Reproductive health examination items

There is no universal “must-do list” for reproductive health check-ups. All items must be customized based on your age, sexual life history, fertility needs, and past medical history. The total cost of regular basic items for healthy adults will not exceed 500 yuan. 90% of the “high-end reproductive health check-up packages” on the market that cost several thousand are premium items, so there is no need to follow the trend.

Speaking of which, I met a typical example in the outpatient clinic last week. A 22-year-old girl had just been sexually active for half a year. She was tricked by a salesperson at a private hospital into doing more than 2,000 "female reproductive anti-aging screenings." She came to me with a thick stack of reports, including tests for premature ovarian failure factors and a full set of reproductive cancer genes. In fact, she had no physical problems at all. She only needed to do a TCT (liquid-based thin-layer cytology test) and a leucorrhea routine. All the extra money spent was paid IQ tax.

If you are a healthy woman who is sexually active, has no discomfort, and has no need to prepare for pregnancy, it is enough to do two items every year: one is cervical screening, and the other is gynecological B-ultrasound. The routine leucorrhea test is only done when you feel itchy vulva and the secretion has a peculiar smell. It does not need to be done every year. There are actually two opinions in the academic circles on whether women under 25 years old should be routinely tested for HPV. The evidence-based view is that women under 25 years old have strong immunity, and most HPV infections are transient. If detected, it will easily cause unnecessary anxiety, so only TCT is enough. ； However, most of our front-line clinical doctors will recommend joint investigation. After all, the age of first sexual intercourse is generally earlier, and there are more and more cases of persistent infection with high-risk HPV. Early detection and early follow-up are better than delaying the disease. Both opinions are reasonable, and everyone can choose based on their own acceptance. If you already have menstrual disorders or intercourse bleeding, then you can add six sex hormones and colposcopy. If you don’t have any symptoms, you really don’t need to make random bills.

Many men always think that reproductive physical examination is a matter for girls, and they don’t need to do it if they don’t have symptoms. I once met a couple who had been trying to conceive for two years but did not get pregnant. The woman had a fallopian tube angiogram, which was all normal. She persuaded the man to do a regular semen test but refused, saying that he was in good health and running marathons. However, it was found that the forward motility sperm was only 18%, which is far lower than the 32% qualifying line of the fifth edition of the WHO, which wasted more than half a year. In fact, the male reproductive physical examination is simpler. If you don’t need to prepare for pregnancy, a regular physical examination of the genital appearance and urine routine every year is enough. If you need to prepare for pregnancy, you can add six items such as semen routine and sex hormones. The total cost is only more than 300. The prostate massage detoxification screening and reproductive ability genetic testing are all IQ taxes, which are not worth half a dime.

Oh, by the way, there is another pitfall in the industry. The "six must-checks for sex hormones" and "complete set of reproductive anti-aging" promoted by many organizations are really unnecessary. If you have regular menstruation, no menstrual disorders, or infertility, checking for sex hormones is a complete waste of money. If one item is found to be slightly higher or lower, it will only cause trouble for yourself. There are also semen routines. Many private institutions are still using the old fourth edition WHO standards, with the passing line set at 50%. In fact, the fifth edition has long been changed to 32%. Many people originally had no problems, but were frightened by the old standards and bought a bunch of useless supplements. They were so wronged.

If you are a couple who is preparing for pregnancy, you can add some targeted items to the basic items. For example, the woman can add TORCH and thyroid function. If the man has the habit of smoking, drinking and staying up late all year round, he can add sperm morphology analysis. There is no need to check anything else. If you are an aunt who is already menopausal, don’t think that you don’t need to have a gynecological examination after menopause. Get a gynecological B-ultrasound and cervical screening every year, which can early detect endometrial cancer and cervical cancer, which are gynecological tumors that are highly common in the elderly. My mother’s physical examination last year showed that the endometrium was thickened. Further tests revealed that it was a benign endometrial polyp, so she had it removed early and felt relieved.

In fact, to put it bluntly, there are not so many bells and whistles about reproductive health physical examination. The core is "choice according to your needs." Don't be fooled by the sales pitches of "the sooner you get tested, the more peace of mind you will have" and "anti-aging and cancer prevention". Don't put off getting checked out because you are embarrassed. After all, compared with your own body, that embarrassment is really nothing.