Infertility check

There are many specific inspection items for infertility examinations. Fourteen male examinations for urinary tract examination, prostate examination, seminal vesicle examination, epididymis examination, testicular examination, sex hormone test, sexual function test, reflex action function test, immune factor test, endocrine examination, varicocele examination, Trauma examination, radiological factor examination, sperm quality examination. Thirteen examinations for women to do vaginal examination, cervical examination, uterine examination, fallopian tube examination, ovarian examination, pelvic examination, endocrine examination, sex hormone examination, immune factor examination, systemic factor examination, mental and psychological factors examination, congenital Factor examination, ovulation function examination, ultrasonic B-ultrasound examination, four routine examinations. Basic Information Specialist classification: eugenics and superiority examination classification: physical examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Normal value: no Above normal: negative: A negative test result indicates that the body is in a normal state. Positive: Common in infertility. Tips: The inspection of each item is best for 3-7 days of menstruation. Normal value All tests were normal and negative. Clinical significance Abnormal result Through the infertility check to investigate the specific causes of infertility, so as to prescribe the right medicine. Infertility patients need to be examined. Positive results may be diseases: female infertility, infertility, male infertility, luteal insufficiency, pelvic inflammatory infertility, tubal obstruction infertility, anovulatory infertility, menstrual disorders Infertility, ovarian infertility precautions Taboo before inspection: 1, it is best to start B-ultrasound from the 12th day of menstruation to monitor your follicular development, whether there is ovulation. 2, on the 3-5 days of menstruation (menstrual period) fasting blood to do six tests of sex hormones (including: luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), testosterone (T ), progesterone (P), estradiol (E2). 3, in the 3-7 days after the end of menstruation to do tubal iodine angiography (the effect of sputum examination is not good, the diagnosis is still unknown or need to do angiography, increase the uterine cavity operation, increase the chance of iatrogenic infection) Understand whether the fallopian tubes are unobstructed. 4, male semen examination: before leaving semen, the patient should stop sexual intercourse for 4 to 7 days. Testosterone propionate, testosterone phenylacetate, and nantrolone phenylpropionate could not be used 1 week before the test. Drinking should be stopped within 1 month before the test. This must be done. Requirements for inspection: 1. When taking semen, you can use soft soap or paraffin oil for penile massage, collect the specimens in sterile test tubes; use condoms (wash clean, no spermicides) or use semen interruption method to collect semen, but this way The amount collected is often small. 2. If the semen is not obtained by the above method, the seminal vesicle and the end of the vas deferens can be massaged through the rectum, and the urine can be collected to check whether there is sperm in the sediment. 3. Do not expose semen to overheated and cold conditions. Hand it to the doctor for reference, no more than 30 minutes. Keep warm in cold weather, and keep it in your underwear pocket when you send it. 4. If bacterial culture is to be carried out, the urethral opening should be rinsed and disinfected, and the semen should be collected in a sterile test tube. 5. If you are not giving birth, both husband and wife must go to check. Inspection process First, medical history It is very important to collect the medical history correctly. The doctor should be responsible and keep the patient secret. The patient should also cooperate vividly and truthfully reflect the following: 1. Occupation and type of work: whether there is contact with poison (lead, mercury, phosphorus), radiation, whether it is hot work, contact time and whether there are protective measures; nutritional status; whether there are bad habits (smoke, wine). 2, past medical history: whether you have gonorrhea, mumps, tuberculosis, epididymitis, prostatitis, pyelonephritis, cystitis or spinal cord injury, with or without dysuria, with or without diabetes or hypothyroidism, treatment and effect. 3. Marriage and sexual life: including attitudes towards sexual life, sexual intercourse and frequency, whether there is no spermatorrhea, impotence, premature ejaculation, etc., whether there is masturbation habit before marriage; how the relationship between husband and wife, wife's health, sexual life coordination, etc. Marriage years, cohabitation time and whether contraceptive measures have been taken. 4, the past inspection and treatment: male semen examination results, collection time and method; whether treatment, how effective; the situation of the woman's examination. 5, family history: family with or without infertility, hermaphroditism, genetic disease, tuberculosis and other patients. Second, physical examination Includes systemic and genital examinations. The systemic examination is the same as the medical method, with special attention to developmental, nutritional and mental conditions, but the focus is on the examination of the reproductive organs. The examinations include: 1, penis: pay attention to whether there are serious phimosis, induration, inflammation with tumor or developmental abnormalities. 2, the urethra; with or without pupil, crack, induration. 3, the prostate: through the anus examination can check its size, with or without induration, tumor, but also massage to take prostate fluid examination. 4, testis: measure its size, palpation hardness, with or without induration, tenderness, mass, whether it is cryptorchidism. 