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Zhang Wei Wei
Integrative Medicine
About me
Zhang Weiwei, associate chief physician, graduated from Hunan University of Traditional Chinese Medicine, engaged in the clinical work of integrated Chinese and Western internal medicine for more than 10 years, and studied in the oncology department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine. He has rich clinical experience.
Proficient in diseases
Specializes in the diagnosis and treatment of advanced tumors, infertility, menstrual disorders, pelvic inflammatory disease, breast diseases, and cardiovascular diseases using a combination of traditional Chinese and Western medicine.
Voices
Infertility is what it means.
I think it's important to first clarify the definition of infertility, which is defined as couples living together for over two years with regular sexual activity, not using contraception, and not conceiving. Those who have never conceived without contraception after marriage are defined as primary infertility, while those who have been pregnant before and then, without using contraception, have not conceived again for two years are defined as secondary infertility. According to the World Health Organization's manual on standard examinations and diagnoses for infertile couples, the clinical standard for infertility is defined as one year. However, currently, we think that individuals who have had regular sexual activity without contraception and have not conceived for over a year should be advised to visit a specialized hospital and consult the gynecology or traditional Chinese medicine departments to investigate the causes of infertility.
What are the causes of male infertility?
There are many diseases or factors that can lead to male infertility, leading to azoospermia, severe oligospermia, and oligozoospermia, as well as normospermic infertility, polyspermia, asthenospermia, etc. The main causes can be summarized in the following points: First, male sexual dysfunction, such as erectile dysfunction, premature ejaculation, and anejaculation, can all cause male infertility. Second, abnormalities in sperm structure and seminal plasma can affect sperm motility, capacity, and reaction. Third, obstruction of the vas deferens affects the transport of sperm. Fourth, infection of the reproductive tract. Fifth, endocrine disorders, including deficiencies in gonadotropins. Sixth, chromosomal abnormalities, including the common pseudohermaphroditism chromosome.
How is infertility caused?
Common causes of infertility in women often stem from ovulatory disorders and tubal factors. The common ovulatory disorders mainly include dysfunction of the hypothalamic-pituitary-ovarian axis, ovarian diseases, and endocrine metabolic diseases such as hyperthyroidism or hypothyroidism. Other causes include systemic diseases, chronic consumptive diseases, severe malnutrition, excessive obesity, and excessive thinness. The second aspect involves tubal factors, such as inflammation and blockage of the fallopian tubes leading to infertility. The third aspect is uterine factors, which include poor uterine development, uterine abnormalities, endometritis, and endometrial tuberculosis, all of which can cause infertility. The fourth aspect is cervical factors, including cervical myomas, cervical inflammation, and abnormalities in cervical immunological function. The fifth aspect is factors related to the vaginal and perineal areas, where abnormal development, inflammation, and scarring of the vagina can cause infertility. As for men, the causes of infertility include abnormalities in semen, sexual function, and immunological factors. Immunological factors primarily involve the production of antibodies against one's own sperm in the body, causing ejaculated semen to agglutinate with itself and fail to pass through cervical mucus. Thus, from the perspectives of both men and women, these are the main causes of infertility.
Can you have sexual intercourse before infertility examination?
There are many types of examinations for infertility. If the examination is for male infertility, such as a semen analysis, it is recommended not to have sexual intercourse three days prior to the test. For females, if the examinations involve blood tests or a gynecological ultrasound, intercourse is permissible. However, if the examination includes a routine vaginal discharge test, it is advised not to have sexual intercourse for at least three days beforehand. More stringent timing is required for examinations like hysteroscopy or a fallopian tube radiography. The principle here is to conduct these tests three to seven days after menstruation has ended, in order to complete the fallopian tube radiography and hysteroscopy effectively.
Can acute mastitis continue breastfeeding?
