Information regarding Medical Examinations

Failure to achieve pregnancy within two years or more, despite having normal conjugal relations.

• Wife younger than 35 years old: Failure to achieve pregnancy within 1 year.
• Wife older than 35 years old: Failure to achieve pregnancy within 6 months.

• Fallopian tube factors → tube blockage, stenosis, adhesion.
• Ovarian factors → PCOS (polycystic ovary syndrome), other ovulation disorders
• Uterine factors → endometrial polyp, uterine submucous myoma, endometriosis
• Azoospermia (obstructive azoospermia, non-obstructive azoospermia)
• Spermatic varicocele
• Erectile dysfunction, ejaculation disorder
• Pituitary hypogonadism

Immunological infertility and other problems are considered to be causes of infertility.

Infertility is not only caused by female factors. 30-40% of all infertility cases are due to male factors, and 20% of all cases are due to both male and female factors. From this, cause of infertility is almost 50-50.

Seminal examination, palpation and visual inspection, ultrasound examination and hormone test. Chromosomal test, AZF test, as needed.

Micro-TESE, Simple-TESE, spermatic vericocele (basically, one day surgery under local anesthesia is performed)

1. 1.Azoospermia
   1. Non-obstructive azoospermia→Micro-TESE
   2. Obstructive azoospermia→ Simple-TESE, vasovasostomy
2. Spermatic varicolele→ Low ligation
3. Erectile dysfunction and ejaculation disorder → Counseling, drug administration (Viagra, Levitra, Cialis)
4. Pituitary hypogonadism → hCG-rFSH therapy
5. Other → Non-hormonal therapy (Chinese herbal remedy, vitamins, supplements, etc.), hormonal therapy (clomiphene, letrozole, etc.), AIH (mild oligozoospermia/asthenozoospermia, post-coital test), ICSI (severe oligozoospermia, asthenozoospermia, immotile sperm, azoospermia, conception failure due to in-vitro fertilization, etc.)

Medical interview, pelvic examination, hormone test, AMH, hysterosalpingography (HSG), basal body temperature, post-coital test, cervical mucosa, antisperm antibody, hysteroscopy, chlamydia test, cancer screening, etc.

• Fallopian tubal factors → FT (Falloposcopic Tuboplasty), in-vitro fertilization
• Ovarian factors → For PCOS, rFSH low dose step-up protocol, IVM (in-vitro maturation of inmature eggs), in-vitro fertilization
• Uterine factors → Endometrial polyp, uterine submucous myoma → Resection
• Endometriosis → Different methods depending on the age of the patient and duration of infertility
• Unknown causes (immunological infertility) → in-vitro fertilization.

When the cause of infertility is unknown, combination treatment of in-vitro fertilization and micro fertilization may be implemented. For globozoospermia, or when fertilization rate by ICSI is less than 30%, combination treatment of ICSI and oocyte activation (Ca ionophore and strontium) may be implemented.