Patient's question:
In 2010, I had an induced abortion. In June 2015, I became pregnant, but the ultrasound could not detect a gestational sac. Around the 50th day, I experienced slight abdominal pain and bleeding, and was hospitalized for a suspected ectopic pregnancy. During my hospital stay, I had continuous blood tests and ultrasounds, but the bleeding was similar to my regular menstrual period, and no gestational sac was found. I was discharged after a week without any treatment. After my period ended, the outpatient doctor recommended an hysterosalpingogram (HSG).By the end of 2015, the HSG showed that both fallopian tubes were patent but not fully open. Subsequently, I underwent tubal recanalization surgery. In May 2016, I became pregnant again, but the gestational sac could not be found. Around the 50th day, I experienced bleeding similar to my menstrual period, and it was diagnosed as a biochemical pregnancy. After that, I underwent all the tests recommended by the hospital, except for genetic testing for both me and my husband, which was normal. My husband was also tested and found to be normal. My menstrual cycle has always been irregular, often delayed.
Since the biochemical pregnancy in May 2016, I have been taking dydrogesterone every month until December 2016. My period arrived around the 30th day in November, and I received HMG injections for 10 days. During the mid-cycle ultrasound, the follicular membrane was measured at 9 mm, with a follicle size of 15x18x19 mm. The follicle ruptured the next day, and the doctor advised intercourse. In December, blood tests revealed high androgens, so I took Dianette for a month and then stopped taking Western medicine, starting with traditional Chinese medicine instead.
In May 2017, I stopped taking Western medicine for 5 months and took traditional Chinese medicine for 5 months. I wanted to check my sex hormone profile, but since my period had not arrived for 12 days in May, I had blood tests directly. The next day, my period arrived, and the results showed high prolactin (48). I started taking bromocriptine half a tablet in the morning and half a tablet in the evening. This past Sunday, I began taking clomiphene for 5 days and received HMG injections for 3 days. On the 11th day of my period, the endometrium was measured at 6.9 mm, with a follicle size of 10x12 mm. On the 14th day, the endometrium was 7.1 mm, and the follicle was 10.5x12 mm. On the 18th day, no large follicles were detected, and the endometrium was measured at 10 mm.
In June, my period did not arrive for 8 days, and blood tests showed prolactin at 2.9. The doctor reduced my bromocriptine dose to half a tablet every other day. Now, the doctor says I have hypothalamic-pituitary axis dysfunction, and that my follicles do not grow well with medication or injections. He has recommended IVF multiple times, even this time after my period on June 25. I do not want to undergo IVF, so the doctor has asked me to do SSG (superovulation induction) this cycle. I feel very lost and do not know what to do next.
Doctor's answer:
The cost of treatment depends on the specific situation of the patient after screening. The infertility examination for patients is conducted step by step. First, the major factors causing infertility are screened. For example, the main cause of female infertility is fallopian tube blockage. The doctor will first perform a screening for the fallopian tubes. If it is confirmed that the infertility is due to fallopian tube issues, then the patient's examination fee will only cover the cost of the fallopian tube examination.