Which couples who are preparing for pregnancy need a reproductive doctor to intervene in advance?

Which couples who are preparing for pregnancy need a reproductive doctor to intervene in advance?

Jun 11, 2021XieYifang

Human fertility is a natural process. There is no need to monitor ovulation or learn related knowledge. The vast majority of men and women who have sex between men and women can conceive naturally without help. So living things, including humans, can multiply endlessly.

I am an assisted reproductive medicine doctor. The more popular understanding of assisted reproductive department is to help you with pregnancy department. Although childbirth is a natural process and can be completed without help, in fact, some couples cannot become pregnant within one year after marriage. This condition is called infertility, and infertile couples need our assisted reproductive doctors.

In theory, married couples live normally after marriage, and only those couples who have not been pregnant for a year without any infertility measures need the help of an assisted reproductive doctor. But some people should not stick to this "one year" time, and should seek help from us earlier.

Old age

The ovarian reserve function of elderly women declines, and the quality of eggs declines. The decline in ovarian reserve means that the time to ovulate is already very short. Menopause may come at any time and there is no chance of pregnancy. The decline in egg quality also reduces the pregnancy rate of each ovulation, spontaneous abortion after pregnancy, and fetal arrest. The incidence of fertility and fetal abnormalities has increased. The advanced age should not blindly try for a long time to conceive naturally. If you are over 35 years old and have not been pregnant for half a year, you should evaluate the cause of infertility and provide help if necessary. If you are over 38 years old, you should directly consider doing third-generation IVF, screening embryos, and selecting embryos with normal chromosomes for transfer. Reduce the abortion rate and increase the normal pregnancy rate. Even if you don’t want to do third-generation IVF, women over 40 should consider doing first- and second-generation IVF to increase the probability of pregnancy. I often say that doing IVF at an advanced age is to grab the few remaining eggs in the ovaries.

If the eggs in the ovaries are not actively harvested, they will slowly disappear naturally.

Menstrual disorders

People with menstrual disorders, especially those with prolonged menstrual cycle and amenorrhea, need to intervene in advance.

There may be ovulation before every menstruation, and there is basically no ovulation without menstruation (a very small part of the reason is that the uterus does not come to menstruation, but there will be ovulation). Normal people ovulate 12 eggs each year, and there are 12 chances of pregnancy. People with oligomenorrhea, oligoovulation, and amenorrhea have less ovulation and less chance of pregnancy. Ovulation induction therapy should be carried out as soon as possible to increase the chance of pregnancy.

If it is uterine amenorrhea, it means that the uterus is abnormal. Although it does not need to promote ovulation, it needs treatment. The uterus is abnormal and still can't get pregnant.

The most common menstrual disorder is polycystic ovary syndrome. After the intervention of the assistant doctor, basic treatment is required to reduce weight, improve insulin resistance, reduce androgen, and promote ovulation. After such treatment, a smooth pregnancy can be achieved.

Menstrual disorders may also be caused by decreased ovarian reserve. Some people are not old, but the ovarian reserve function is significantly reduced, and premature aging may occur, so they should also be rushed to harvest as soon as possible.

In short, menstrual disorders affect pregnancy and should be intervened as soon as possible.

Endometriosis surgery

Endometriosis is a disease common to young women, often dysmenorrhea, ultrasound finds chocolate cysts on the ovaries. This disease can affect pregnancy and even infertility. As time goes by, it will relapse and worsen, making it more and more difficult to get pregnant. Once endometriosis is diagnosed, regardless of whether it is operated or not, pregnancy should be considered as early as possible. If after the operation, you can try to conceive naturally for half a year or 2-6 cycles of artificial insemination for stage Ⅰ and stage Ⅱ, and still fail to conceive, consider IVF. For stage III and IV endometriosis, the IVF process should be directly entered after the operation. Not only have to fight for time with the decline of ovarian function, but also with ovarian failure.

The operation of the cyst and the operation of the cyst will affect the reserve function of the ovaries, and there is a certain probability of recurrence after the operation of the cyst.

Patients with severe dysmenorrhea may have or will have a higher probability of endometriosis and adenomyosis in the future, and pre-pregnancy examinations should also be done early.

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