What are the routine examinations for infertility?

Written by Kang Jian Hua
Reproductive Center
Updated on September 04, 2024
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Infertility examinations typically include physical exams and special tests. Physical exams mainly involve checking the development of internal and external reproductive organs and secondary sexual characteristics. Special tests can include examining the quality of male semen, endocrine conditions, and anti-sperm antibodies. Additional procedures can include scrotal ultrasound, prostate ultrasound, prostate massage fluid analysis, and monitoring of the spermatic veins with ultrasound to check for varicoceles.

For females, it is important to check for any underlying diseases and ensure normal development of the uterus, ovaries, and adnexa. Examinations should also check for uterine fibroids, ovarian cysts, and endometriomas, and assess for any abnormalities in the reproductive tract. Monitoring ovulation is also crucial to identify any abnormalities in ovulation. If ovulation is normal, the patency of the fallopian tubes should be checked, which can be done through a fallopian tube iodine contrast imaging procedure.

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Written by Kang Jian Hua
Reproductive Center
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Infertility means the inability to conceive (get pregnant) after a year or more of regular sexual activity without contraception.

Many people are not clear about the difference between infertility and sterility, thinking that infertility refers to the inability of a woman to conceive, while sterility refers to the inability of a man to reproduce. Actually, this understanding is incorrect, or rather, incomplete. Infertility should be defined as a couple living together for more than a year, having normal sexual intercourse without contraception, and being unable to cause pregnancy in the female, which is called infertility. Sterility, on the other hand, refers to the situation where the female can get pregnant but cannot give birth. Therefore, there is a certain difference between the two. There are primary and secondary infertility. Primary infertility refers to those who have never been pregnant or given birth before. Secondary infertility refers to those who have previously been pregnant or given birth, but later, due to some reason or disease, are unable to conceive after living together for more than a year, which is called secondary infertility.

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Written by Zhao Min Ying
Reproductive Medicine
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How does infertility arise?

Couples who live together and have normal sexual relations without any contraceptive measures for over a year are diagnosed with female infertility in the case of the woman, and male infertility in the case of the man. Infertility is related to many factors. For men, the main factors are abnormalities in the semen, which include low sperm count, weak sperm motility or even a complete absence of sperm, as well as sexual dysfunction, where various factors prevent the completion of normal sexual activities. For women, the main factors include, first, ovulatory disorders, which are primarily abnormalities in menstruation, although some may have normal menstruation but still experience ovulatory disorders. Second, factors related to the fallopian tubes; these can include previous conditions like pelvic inflammatory disease, appendicitis, etc., or infections caused during procedures involving the uterine cavity leading to blockages in the fallopian tubes, which can be diagnosed via hysterosalpingography. Third, conditions such as endometriosis and adenomyosis, which can also affect the chances of pregnancy. Fourth, factors related to the uterus, such as uterine fibroids, polyps, and malformations, which can create barriers to pregnancy. Lastly, some immunological factors, including antisperm antibodies or other antibody factors, etc.

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Written by Zhang Lu
Obstetrics
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How long does it take to be considered infertile when trying to conceive?

Pregnancy for women requires a certain amount of time to be successful, and if one cannot become pregnant in the short term, it does not necessarily mean infertility. It could be due to irregular ovulation or incorrect timing of sexual activity. In clinical practice, it is generally considered that if one has been trying to conceive normally without deliberate contraception and still cannot become pregnant after a year, then infertility should be diagnosed. For cases where conception hasn't occurred after a year of trying, examinations should be carried out for both partners to determine if there are any pathological factors. First, the male partner should have chromosome and sperm analysis; Second, the female partner should be checked for chromosomal infections, immune factors, rheumatology factors, etc. After clearly identifying the reasons, interventions should be made as much as possible to guide normal conception.

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Written by Zhao Min Ying
Reproductive Medicine
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Can sexual apathy cause infertility?

Sexual indifference is a matter concerning the harmony of sexual life between couples, the stability of their relationship, and the quality of life. Regarding fertility, as long as the couple can have sexual intercourse, the male can ejaculate, and the semen can be deposited into the female reproductive tract, there is a chance of pregnancy. Therefore, from this perspective, mere sexual indifference, as long as intercourse can be completed, does not affect conception. However, if sexual indifference prevents intercourse, then it does affect the possibility of pregnancy. Therefore, ultrasound monitoring of ovulation and guiding intercourse during the ovulation period can increase the chances of pregnancy. When necessary, artificial insemination can also be considered to aid conception.

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Written by Kang Jian Hua
Reproductive Center
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How to treat infertility?

The treatment methods for infertility primarily include medication, surgical treatment, and assisted reproductive technologies. For couples with infertility, it is essential to adopt appropriate treatment methods based on different causes and conditions. Medication is a commonly used method, mainly targeting conditions such as oligospermia, asthenozoospermia, and reproductive tract infections in men, as well as menstrual disorders and reproductive tract infections in women. Surgical treatment mainly targets conditions such as varicocele and vas deferens obstruction in men, and uterine fibroids and polycystic ovary syndrome in women. Assisted reproductive technologies are mainly used for some patients who do not respond well to medication or surgery, such as men with idiopathic oligospermia and women with blocked fallopian tubes, requiring these technologies for treatment.