Diagnosis criteria for infertility

Patient's question:

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Doctor's answer:

Women of childbearing age who have been married and cohabited for more than two years without using contraception and remain infertile are referred to as primary infertility. Those who have previously given birth or experienced a miscarriage and have not conceived again for more than two years are considered secondary infertility.
Infertility is a symptom, and it is necessary to identify the underlying factors or causes for treatment.
(1) The male partner can undergo a semen analysis. The examination of the female partner is more complex. Before conducting a systematic examination of the female partner, the male partner should first be tested, primarily for reproductive organ and semen analysis. Normal semen volume is approximately 3–5 mL, with no more than 5 white blood cells per high-power field, and more than 60 million sperm per mL. Among these, the percentage of abnormal sperm should be less than 10%, and 80% of the sperm should maintain normal motility within 2 hours.
(2) Examination of the female partner
1. Medical history includes menstrual history, sexual history, and a history of pelvic diseases.
2. A general physical examination should focus on nutrition, the development of secondary sexual characteristics, and thyroid conditions. The basal metabolic rate may be measured if necessary.
3. A gynecological examination should assess the development of reproductive organs and check for inflammation, tumors, or other conditions.
4. Ovulation function testing.
(1) Endometrial sampling is taken 1–2 days before menstruation or within the first 12 hours of the menstrual period to check for secretory changes and determine if ovulation has occurred, while also ruling out endometrial lesions.
(2) Cervical mucus crystallization test
(3) Basal body temperature measurement
(4) Tubal patency testing and fluid infusion to assess whether the fallopian tubes are open.
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