Understand first: Fertility inspections must be conducted for both men and women!
Many people mistakenly believe that fertility testing is an "exclusive item" for women. In fact, the assessment of male fertility is equally important. Childbirth is a matter for both couples. Only when both parties are clear about their physical conditions can the pregnancy preparation plan be adjusted in a more targeted manner. Next, let's start with the core examination items for men and women respectively.
1. Male fertility examination: Focus on "sperm combat effectiveness"
The core of male fertility examination is to assess sperm quality. The most critical examination item is routine semen examination. In addition, reproductive system ultrasound, infectious disease screening, etc. may also be involved. Among them, several indicators of semen routine directly determine the "fertility ability" of sperm.
1. Routine semen examination: Report on the "combat effectiveness" of sperm
This is the "highlight" of men's examination, mainly looking at the following five core indicators
① The normal range of semen volumeis generally 2-6 ml. Less than 1.5 ml is a small amount, which may affect the survival environment of sperm in the vagina; more than 6 ml may reduce the concentration of sperm due to dilution, which is also not conducive to pregnancy.
② Liquefaction time Thesemen is gelatinous when just discharged, and under normal circumstances, it will liquefy into a liquid state within 15-30 minutes. If it has not been liquefied for more than 60 minutes, it means that "semen is not liquefied", which will trap the sperm, affect their mobility, and thus hinder conception.
③ Sperm concentrationrefers to the number of sperm per ml of semen, and the normal reference value is ≥ 15 million/ml. Below this value is "oligospermia", which means that the number of sperm is insufficient and the probability of pregnancy will decrease accordingly; but it is not possible that the more the better. Too high a concentration may lead to crowded sperm activity space and affect vitality.
④ Sperm vitalitymainly depends on the "proportion of forward moving sperm"(PR), which is the proportion of sperm that can actively move forward. Under normal circumstances, PR≥32%. If it is lower than this value, it belongs to "asthenospermia". Only sperm that move forward can break through the cervical mucus and reach the fallopian tube to combine with the egg. Lack of vitality will directly affect the success rate of conception.
③ If theproportion of sperm with normal sperm shape is ≥4%, it is considered qualified. Many people panic when they see that "most sperm have abnormal morphology." In fact, this is a normal phenomenon, because sperm are prone to morphological mutations during the production process. As long as the proportion of normal morphology meets the standard, there is no need to worry too much.
2. Other key checks: Eliminate potential problems
In addition to semen routine, men may also need reproductive ultrasound (to check the testicles, epididymis, prostate and other organs for inflammation, cysts and other diseases), and screening for infectious diseases (such as hepatitis B, hepatitis C, syphilis, AIDS, etc. to avoid mother-to-child transmission). If semen indicators are abnormal, your doctor may recommend further testing of hormone levels (such as testosterone) to check for endocrine problems.
2. Female fertility inspection: focusing on "egg quality" and "breeding environment"
There are relatively many fertility examinations for women, with the core focusing on the three cores of "whether the eggs are of high quality","whether the fallopian tubes are smooth" and "whether the uterus is suitable for implantation." Common examinations include gynecological ultrasound, six sex hormone tests, fallopian tube patency tests, and five screening tests for infectious diseases and eugenics.
1. Gynecologic ultrasound: see clearly the "state" of the uterus and ovaries
Gynecologic ultrasound (transvaginal or transabdominal) is a basic examination that mainly evaluates the health of the uterus and ovaries
① The focus of the uterusis whether the size and shape of the uterus are normal, whether the thickness of the endometrium is appropriate, and whether there are problems such as uterine fibroids, endometrial polyps, and intrauterine adhesions. For example, the thickness of the endometrium will change with the menstrual cycle. Reaching 8-12 mm before and after ovulation is an ideal "implantation thickness". Too thin or too thick may affect embryo implantation.
② The ovarymainly focuses on the size of the ovary, the number of antral follicles (to evaluate ovarian reserve function) and whether there are ovarian cysts. Antral follicles are immature follicles in the ovaries. The number of antral follicles in both ovaries is generally counted by ultrasound, and the normal range is 5-12. If the number is less than 5, it may indicate a decrease in ovarian reserve and insufficient egg number; if more than 12, it may be related to polycystic ovary syndrome, which needs to be further judged in conjunction with other indicators.
2. Six sex hormones: understanding the "code" of endocrine
Six sex hormones (including follicle stimulating hormone FSH, luteinizing hormone LH, estradiol E2, progesterone P, testosterone T, and prolactin PRL) need to be checked at a specific time during the menstrual cycle (usually on the 2nd-5th day of menstruation, basic endocrine). Blood tests should be carried out to reflect ovarian function and endocrine balance
① Follicle stimulating hormone (FSH)directly affects follicular development and is an important indicator for assessing ovarian reserve. The normal range of basal FSH is generally 3.8-8.7 IU/L. If it exceeds 10 IU/L, it indicates that ovarian reserve function may be reduced; if it exceeds 25 IU/L, the risk of ovarian function decline is higher.