Acute mastitis is an acute suppurative infection, which can be divided into three stages according to its cause and pathological process: acute inflammatory stage, abscess formation stage, and ulceration stage. Corresponding treatments are applied at each stage. During the acute inflammatory phase, antibiotics such as penicillin should be used to control the progression of inflammation. Once an abscess forms, the main measure is to incise and drain pus in a timely manner, while also taking medicine to clear heat and detoxify. In the ulceration stage, proactive dressing changes and wound cleaning are necessary, along with internal use of heat-clearing and detoxifying medications, and decoctions that promote pus drainage. In principle, breastfeeding should be temporarily halted, and a breast pump should be used regularly to extract milk, ensuring smooth milk flow and preventing stasis. Additionally, wearing a supportive bra can help lift the breasts, and moist heat should be applied to the affected area for 20 to 30 minutes, three to four times a day. Afterwards, the nipples should be cleaned with diluted saltwater. (The use of medications should be conducted under the guidance of a doctor.)
Can infertility ovulate?
I would like to discuss the causes of female infertility. The main causes of female infertility are ovulatory disorders and fallopian tube factors. If infertility is primarily due to fallopian tube factors, the patient does not have ovulatory disorders and can ovulate normally. Many cases of infertility are due to ovulatory disorders, which may be caused by ovarian dysfunction leading to persistent anovulation. Some are due to ovarian diseases, underdeveloped ovaries, polycystic ovary syndrome, premature ovarian failure, and functional ovarian tumors. Or it could be due to dysfunction of the hypothalamic-pituitary-ovarian axis causing anovulation. It could also be due to endocrine metabolic diseases, such as hyperfunction or hypofunction of the thyroid or adrenal cortex, which can lead to anovulation. Therefore, in women with infertility caused by fallopian tube factors, ovulation can occur; if it is caused by ovulatory disorders, it involves ineffective ovulation or an inability to ovulate.
What to check for infertility
What tests should be done for infertility? The tests for males are much simpler compared to those for females, primarily focusing on semen analysis as well as prostate and ultrasound examinations. For females, besides examining the development of the internal and external genitalia, checking for inflammation and inflammatory masses, and assessing breast lactation, several specialized tests can also be conducted. These include evaluating the patency of the fallopian tubes by hysterosalpingography, ovarian function tests including basal body temperature (BBT) measurements, vaginal cytology, endometrial examination, and female hormone assessments. Immunological tests include checking for anti-endometrial, anti-ovarian, anti-trophoblast, and anti-sperm antibodies, among others. Ultrasound examinations help in detecting pelvic tumors and uterine conditions, and also in monitoring follicle development and ovulation. Other tests include hysteroscopy, laparoscopy, and an analysis of chromosomal abnormalities in the couple.
Which department should I go to for infertility treatment?
For infertility issues, one should first visit a formal hospital. At the hospital, men can choose to see either a traditional Chinese medicine andrologist or a Western medicine andrologist, while women can opt to visit a traditional Chinese medicine infertility specialist, or a gynecology or obstetrics department. After consulting these departments, doctors will conduct various tests to identify and rule out causes of infertility. Then, based on the test results, they will administer targeted treatments or interventions. This approach helps infertility patients to conceive as soon as possible.
Clinical manifestations of liver abscess
Clinical manifestations of liver abscess include irregular, purulent fever, especially noticeable in bacterial liver abscesses. The fever is irregular and typically high, preceded by chills, followed by persistent pain in the liver area, which worsens with deep breaths or movement. Depending on the location of the abscess, it can lead to corresponding respiratory and abdominal symptoms, often with a history of diarrhea. If the abscess ruptures, it can evolve into purulent peritonitis with pyothorax. Special signs include liver enlargement, and in the intercostal space corresponding to the abscess, there's localized edema and clear tenderness. Some patients may exhibit jaundice. If the abscess breaks into the chest cavity, lung abscesses can occur, or if it perforates into the abdominal cavity, peritonitis may develop.
Why is there a low fever with a liver abscess?
Why do patients with liver abscesses continuously have a low fever? This is because a liver abscess is a purulent liver condition caused by various microorganisms such as bacteria, fungi, or amoebas, indicating severe inflammation due to the presence of pus in the liver, resulting in a fever. But why is it a low fever? The reason may be attributed to the fact that it is inherently a bacterial infection. Treatment requires prolonged use of high-dose, full-course antibiotics. During this process, some bacteria might not be completely eradicated, or some residual bacteria continue to linger in the liver, thereby easily causing fever. Fever is a manifestation of the body's self-protection, so there is no need for excessive worry or anxiety. With proper full-course treatment, the disease can be cured. (Please use medication under the guidance of a doctor.)