the specific situation, not everyone does a chromosome test.
If a problem is found, it can be directly treated, such as tubal adhesions, uterine fibroids, ovarian cysts, uterine adhesions or polyps, etc., and can also be directly treated under hysteroscopy. So it's both a test and a treatment.
08. Hysteroscopy and laparoscopy
This small lens is also a good thing, some infertility can not find the cause, you can do a uterine, laparoscopy, intuitively understand whether there is a problem.
Find the cause to treat:
Infertility treatment is sometimes not difficult, find the cause, for the cause to treat, if the cause is simple, in the outpatient measurement of ovulation, or the man's sperm vitality is poor to take medicine on the line; if the cause is complex, hospitalization for surgery, such as tubal adhesions, blockages, sperm abnormalities caused by the man's varicocele, cryptorchidism, vas deferens blockage caused by azoospermia; it is really natural to conceive, but also assisted reproduction.
Therefore, do not blindly go to the treatment, take a detour, and cooperate with the doctor to do a good job of examination.