5, spermatic cord: touch the hardness of the vas deferens, with or without nodules, tenderness, with or without varicocele. Third, laboratory inspection In addition to the semen examination as a mandatory item, the rest depends on the patient's specific circumstances: 1. Semen analysis: This is helpful to understand male fertility and is a must-check for infertility. The examination includes color, quantity, liquefaction time, pH, sperm count, activity, survival rate and morphology. 2. In vitro xenogeneic insemination experiments: Even though conventional semen analysis is completely normal, it sometimes does not fully represent the insemination ability of sperm. In vitro xenogeneic insemination experiments can more accurately estimate the fertilization ability of sperm, which is of great value in judging male fertility. Commonly used is the heterologous insemination experiment of human sperm penetrating hamster eggs, and the sperm of normal fertiles is used as a control. 3, prostatic fluid examination: normal milky white, alkaline, high magnification, visible full field of view of small, refractive lecithin particles, a few epithelial cells, amyloid and sperm, white blood cell count greater than ten, increased white blood cell count Even seeing piles of pus cells, lecithin particles are significantly reduced. Fourth, endocrine examination. The function of the hypothalamus-pituitary-testicular axis can be understood by gonadotropin-releasing hormone or kevififene stimulation test. Determination of testosterone levels directly reflects the function of the cytoplasm. Thyroid hormone, adrenal sebum or prolactin can be measured if necessary. Five, Doppler ultrasound examination. Helps confirm varicocele. Sixth, X-ray inspection. In order to determine the obstruction site of the vas deferens, vas deferens, epididymis angiography, vas deferens, seminal vesicle angiography or urethrography can be used. In patients with hyperprolactinemia, the sphenoidal tomogram (positive and lateral) can be used to determine the presence or absence of pituitary adenoma. . Seven, immunological examination. Sperm agglutination antibodies or brake antibodies in serum or seminal plasma are detected by sperm agglutination test or brake test. Although there are many detection methods, they should be selected according to local conditions. Eight, testicular biopsy. For azoospermia or oligozoospermia, directly check the spermatogenic function of the testicular seminiferous tubules and the development of interstitial cells. The synthesis and metabolism of local hormones can be reflected by immunohistochemical staining. Nine, karyotype analysis. For genital malformations, testicular dysplasia and unexplained azoospermia. Female infertility examinations need to be very detailed, because the causes of female infertility are many and often overlap. Many patients want to know in advance the specific steps of female infertility examination, or do not pay attention to it, and think that it is optional. This is not conducive to the final treatment of infertility, I hope the patient can change. Female infertiles can find the cause according to the results of medical history, physical examination, gynecological examination and laboratory examination, but many patients still need to do some special examination to further identify the cause of the disease. 1. Four basic gynecological clinical examinations: Refers to basal body temperature measurement, vaginal exfoliation cell examination, cervical mucus examination and endometrial biopsy. These four basic examination methods are simple and can be performed in the outpatient clinic. The examination can initially understand the ovarian function and the response of the reproductive organs and tissues to the ovarian endocrine. 2, B-mode ultrasound examination: Check the development of the uterus and attachments and morphological location, with or without lesions such as endometriosis, ovarian and fallopian tube tumors, uterine fibroids. 3, tubal patency test: More use of uterine fallopian tube dynamic lipiodol angiography. It is usually arranged 3 to 8 days after the menstruation is clean. 4. Immunization test: In the case of suspected immune infertility, it can be used for the examination of anti-sperm antibodies and cervical mucus anti-sperm antibodies in the blood. 5, endocrine measurement: Follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and estradiol (E2) can be measured by fasting blood in the early stage of ovulation and ovulation, and blood progesterone (P) should be in basal body temperature and high temperature. Mid section inspection. 6, laparoscopy: At the same time as the laparoscopic examination, treatment can be performed under direct vision. Therefore, laparoscopy is an important measure for the diagnosis of infertility. It can directly observe the presence or absence of adhesions in the abdominal cavity and the development of the uterus, ovaries and fallopian tubes. 7, hysteroscopy: The morphology of the cervical canal, the uterine cavity and the bilateral fallopian tubes can be directly observed, and the living tissue can be examined under direct vision. 8. Test after sexual intercourse: This trial is scheduled to take place 1 to 2 days before ovulation or basal body temperature rise. 9. Sexual chromatin, chromosomes and other laboratory tests: In cases of suspected hereditary abnormalities, both couples should perform chromatin examination and blood chromosome examination of the buccal mucosa. Not suitable for the crowd Infertility tests are generally not traumatic and have no specific contraindications. Adverse reactions and risks Risk of infection: If you use a dirty inspection device, you may be at risk of infection, especially if the woman is not thoroughly disinfected when the vaginal examination is done.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.