Department of Reproductive Health and Infertility

Many people’s first understanding of this department is that it “treats areas where you cannot conceive.” This answer is only less than one-third correct—the services of the Department of Reproductive Health and Infertility cover the entire life cycle from reproductive health care in adolescence, fertility assessment and assisted pregnancy during childbearing years, to reproductive health management in menopause. Infertility diagnosis and treatment is only part of its core business.

Speaking of which, I met a young girl born in 1995 in the clinic last week. After registering, she stood at the door of the clinic for a long time without daring to enter. The first thing she said when she came in was that her face turned red: "Doctor, I'm not married yet. I just have polycystic menstruation. Will I be misunderstood if I come to your department?" ”I was very happy at the time. I have encountered this kind of misunderstanding too many times. Even my distant cousin wanted to freeze her eggs a while ago, and she made a special phone call to ask secretly, "Does your department only allow those who can't conceive? Will they gossip if I go to register?" ”

Don't tell me, most people know about our department because of our assisted reproduction business. After all, the infertility rate among people of childbearing age in China has now reached about 18%, and patients who come to consult about in vitro fertilization and artificial insemination account for more than half of the outpatient clinics. But when it comes to assisted reproductive solutions, there is actually no unified "standard answer" in the industry. The philosophies of the two schools of doctors are quite different: one school is the "nature first school". When encountering patients with blocked fallopian tubes and mildly weak sperms in the male partner, as long as they are young and have decent ovarian reserves, they will recommend trying to conceive for 3 to 6 months first, with lifestyle adjustments and necessary medication to minimize intervention. ； The other group is the "efficiency-first group". Especially for patients who are over 35 years old and whose AMH (the core indicator reflecting ovarian follicle reserve, the lower the value, the smaller the "stock") is already very low, they will directly recommend artificial insemination or in vitro fertilization. After all, ovarian function is irreversible. If it cannot be adjusted after a year and a half, the follicles will be exhausted, and there will be no chance of assisted pregnancy. Last year, there was a patient who was a 36-year-old university teacher. He was determined to conceive naturally from the beginning. He went to a conservative doctor for a year, and his AMH dropped from 1.2 to 0.6. He was so anxious that he shed tears. Later, he was transferred to our department and directly underwent a first-generation test tube. The implantation was successful in the first time. Now the baby is half a year old. Last month, he even held her and gave her wedding candy. To be honest, no one plan is absolutely right. It depends on the patient's own needs and physical conditions, and the best one is the best.

Oh, by the way, in addition to assisted reproduction that everyone is familiar with, our department also has a core business that many people don’t know: fertility preservation. I just received a 22-year-old girl with leukemia last month, and she is about to start chemotherapy. Her mother came with her crying, saying that the girl has not been in love yet, and if she can't be a mother in the future, she will never survive in her life. Our team worked overtime to carry out the emergency ovulation process for her, and took out 12 mature oocytes for cryopreservation. Later, when the girl was undergoing chemotherapy, she sent me a WeChat message, saying that the thought of 12 "little seeds" waiting for her outside her belly made her feel unbearable. Nowadays, more and more cancer patients who are undergoing radiotherapy and chemotherapy, and young people who do not want to have children temporarily but are afraid that they will not be able to conceive when they are older, will come to inquire about egg freezing, sperm freezing, and even ovarian tissue freezing. To put it bluntly, it is to "insure" their future reproductive rights. Of course, there are a lot of controversies in this area. For example, whether single women can freeze their eggs, the industry has been arguing for several years. Some experts think that liberalization will easily lead to commercialization and a lot of ethical problems in the future. Some experts think that this is women’s reproductive autonomy and should not be restricted by marital status. There is currently no liberalization policy in China, and we can only follow the rules. Every time we meet a single girl asking about egg freezing, we have to explain it for a long time.

In fact, not only for people of childbearing age, but also for many reproductive problems during adolescence and menopause, we are more targeted than simply going to gynecology. For example, for adolescent girls with precocious puberty and menstrual disorders caused by polycystic ovary syndrome, we will make detailed adjustments from the perspective of reproductive endocrinology, not only to regulate menstruation, but also to avoid affecting future reproductive functions. ； For menopausal aunts who have hot flashes, night sweats, vaginal dryness, and uncomfortable sexual life, we can also provide individualized hormone supplementation plans and pelvic floor function rehabilitation guidance. There was a 52-year-old aunt who had endured sexual intercourse pain for five or six years and was too embarrassed to see her. Later, she was introduced to our department by an old sister. After two months of treatment, she told me that her relationship with her husband is now much better.

To be honest, I have been in this department for almost ten years and have seen too many patients with emotional breakdowns. Our doctors sometimes have to work part-time as psychiatrists. After all, the impact of emotions on the endocrine system is really great. Patients are so anxious that they can’t sleep every day, and their follicles cannot grow properly. Sometimes when we meet patients who are under great pressure, we can chat for half an hour, and there is nothing we can do about the number of patients afterward. A few years ago, there were still people pointing at the door of the clinic and saying, "Everyone who comes here is a chicken that can't lay eggs." Now there are far fewer such voices. People have gradually opened their minds and know that fertility problems are not women's fault, nor is it a shameful thing.

Last week, the 36-year-old patient came to deliver wedding candy with twins in his arms. All the nurses in the department gathered around to touch the baby's soft little hands. The baby even spit out bubbles and grabbed the buttons of my white coat. At that time, I felt that whether it was regulating menstruation, freezing eggs, or doing in vitro fertilization, what we were doing was, in the final analysis, to help everyone take the right to have a child in their own hands - to have a choice when they want to have a baby, and to be able to wait without worry when they don’t want to have a baby. This is enough.

Oh, by the way, one last thing, if you have reproductive-related problems, don’t be embarrassed to register. Our department really does not only allow infertile people to enter. Even if you just want to test your fertility and see if your ovaries are good, you can come. There is no shame in it.