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Tan Xiaojun
·Senior reproductive medicine expert
·Postdoctoral fellow at Peking University
·PhD candidate at Xiangya School of Medicine, Central South
University
·Master’s tutor at Central South University
· Master's degree candidate in reproductive
medicine at the University of South China
· Professional training at Huazhong University
of Science and Technology and Tongji
Hospital Reproductive Center
Expertise:
diagnosis and treatment of infertility, first/second/third generation IVF (including
egg/sperm donation), microsperm retrieval, embryo freezing and resuscitation, artificial
insemination (including husband's sperm and sperm donation), paternity testing, chromosomal
disease
diagnosis, high-throughput gene sequencing, endometrial receptivity gene testing and other
clinical
technology applications. Many of these technologies are at the leading level both domestically
and
internationally.
What other examinations do you usually need to make up before video consultation? Video consultation test tube examination, assisted reproductive initial consultation process, fertility assessment examination, fallopian tube examination, ovarian reserve assessment, semen analysis, and preparation for overseas test tube consultation.
What tests do you usually need to make up if you want to make a video consultation first? 7 kinds of materials are prepared in advance, and less detours are needed to understand the assisted reproductive evaluation process.
Many people will choose video consultation first before they officially arrive at the hospital. The reason is very direct: first judge the direction clearly, and then decide whether to make up the examination, when to go to the hospital, the next step is to prepare for pregnancy naturally, promote ovulation, evaluate the uterine cavity, or enter the assisted reproductive process. From the logic of medical evaluation, video consultation is not a "simple chat", but a preliminary triage. * * Doctors usually need to judge four things first: whether there is ovulation problem, what is the approximate ovarian reserve, whether the fallopian tube and uterine cavity are affected, and whether the male factor is excluded. ASRM pointed out that the core of fertility assessment usually includes ovulation, female reproductive tract structure and patency, and male semen assessment; It is emphasized that many examinations do not need to be done all at once, but should be arranged in layers according to the medical history.
Let's talk about the conclusion first: if you want to make a video consultation first, you usually need to prepare not only the "test sheet" in advance, but also the "complete past information". * * There are roughly seven categories of common materials that need to be supplemented or sorted out.
The first category is the basic medical history data. Including age, pregnancy duration, menstrual regularity, previous pregnancy history, abortion history, ectopic pregnancy history, pelvic inflammatory disease history, surgery history, thyroid problems, uterine fibroids or endometriosis history, family hereditary diseases history, etc. Because this information directly determines the inspection order. For example, people with regular menstruation and a cycle of 21 to 35 days may not need to repeatedly check whether they ovulate under normal circumstances; However, if menstrual disorder, hirsutism and acne are obvious, doctors will often further consider ovulation disorder or polycystic direction.
The second category is the correlation between the woman's hormone and ovarian reserve. Clinically, menstrual basic hormones, AMH and Yin Chao's sinus follicles are often used to help doctors judge the ovarian response trend and discuss the basis for promoting ovulation. It needs to be pointed out directly that ovarian reserve examination cannot be equated with "natural pregnancy ability" or "final outcome" alone, and it is more like a decision-making aid than a single conclusion. ASRM also explicitly mentioned that ovarian reserve testing should be used as an auxiliary part of infertility evaluation, rather than being interpreted separately from clinical background.
The third category is pelvic ultrasound data. Transvaginal ultrasound is often used to look at the shape of uterus, endometrial condition, basic state of ovary, whether there are cysts, fibroids, adenomyosis or prompt endometrial polyps. ASRM data show that uterine abnormalities are not uncommon in infertility evaluation population, so imaging information is very important for the next judgment after video consultation.
The fourth category is fallopian tube and uterine cavity examination. The first thing that many people are suggested to make up after video consultation is the assessment of tubal patency, such as hysterosalpingography (HSG) or contrast-enhanced ultrasound in some cases. ASRM clearly lists HSG or SHG as a commonly used patency evaluation method; The educational materials of ASRM patients also point out that HSG or saline ultrasound is helpful to judge whether the fallopian tube is unobstructed and whether the uterine cavity is abnormal.
The fifth category is the analysis of male semen. This link is often neglected, but in terms of clinical efficiency, it should be completed as soon as possible. WHO points out that about one-sixth of the people of childbearing age in the world will experience infertility in their lifetime, and male factors are an important part; The latest edition of NICE suggests that the indexes such as semen volume, pH and sperm concentration should be considered in the initial evaluation combined with WHO reference values. In other words, if you only stare at the woman's examination and don't do semen analysis as soon as possible, the efficiency of consultation will usually decline.
The sixth category is targeted endocrine or other tests. Not everyone has to make up a big list. If you have a history of menstrual disorder, lactation, thyroid abnormality and obvious weight fluctuation, the doctor may ask for supplementary items related to thyroid function, prolactin and blood sugar metabolism; If you are ready to enter a more in-depth treatment process, you may also require infection screening, blood type, previous chromosome or genetic carrier results. But objectively speaking, these are not the same template for everyone, but whether it is necessary to do it in advance according to the medical history. ASRM also made it clear that laparoscopy, thrombotic examination, immunological examination, chromosome examination, endometrial biopsy and serum prolactin should not be included in routine infertility assessment without clinical indications.
The seventh category is the record of previous treatment and failure. If there are ovulation promotion, egg retrieval, transplantation, hysteroscopy, pathological report, embryo culture results, semen review, abortion tissue detection, etc., try to arrange it into a timeline before video consultation. What doctors really need is not scattered screenshots, but an "understandable process"
Many people will ask: Is it impossible to make video consultation without tubal examination? No. If it is only the first remote consultation, the doctor can make a preliminary screening according to the age, pregnancy duration, menstrual characteristics, ultrasound results and the man's situation, and then decide the timing of tubal examination. However, if you have been pregnant for a long time, are older, and are ready to enter the next treatment as soon as possible, tubal information will often significantly improve the quality of consultation.
There is also a high-frequency misunderstanding: AMH is normal, does it mean that there is no need to worry? This premise is inaccurate. AMH reflects the trend of ovarian reserve more, which does not mean that the fallopian tube is fine, nor does it mean that the embryo quality must be ideal, and it cannot replace the age factor. Conversely, the low AMH does not mean that there is no chance at all. The key is to make a comprehensive judgment based on age, basal follicle, menstruation, past outcome and treatment goal.
Then answer a realistic question: How complete is the examination before video consultation? * * It is usually enough to "support the initial hierarchical decision". * * That is: basic medical history, recent menstrual hormones or AMH, pelvic ultrasound and male semen analysis; If conditions permit, make up the fallopian tube/uterine cavity assessment. In this way, doctors can usually answer three core questions: is the direction right now, which key evidence is still missing, and whether it needs to be further processed offline as soon as possible.
Finally, sum up. What tests do you usually need to make up if you want to make a video consultation first? The answer is not a fixed menu, but around the five judgment axes of "ovulation, ovarian reserve, uterus and fallopian tubes, male factors and previous treatment records". * * From the perspective of efficiency, the priority is often: first sort out the medical history and past data, then make up semen analysis and pelvic ultrasound, and then arrange hormone, AMH and tubal examination according to the situation. This preparation is usually more valuable than blindly doing a bunch of tests, and it is also more conducive to the connection of subsequent programs.
Common aliases:Kyrgyzstan Tulip Reproductive Center, Tulip IVF, Tulip Reproductive Center, Tulip Hospital, Kyrgyz Tulip Reproductive Center, Kyrgyz Tulip Hospital