② Luteinizing hormone (LH)and FSH synergistically promote follicle maturation and ovulation. The normal range of basic LH is about 2.1-10.9 IU/L. If the LH/FSH ratio is greater than 2-3, combined with the presence of many antral follicles on ultrasound, it may indicate polycystic ovary syndrome. LH will have a "peak" during ovulation to help the egg be expelled.
③ Estradiol (E2)is mainly secreted by follicles, reflecting the development of follicles. The normal range of basal E2 is about 24-114 pg/ml. If E2 is too high, it may indicate a decrease in ovarian reserve; if it is too low, it may affect follicular development and endometrial growth.
④ Progesterone (P)is mainly secreted by the corpus luteum, and whether ovulation and corpus luteum function are evaluated. Basal progesterone is generally low (3.2 nmol/L). If progesterone is ≥15.9 nmol/L after ovulation, it means that the corpus luteum functions well and can provide a stable environment for embryo implantation; if progesterone is low, it may lead to insufficient corpus luteum function and increase the risk of abortion.
③ Testosterone (T) Asmall amount of testosterone in women is secreted by the ovaries and adrenal glands, with the normal range of about 0.2-1.6 nmol/L. If testosterone is too high, it may inhibit ovulation, leading to symptoms such as irregular menstruation and hirsutism. You need to be vigilant about polycystic ovary syndrome.
④ The main role of prolactin (PRL)is to promote milk secretion, and the normal range is about 3.34-26.72 ng/ml. If prolactinemia is too high (hyperprolactinemia), it will inhibit FSH and LH secretion, leading to ovulation disorders, oligomenorrhea and even amenorrhea, which affects pregnancy.
3. Anti-Mullerian hormone (AMH): the "gold indicator" of ovarian reserve
In addition to ultrasound and sex hormones, anti-Mullerian hormone (AMH) testing is also an important item in assessing women's ovarian reserve function, and is even called a barometer of "ovarian age." AMH is secreted by immature preantral follicles and small antral follicles in the ovary. Its level can directly reflect the number and quality of follicles in the ovary. It is not affected by the menstrual cycle and can be detected at any time.
Core interpretation of AMH: The normal reference range is generally 2- 6.8 ng/ml. If the AMH value is between 1.1 and 2ng/ml, it indicates that the ovarian reserve function has decreased and the egg reserve volume has decreased; if it is lower than 1.1ng/ml, it means that the ovarian reserve function has decreased significantly, and the difficulty of conception will increase; if the AMH is higher than 7ng/ml, combined with the presence of too many antral follicles on ultrasound, it is necessary to be vigilant about the possibility of polycystic ovary syndrome. These women often suffer from ovulation disorders. It should be noted that AMH only represents the "number" of follicles and is not directly equated with "quality". Even if the AMH is low, as long as high-quality eggs are expelled, there is still a chance of natural conception.
4. Fallopian tube patency check: ensure that the "channel" is smooth
The fallopian tube is the "bridge" between sperm and eggs to meet and combine. If the fallopian tube is blocked or is not smooth, it will directly lead to infertility. Common examination methods include salpingography and hydrotubation, among which imaging can more clearly show the shape and location of the fallopian tube. The examination results are generally divided into "unobstructed","unobstructed but not smooth" and "completely blocked". If there is a blockage, a treatment plan needs to be formulated based on the location and degree.
5. TORCH: Screening for teratogenic risks
The five eugenics include Toxoplasma gondii, rubella virus, cytomegalovirus, and herpes simplex virus types I and II, which mainly check for infection with these pathogens that may cause fetal malformation or abortion. The two indicators "IgM" and "IgG" in the report are very critical: positive IgM indicates a recent infection, which may affect the fetus and requires treatment before preparing for pregnancy; positive IgG indicates a previous infection, antibodies have been produced in the body, and there is little impact on the fetus; If both are negative, it is recommended to vaccinate relevant vaccines (such as rubella vaccine) in advance to enhance resistance.
3. Don't make your own conclusions on the report
After reading the above interpretation, I believe you have a preliminary understanding of the fertility examination report, but you must pay attention: no indicator can be viewed in isolation and needs to be comprehensively judged based on personal medical history, menstrual cycle, physical signs, etc. For example, a slight abnormality in a certain indicator may be a temporary physiological fluctuation and may not necessarily mean a "fertility problem."
After receiving the report form, the most critical step is to hand it to the doctor in time, and the professional doctor will interpret it based on your specific situation to clarify whether further examination or conditioning is needed. Preparing for pregnancy is a process that requires patience and scientific methods. Understanding the report is only the first step. Only by maintaining good living habits and actively cooperating with the doctor's guidance can the baby's arrival be welcomed more smoothly.