Patient's question:
Here is the translation of the provided text into English, with the specified requirements in mind:"How three times in these three years I had natural miscarriages. Examination revealed immune infertility, and each time it was in the 40s days that I couldn't hold on."
Doctor's answer:
Step 1: Detailed medical history inquiryInquire about the patient's medical history, including whether they have any genetic issues, whether they have previously had cryptorchidism, recurring orchitis, or orchitis caused by mumps, whether they frequently consume cottonseed oil, wear tight pants, and other factors. These factors can be identified through the medical history, potentially revealing causative factors or etiology.
Step 2: Physical examination
The examination includes assessing the size, hardness, and elasticity of the testicles, checking whether the vas deferens is patent, and evaluating whether the prostate and seminal vesicles are functioning properly. If no significant issues are found through these examinations, or if conditions such as prostatitis or injury factors are present, it is necessary to investigate whether there are any immune factors involved.
Step 3: Immunological tests
1. Reproductive immunology tests: This primarily includes tests for antisperm antibodies, sperm antigens, and antierectile tissue antibodies. If conditions permit, further tests in fluid immunology can be conducted.
2. Intrauterine cervical mucus function test: Post-coital test, used to assess cervical mucus function, sperm viability, and penetration ability.
3. In vitro sperm-cervical mucus contact test: The test is performed during the predicted ovulation period. A common method is the slide method: a drop of seminal fluid and a drop of mucus are placed on a slide, and the slide is gently shaken to bring the two drops of liquid close together. After placing a coverslip, it is examined under a microscope.