Fully understanding the standardized diagnosis and treatment of infertility can help you avoid detours

This is the 4677th article of Da Yi Xiao Hu

Conception is a complicated process. There are many reasons for infertility. So where should we start to check and treat it? In the process of treating infertility, I met many couples who were desperate to seek medical treatment, and took many detours. In the end, they spent a lot of money and energy, and delayed the best treatment time. The most common thing is that infertile couples go to different hospitals and different doctors. Some patients go to the doctor with nothing in their hands and have no information. When asked what examinations and treatments they have done before, what drugs they have used, etc., these patients usually hesitate and can't answer. This brings great trouble to the doctor's judgment of the condition. Sometimes it needs to be done again, and the inspection cycle is very long. It not only wastes the patient's energy and financial resources, but also is not conducive to choosing the best treatment method and delays treatment.

Here I would like to share with you the standardized diagnosis and treatment process of infertility. In fact, the inspection principles of all diseases are unified: from simple to complex, from common problems to complex and difficult problems, from cheap inspection items to expensive and complex inspection items. Specifically for infertility, first ask about menstruation and marriage and childbearing status, and do specialist physical examination. The first inspections that should be done are: leucorrhea routine, chlamydia, basic hormone determination, anti-Mullerian hormone (AMH), thyroid function, eugenics virus series, uterine double attachment B-ultrasound, etc. Does it sound like a lot and feel very troublesome? Here is a little trick to teach you. It is the most time-saving to go to the hospital within the 2nd to 5th day of menstruation. All the above inspections only need to go to the hospital twice to complete. At the same time, it is very important that boys must check their semen! Looking strong and healthy does not mean that the sperm is normal. In clinical practice, we have seen many young and strong men with few, weak, abnormal sperm or even no sperm. Being able to ejaculate does not mean that there must be good sperm. In addition, just because there was no problem with semen in the past does not mean there is no problem now! Therefore, male examination is really important, and it is convenient and cost-effective, so why not do it? After excluding the above problems of the man, the doctor will arrange for the woman to undergo further hysterosalpingography examination.

So how should it be treated? First of all, the treatment should be targeted at the causes of both men and women, and methods such as drugs, surgery, and assisted reproduction should be adopted. It should be noted that not all infertile couples need assisted reproductive technology to assist pregnancy treatment. In fact, among the infertile population, only a small number of patients need to conceive with the help of assisted reproductive technology. So is assisted reproduction a test-tube baby? No, assisted reproductive technology is divided into artificial insemination and in vitro fertilization-embryo transfer technology (commonly known as test-tube babies). Artificial insemination is a technology that injects sperm into the female reproductive tract through non-sexual intercourse to make it pregnant. We can understand it as a "matchmaker". After gathering the army of male sperm, we carefully select the best elites. In order to reduce the chance of sperm brothers getting lost on the way to find egg sisters and shorten the journey, we directly send sperm brothers to the woman's uterine cavity, so that it is easier to meet the desired egg sister. So is a test-tube baby a baby grown in a test tube? The answer is of course no. IVF refers to the process of taking eggs from the ovaries of infertile women, fertilizing them with sperm in vitro and cultivating them into embryos, and then transplanting the developed embryos into the female uterine cavity to make them implant and develop into fetuses. We can understand it as the "strongest matchmaker", directly taking the girl from her home, and then taking the boy and putting them together, or even putting the boy directly into the girl's heart, giving them a beautiful environment to get along for a few days, and then transferring them directly to the new house (uterus) to live and work in peace and contentment when they reach the right stage. So is it better to do artificial insemination or IVF? Is the first generation of IVF better or the second or third generation better? This requires doctors to make specific assessments based on the circumstances of both men and women.

Author profile: Peng Zhen, resident physician. Zou Lin, chief physician, master's tutor, deputy director of the Department of Reproductive Medicine, Affiliated Hospital of Guangdong Medical University