How is female infertility investigated?

Written by Zou Fu Hua
Obstetrics and Gynecology
Updated on March 04, 2025
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There are many tests to be done for female infertility. For example, during menstruation, a fasting blood test can be done to check for six sex hormones, including follicle-stimulating hormone, luteinizing hormone, prolactin, estrogen, testosterone, and progesterone. Between days 3-7 after menstruation ends, a fallopian tube hydrotubation and imaging can be performed, but intercourse must be avoided and there should be no gynecological inflammation to proceed with this examination. Additionally, routine vaginal secretion and mycoplasma infection tests can be conducted to check for any related issues. Moreover, around the tenth day of the menstrual cycle, a follicle monitoring ultrasound can be done to observe if there are dominant follicles and whether ovulation occurs. The male partner should also undergo some related tests. In summary, different tests can be conducted at different times for female infertility.

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Secondary infertility is how it comes about?

Secondary infertility is when a woman has been pregnant before but has not conceived after a year of not using contraception. The causes of secondary infertility are divided into male factors and female factors. Common male infertility factors include older age or habitual smoking and drinking, leading to decreased sperm quality. Female infertility factors are more numerous, such as excessive sexual activity during reproductive years or weak immune system leading to pelvic inflammatory disease. This inflammation can affect the fallopian tubes, causing blockages and resulting in infertility due to tubal factors; it can also spread to the endometrium, causing endometritis and altering the intrauterine environment, making conception difficult. Some women may suffer from endometriosis, which can also lead to infertility. In some cases, women who have had uterine procedures may experience adhesions in the cervical canal and uterine cavity or abnormal uterine shapes, leading to infertility. Additionally, some women experience significant blood loss after childbirth, leading to pituitary necrosis, hormonal imbalances, and ovulation disorders, which can affect normal conception.

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Can chronic bacterial vaginitis lead to infertility?

Long-term bacterial vaginitis can lead to infertility. If bacterial vaginitis occurs, a large number of bacteria proliferate in the vagina. When sperm enter, they may quickly die off. Even if they do not die, their quality is greatly reduced. Vaginitis results in a significant increase in vaginal discharge. The secretions contain a large number of white blood cells, which can hinder the survival of sperm, thus potentially causing infertility. Therefore, women must pay attention to personal hygiene. Once the inflammation of bacterial vaginitis becomes severe, it can spread to the uterine cavity and cause more serious diseases such as adnexitis and pelvic inflammatory disease. If not treated promptly, these can lead to infertility. It is important to develop good hygiene habits regularly.

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How is infertility caused?

Infertility can occur if there is an issue with either partner. The main factors causing infertility in women include ovulation disorders, fallopian tube factors, and abnormal endometrial receptivity. The primary factors causing infertility in men are abnormal spermatogenesis and ovulation disorders. Common etiological diagnoses generally include ovulation disorders, abnormal semen, fallopian tube abnormalities, unexplained infertility, endometriosis, and other immunological infertility. Additionally, cervical factors can also lead to infertility, such as cervical stenosis, which accounts for more than 5% of cervical factors.

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"What does infertility OC mean?"

Infertility OC refers to the ovarian stimulation protocols for in vitro fertilization (IVF), commonly divided into long and short protocols. Ovarian stimulation in IVF is done to obtain more eggs for better results. The choice between protocols is not determined by time, but by assessing the patient’s ovarian function. Patients with good ovarian function use the long protocol, while those with poor ovarian function use the short protocol. Although the long protocol takes more time, it provides better ovulation results and a more consistent ovarian response, preventing premature ovulation. The short protocol, although quicker, often has less effective stimulation results and an inconsistent ovarian response, which frequently leads to premature ovulation. Thus, the long protocol is the standard for ovarian stimulation, while the short protocol is a contingency plan used when there is concern that poor ovarian function might prevent follicle development with the long protocol.

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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.