Author: Dr. Jojo
Do you want children or not? Everyone thinks of infertility! And what exactly is infertility? Is it not successful to try to conceive for three months?
Infertility refers to a person who has a regular sexual life (such as the frequency of sexual life, generally ≥ 2 times a week) in the absence of contraception, and who have lived together for more than 1 year without pregnancy.
The natural pregnancy rate of a couple who have sex without contraception is about 20% to 25% per menstrual cycle, the cumulative pregnancy rate in the first year after marriage is about 84%, and the cumulative pregnancy rate in the second year after marriage is about 92%.
Infertility can be divided into primary infertility and secondary infertility. Those who are not in contraceptive and have never been pregnant are called primary infertility; secondary infertility is a person who has been pregnant (such as term birth, premature birth, miscarriage, ectopic pregnancy, gestational trophoblastic disease, etc., excluding biochemical pregnancy) and then has not been contraceptive for more than one year.
The incidence of infertility in China is about 7% to 10%.
But everyone often has the illusion that once they can't conceive a child, they think it's our girl's problem, but in fact, infertility is not so simple.
Studies have found that the causes of infertility account for about 40% of the factors of women, about 30% to 40% of the factors of men, about 10% to 20% of the factors of men and women, and about 5% to 10% of the unexplained causes.
ps: Infertility (fertility) classification: (see table below)
(This figure is quoted from Academician Chen Zijiang's "Diagnostic Criteria for Infertility (Fertility) And Its Interpretation")
Determine whether infertility is still to raise awareness and actively diagnose and treat.
--I heard that there are many examinations and the process of infertility treatment is also very troublesome, is it true?
--Don't worry, know today's dry goods! The infertility process can also become so easy!
1. Both husband and wife need to see a doctor at the same time
In outpatient clinics, it is often encountered that the man is reluctant to do a semen examination, and many men are willing to wait until the woman checks that everything is normal before they are willing to perform a semen examination.
Now that the male factor or both factors are accounting for an increasing proportion of infertility, this misconception should be dispelled and the man should have his semen checked as early as possible.
Semen examination time: abstinence within 3 to 7 days, during the examination to avoid colds, stay up late, physical discomfort and other external factors interference.
2. Special groups need to be diagnosed early
According to the definition of infertility, infertility is only infertility without contraception for more than 1 year;
However, in the following cases, it is not necessary to wait for 1 year to see the doctor, and can be diagnosed and treated in advance:
(1) Have a history of diseases affecting fertility, such as amenorrhea, menorrhagia, pelvic inflammatory lesions, history of miscarriage surgery, cryptorchidism, etc.;
(2) Females are 35 years of age or older. (It is generally believed that when a woman is over 35 years old, her ovarian reserve function begins to decline, the number of eggs decreases, the quality of eggs decreases, and the risk of infertility increases)
3. Primary infertility (no contraceptive and never pregnant)
Ovulation monitoring should be done first
There are many methods of ovulation monitoring, such as yin ultrasound, urine LH dipstick, basal body temperature (BBT) measurement and other methods, but the most accurate method is yin ultrasound, and those who have the condition try to use the method of yin ultrasound for follicle monitoring, because other methods have defects such as unclear judgment or false positive.
For primary infertility, follicle monitoring is generally performed first, and primary infertility with a history of polycystic ovary syndrome (PCOS) can be first monitored for ovulation after ovulation monitoring follicles for 3 months, and then consider fallopian tube testing as appropriate.
Follicle monitoring time: generally from the 9th to 12th day of menstruation (starting from the first day of menstruation) to the hospital through the first follicle monitoring by yin ultrasound, followed by 1 to 4 days of 1 to 4 days, a total of 3 to 5 times of monitoring is required in 1 menstrual cycle.
4. X-ray hysterosalpingogram is
The preferred method of checking tubal patency is currently available
There is a history of abortion, a history of fetal cessation, a history of diagnostic curettage, a history of pelvic surgery such as chocolate cyst removal, a history of pelvic abscess or tuberculosis, a history of intrauterine contraceptive use, a history of caesarean section, a history of ectopic pregnancy with major hemorrhage in the abdominal cavity, a history of sexually transmitted diseases, and a history of appendicitis, and it is necessary to perform fallopian tube examination as soon as possible.
Tubal patency examination methods include: hysterosalpingogram (HSG) below X-ray, ultrasound-guided hysterosalpingogram, laparoscopic fluid, hysteroscopic fluid, tubal fluid, but the preferred and recommended method is HSG.
Hysterosalpingography (HSG) is a catheter that injects contrast into the uterine cavity and fallopian tubes, and then x-ray and filming are performed to understand whether the fallopian tubes are unobstructed, the site of obstruction and the morphology of the uterine cavity, and uterine malformations according to the development of the contrast agent in the fallopian tubes and pelvic cavity.
HSG is simple and safe, requires no anesthesia, is less traumatic, has no significant pain, can be completed on an outpatient basis, and does not require hospitalization;
Clinically used for decades, it is an ancient, safe, economical and highly diagnosed tubal examination, and it also has a certain therapeutic effect on tubal obstruction.
HSG check time: within 3 to 7 days after menstruation is clean, you cannot have sex in the same month. In general, pregnancy can be tested the following month after HSG.
5. The examination time of sex hormones is the 2nd to 5th day of the menstrual cycle.
Not clean after 2 to 5 days
For patients with low menstrual flow and abnormal menstrual cycle, the determination of sex hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), testosterone (T), and progesterone (P) is carried out as soon as possible to exclude infertility caused by endocrine abnormalities.
Duration of sex hormone testing: Days 2 to 5 of the menstrual cycle, counting from day 1 of menstruation.
The order of diagnosis and treatment of infertility needs to be based on the primary infertility or secondary infertility, menstrual law or irregularity, etc., to select one or more of the above 5 articles for investigation;
In addition, the collection of male and female medical histories, physical examination, reproductive system ultrasound, etc. are also very important for the diagnosis of the disease. Hysteroscopic, laparoscopic, magnetic resonance imaging (MRI), peripheral blood chromosomes, immune antibodies, and other tests may also be used as appropriate.
Knowing these 5 tips, the medical treatment process is not only more effective with half the effort, but also makes your pregnancy preparation process easier.
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