Our husband and wife undergo annual physical examinations, with normal indicators and good lifestyle habits. Why hasn't there been any movement after two years of preparing for pregnancy? "This is almost a daily confusion heard in the consultation room of the Tulip International Reproductive Center. Behind this question, a common cognitive misconception is revealed: there is a huge gap between routine "health check ups" and professional "fertility assessments".

Many 'invisible killers' that truly hinder pregnancy do not appear in routine medical examination reports. They are not painful or itchy, but they silently affect your fertility potential. Today, we will systematically organize these questions for you in the form of Q&A.

Q1: Why is it possible to have fertility disorders even though the routine physical examination report says' everything is normal '?

A: This is because routine physical examinations mainly focus on the basic functions of various organ systems throughout the body, such as heart, liver, kidney function, blood glucose, blood lipids, etc., with the aim of screening for common chronic diseases and health risks. Fertility is a complex process precisely regulated by the hypothalamic pituitary ovarian (testicular) axis, involving many specialized examinations that are not covered by routine physical examinations. A 'healthy' medical examination report does not equal a 'good pregnancy' passport.

Q2: What are the common but easily overlooked "invisible killers" for women?

A: Clinical statistics show that ovulation disorders, fallopian tube factors, and endometrial problems are the main causes of female infertility. They usually have strong concealment.

Tubal dysfunction: The fallopian tube is the only channel through which sperm and egg meet and combine. Tubal blockage, hydrosalpinx, or adhesions caused by pelvic inflammatory disease, history of appendicitis surgery, or endometriosis can directly block the fertilization process. In most cases, blocked fallopian tubes themselves do not cause any physical discomfort and can only be detected through specialized hysterosalpingography (HSG) or laparoscopic examination.

Endometriosis: Active endometrial tissue "runs" to areas outside the uterine cavity (such as the ovaries, pelvic peritoneum, etc.) for growth. These "ectopic" endometrium not only cause progressive worsening of dysmenorrhea, but also seriously interfere with the fertility process through multiple mechanisms such as local inflammatory reactions, pelvic adhesions, affecting egg quality and embryo implantation.

Polycystic ovary syndrome (PCOS): This is a common endocrine disorder. Its typical feature is that although there are many small follicles in the ovaries, they cannot develop and mature normally and be discharged, resulting in persistent anovulation. Menstrual thinning or amenorrhea, hirsutism, acne, weight gain, and other common symptoms are common, but there are also some patients whose symptoms are not typical and only manifest as long-term infertility.

Decreased ovarian reserve function (DOR): The number and quality of follicles in the ovaries irreversibly decrease with age. In addition to age as the biggest factor, long-term mental stress, unhealthy lifestyles, environmental pollution, and other factors are all accelerating this process. Ovarian reserve function needs to be professionally evaluated through anti Mullerian hormone (AMH) testing and basal antral follicle count (AFC), and routine physical examinations cannot provide early warning.

Q3: Is male factor really that important in fertility issues?

A: Absolutely important, and its importance is often severely underestimated. According to data from the World Health Organization, in infertile couples, male factors alone account for about 20% -30%, while factors shared by both men and women account for about 20% -30%. Overall, issues related to male fertility account for nearly 50% of all infertility cases.

The idea of letting women bear all the checks and pressure alone is extremely wrong and inefficient. Common male infertility factors include:

Abnormal semen quality: This is the main factor, including oligospermia (insufficient quantity), asthenozoospermia (poor motility), and teratozoospermia (abnormal morphology). Long term staying up late, smoking, excessive drinking, and high temperature environments (such as frequent hot spring baths and prolonged sitting) are all culprits that damage sperm quality.

Varicocele: This is one of the common causes of male infertility. It can cause local temperature rise and blood stasis in the testicles, thereby affecting the spermatogenic function of the testicles and leading to a decrease in sperm quality.

Therefore, when facing difficulties in preparing for pregnancy, the most efficient and scientific first step is for both husband and wife to undergo examinations simultaneously. Men only need to undergo a non-invasive semen routine analysis once to obtain preliminary key information.

Q4: Can you share a real case to illustrate the importance of couples checking together?

A: Of course. Last year, 35 year old Ms. Wang and her husband walked into the Tulip International Reproductive Center. They have been preparing for pregnancy for nearly three years, during which Ms. Wang has undergone almost a complete set of examinations at multiple hospitals in China, including six sex hormone tests, B-ultrasound, fallopian tube imaging, etc., all of which showed "basically normal", with only slight menstrual irregularities. All doctors and family members believe that Ms. Wang is under too much pressure.

During these three years, Ms. Wang has borne a huge psychological burden and tried various traditional Chinese medicine treatments and folk remedies, but to no avail.

In our initial consultation, the expert insisted that her husband must also undergo a comprehensive fertility assessment. At first, her husband was very resistant, thinking that he was physically strong and the problem could not be with him. But with our patient explanation, he ultimately agreed to undergo semen analysis.

The test results were surprising: his sperm motility (forward movement) was only 8%, far below the normal reference value (≥ 32%), and the sperm deformity rate was as high as 97%, diagnosed as severe "asthenozoospermia".

This clear diagnosis instantly solved the mystery that had troubled them for three years and also relieved Ms. Wang. Subsequently, we developed a targeted "ICSI (intracytoplasmic sperm injection)" IVF protocol for them, by selecting the sperm with the best morphology and vitality in the laboratory and directly injecting them into the egg, bypassing the obstacles of natural fertilization. In the end, they successfully obtained multiple high-quality embryos and became pregnant after the first transfer.

This case vividly illustrates that any preconceived assumptions on the path of reproduction can lead to significant waste of time and emotions. Couples investigating together is the shortest path towards the correct solution.

Fertility is never a task that can be completed by one person's "health standards", but a precise project that requires the participation and systematic evaluation of both men and women. At Tulip International Reproductive Center, we advocate putting aside meaningless speculation and prejudice, and facing problems together from a scientific and equal perspective. Because true love and responsibility are willing to join hands to explore the truth and overcome difficulties together.

For fertility consultation in Kyrgyzstan, please contact your dedicated consultant

/Fertility Consultation /

Dr.Chan

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