常见问题解答

Experiencing difficulties getting pregnant or having infertility is a stage of being infertile. It means not able to get pregnant after being married for a while.  Infertility can happen to both men and women. For men it is about 20-30%, for women is 40-55%, both sides are 10-40%, and unknown causes are 10-20%.

These are the indicators :

1. Having regular sexual intercourses (2-3 times per week) without any form of birth control for a year but still cannot get pregnant.

2. Married couples who are ageing especially women who are older than 35 years old. They may have diseases that would interfere with reproductive system such as endometriosis or polycystic ovary.

Causes of Infertility

1. Causes from women

   Women may have abnormal reproductive system since birth, infection or hormone abnormality that cause problems for ovulation, abnormal growth of uterine wall, blockage in ovarian tubes, adhesion, cyst and endometriosis.

2. Causes from men

   Common causes that are found in men are having low sperm count, abnormal sperm movement, abnormalities in sperm production and sperm transferring, the way they have intercourse, ejaculation, and the ability to fertilize with eggs. 

There are many abnormalities that can take place in each cause. Furthermore, it could be because of abnormal immune system, retrograde ejaculation, blockages in vas deferens, other sicknesses, infection, or abnormal reproductive system since birth. Some can associate with obesity, disabilities, stress, cigarette, and alcohol. These have a direct effect of sperm’s health.

By Assoc.Prof. Matchuporn Sukprasert

There are many methods of infertility’s treatment. It depends on different factors such as causes of infertility, timing, ages of married couples and other environmental factors.

The first step is to find out the causes of infertility. A thorough checkup needs to be done in both men and women because it could be from both individual. There are some cases that abnormalities were not found. We still offer treatments that can increase the chances of getting pregnant such as IVF ICSI that uses fertility technology to help as well.

Infertility Evaluation in Married Couples

The evaluation should be done together for both husband and wife. Generally, we will start asking about their medical history.

Women: Any history in gynecology, history of sickness, surgery, menstrual period in the past, menstrual cramps, history of pelvic floor’s infection, any history of getting Diethylstilbestrol (DES) medication when the mother was pregnant, and history in endocrine disease.

Men: Any history of surgery or accident that was involved with reproductive organs, history of infection, mumps, other diseases and medical history. Also, it is important to know sexual intercourse history of both sides such as ejaculation, pain and other abnormalities during sex, and genetic disorders of both sides.

General Health Checkup

General health checkup such as gynecology checkup to see reproductive organs, reproductive development, pap smear test, and checkup for any abnormalities in testicle, semen analysis, ovulation evaluation, and additional tests for fallopian tubes. Moreover, other checkup tests are also important for infertility evaluation such as any history in pelvic surgery or any pelvic infection.

After finding out the causes for infertility, we can determine the methods of treatment by using high technology to help improve reproductive system.

By Assoc.Prof. Matchuporn Sukprasert

在开始治疗之前，没有必要对输卵管和子宫腔进行造影。因为医生在向子宫腔注射造影时会考虑危险因素。例如，有骨盆手术史、子宫内膜异位症或其他妇科疾病，如子宫肌瘤、子宫筋膜。或先天性子宫异常等。

这个过程类似于检查宫颈癌的内部检查。医生将使用一根小管插入宫颈孔。然后将不透明物质注入子宫并进行X光检查。不透明的物质通过输卵管流动，直到通过输卵管末端到达盆腔，可以看到输卵管和子宫腔的外观。

这项检查可能会在检查期间和之后引起小腹疼痛，但每个人的情况不同。医生通常在检查前服用止痛药。然而，在检查过程中，患者不会以任何方式入睡或麻醉。绝经后2-5天，但不超过月经第一天10-12天。

文章作者：玛祖副教授(Assoc.Prof.Matchuporn Sukprasert)

不是同一种疾病。

卵巢囊肿，也称为多囊卵巢综合征

是内分泌系统疾病导致雌激素、孕酮、雄激素和胰岛素水平不平衡。卵巢中有几个小囊肿，可能是单侧或双侧，因此卵巢变大。它可能导致月经不规则、痤疮、多毛或不孕，主要见于育龄妇女。

巧克力囊肿或卵巢内膜异位症

医学认为这是由月经出血反向引起的，而不是正常的阴道出血。然而，月经的一部分回流到输卵管进入腹部，然后植入卵巢，导致囊肿或血肿。育龄妇女患这种疾病的可能性仅取决于她们的免疫系统。虽然这不是一种危及生命的疾病，但它给患有这种疾病的女孩带来了很多痛苦。

文章作者：玛祖副教授(Assoc.Prof.Matchuporn Sukprasert)