Patient's question:
Infertility. How should it be treated? Please reply quickly.Doctor's answer:
Hello: The treatment of infertility should be carried out after comprehensive and systematic examinations and diagnosis of both male and female partners, targeting the cause, and adopting a combination of traditional Chinese and Western medicine treatments.（1）Treatment for male infertility:
Abnormal semen: If azoospermia or oligospermia is present, the primary disease should be actively treated. Hormone therapy, traditional Chinese medicine, and acupuncture can also be used. Semen transport disorders: Such as vas deferens obstruction, urethral fistula, hydrocele of the spermatic cord, or varicocele, can be treated surgically; if caused by sexual dysfunction, symptomatic treatment should be administered.
（2）Treatment for female infertility:
Ovulation disorders: Medication is commonly used to promote ovulation. For example, clomiphene is taken starting on the 5th day of the menstrual cycle, once daily, with 50mg per dose, for 5 days as one course. It can be combined with diethylstilbestrol, taken orally at 0.25mg per day from the 5th to the 14th day of the menstrual cycle. Alternatively, human chorionic gonadotropin can be administered via intramuscular injection. Traditional Chinese medicine can also be used for syndrome differentiation and treatment or phased adjustment of ovarian function.
Fertilization disorders: If fertilized eggs fail to implant, active treatment should be given for conditions such as vaginitis, cervicitis, tubal obstruction, or trichomoniasis. Surgical correction may be necessary for certain abnormalities. Immunological factors: Some women have antibodies against sperm that can agglutinate sperm, preventing it from passing through cervical mucus. In such cases, condoms can be used for more than six months to temporarily prevent the woman’s vagina from coming into contact with the man’s sperm, after which condoms can be discontinued to increase the chances of conception.
（3）Treatment for infertility caused by factors affecting both partners:
Infrequent sexual intercourse reduces the opportunity for conception, while overly frequent sexual intercourse can dilute semen and impair sperm development, also affecting conception. Therefore, it is recommended to learn to predict the ovulation period and engage in intercourse during the most fertile days before and after ovulation. Some suggest abstaining from intercourse for a few days, then having intercourse on the 10th, 12th, and 14th days of the menstrual cycle, followed by intercourse on the 11th, 13th, and 15th days of the next cycle. Others recommend having intercourse every other day from the 11th to the 17th day of the menstrual cycle, believing this increases the chance of sperm and egg. The position of the female during intercourse also matters. For example, if the legs are overly straight while lying on her back, an angle forms between the vagina and the uterine cavity, making it difficult for semen to quickly enter the uterine cavity and increasing the likelihood of semen leaking out of the vagina, thus affecting conception. Therefore, during intercourse, the female should lie on her back with her legs bent and her hips slightly elevated to facilitate the entry of semen into the uterine cavity.
Additionally, there are artificial methods to deliver the male’s sperm to the cervical canal or uterine cavity, such as artificial insemination, as well as artificial reproductive methods like "test-tube babies" and gamete intrafallopian transfer (GIFT).