What to check for long-term infertility

For couples, it is particularly distressing if they have not been able to conceive for a long time. They hope to have their own baby, and this feeling is understandable. However, there are many reasons for long-term infertility. It may be due to one of the couple, or it may be due to some problems shared by both parties. Therefore, long-term infertility must be checked in time, including both disease and mental and dietary aspects.

What to check for long-term infertility

Why check the man first? 】

When a couple with infertility problems goes to the hospital, after the doctor has ruled out various obvious controllable factors (such as the frequency of sexual life), the doctor should first start by examining the man.

Because the male examination is simple, non-invasive and less painful, the male internal and external genital development is checked first. After confirming that the development and sexual function are normal, the semen examination is then performed. If the semen examination is also OK, then the male factor is basically ruled out and the female factor can be checked.

[Infertility is not always the woman’s fault! 】

Is infertility all women’s fault? Many people are limited by traditional concepts and believe that inability to conceive or give birth is a woman's problem. Their first reaction is to have the woman go to the hospital for examination. In fact, this is not the case. The problem may also lie with the man.

Among the causes of infertility, female factors account for 40% to 55%, male factors account for 25% to 40%, factors of both spouses account for 20%, and the causes are difficult to identify (including immune factors, abnormal egg quality, etc., which are difficult to diagnose), accounting for about 10%, so both husband and wife need to be examined together.

What tests should the woman undergo? 】

In infertility, the main causes of female infertility are reproductive tract malformations, inflammation, tumors, endometriosis and ovulation disorders. If the male semen test is normal, the woman should do the following examinations:

Routine gynecological examination: such as leucorrhea examination, can rule out vaginal malformation, vaginal inflammation and cervical lesions.

Ultrasound examination: It can roughly check whether the uterus, ovaries, and fallopian tubes have any lesions, and rule out uterine myoma, uterine malformation, ovarian cysts or tumors, polycystic ovaries, or hydrosalpinx.

Ovulation test: The development of follicles can be monitored under ultrasound to see whether ovulation is normal. How can you get pregnant if you don't ovulate?

Endocrine examination: including various hormone tests, to understand the ovarian reserve capacity (how normal ovulation functions), to rule out hyperprolactinemia, hyperandrogenemia, abnormal thyroid function, etc.

Fallopian tube patency check: Check whether the fallopian tubes are unobstructed, identify the site of fallopian tube blockage, and check for uterine malformations, submucosal fibroids, and fallopian tube tuberculosis.

Antibody or chromosome test: Check for chromosomal abnormalities, anti-endometrial antibodies, anti-sperm antibodies, and anti-zona pellucida antibodies.

Laparoscopic examination: If the above examinations cannot find the cause, hysteroscopy or laparoscopy can be considered to directly observe the pelvic cavity, uterus, fallopian tubes, and ovaries for lesions or adhesions.