Key points for TCM diagnosis:
(1) Couples of proper age with regular sexual life and without contraception for two years without pregnancy is called sterility. Examination concentrates on the type of build, the secondary sex characteristic and pubes, etc. Gynecological examination is done to see whether there are organic changes.
(2) Assay of ovarian function: BBT tests ovulation. For instance, uni-directional BBT indicates no ovulation; bidirectional BBT, temperature difference ≤0.3℃, or continuous high fever for 1 - 2 days, or gradual increase of body temperature indicate ovulation with hypofunction of yellow body of ovary. Smear examination of the exfoliated cells in the vagina: If the smear examination indicates simple action of estrin or hypofunction of estrin, it suggests no ovulation. Examination of cervical mucus, cervical marks-estimation is for monitoring of ovulation.
(3) Diagnostic curettage and histological examination of endometrium before menstruation or 6 hours within menstruation: This examination is helpful for understanding beth the morbid changes in the cervix and uterus and the functions of yellow body of ovary. Hyperplasic endometrium indicates no ovulation while secretory endornetrium suggests ovulation; early secretory endometrium or insufficiency of secretion suggests ovulation with hypofunction of yellow body of ovary.
(4) Hormone level test is done to analyze whether ovary, pituitary gland and hypothalamus have affected ovulation.
(5) Type B ultrasonic examination is helpful for detecting development of ovum and understanding whether there are organic changes of the uterus and ovary.
(6) Hysterosalpingography is helpful for detecting the pathological changes of the uterus and the conditions of the oviduct.
(7) Abdominoscopy and uterioscopy are helpful for direct observation of the pelvis and the uterus.
(8) PCT tests the ability of semen in penetrating cervical mucus and in survival.
(9) Immune examination of serum and cervical mucus.
(10) Sterility should be differentiated from some congenital defects of genitalia.
Four syndromes of primary infertility categorized in TCM diagnosis
Syndrome of kidney qi asthenia
Syndrome of liver and kidney deficiency
Syndrome of qi and blood asthenia
Syndrome of liver and heart qi stagnation