Reproductive health screening methods

There is no universal standard package for reproductive health screening. The core logic is to "distribute gender and scenario, first non-invasive and then invasive, and prioritize matching symptoms to identify high-risk causes." The vast majority of people do not need to undergo a full set of examinations upon arrival. Over-screening may cause unnecessary anxiety and invasive operation risks. Basic screening can cover more than 90% of common problems.

Last week, I met a 28-year-old girl in the clinic. She was just 3 months pregnant and she was in a panic and wanted to have a full set of reproductive examinations. From AMH to fallopian tube imaging, the list was full of pages. She said that she had read a lot of posts on the Internet and was afraid that there would be problems that would delay her pregnancy. In fact, according to the consensus of most front-line clinical doctors, women who have no previous history of miscarriage, reproductive system, and regular menstruation do not need to undergo invasive examinations at all if they are preparing for pregnancy for less than a year. It is enough to first do a basic gynecological examination, six items of sex hormones for 2-4 days after menstruation, and a routine vaginal ultrasound. The man will first do a routine semen check. After all, examinations such as fallopian tube angiography are invasive procedures and carry inherent risks of infection. There is really no need to suffer from this in advance.

At this point, some people may ask, do only those who are preparing for pregnancy need to undergo reproductive health screening? Not at all. Many people's understanding of reproductive health is still limited to "whether they can have children." In fact, inflammation, developmental abnormalities, and malignant lesions are all within the scope of screening. As long as relevant symptoms appear, you must see a doctor in time, and there is no time to wait until you are preparing for pregnancy. There was a 32-year-old male patient whose scrotum had been swollen for more than half a year. He was too embarrassed to come for a check-up. He always thought it was because he was tired from sitting for a long time at work. In the end, the pain was so severe that it affected sexual intercourse. He was diagnosed with moderate varicocele. If he had come three months earlier, he could have controlled it by adjusting his living habits and taking oral medication. In the end, the only solution was surgery. If a girl often suffers from non-menstrual bleeding, pain during intercourse, or abnormal discharge, don’t try to deal with it. First, check the leucorrhea test, TCT+HPV, and most of the problems can be found out.

Of course, this does not mean that all advanced examinations are unnecessary. There are actually two different screening ideas in the industry: one is to strictly follow the evidence-based medical indications and do not perform additional screening if there are no high-risk factors or symptoms, so as to avoid waste of medical resources and reduce patient anxiety.； The other school is the "advance evaluation" idea that has become popular in recent years, especially among young people who have family planning. For example, after the age of 25, AMH should be checked every year to evaluate ovarian reserve, and testicular ultrasound should be done regularly to check for varicocele. Both statements are reasonable. If you have irregular menstruation, have a family history of premature ovarian failure, or have no plans to have children yet but want to know your physical condition in advance, there is no problem in choosing the latter. ； But if you have a regular schedule and no abnormalities in your body, there is really no need to spend hundreds of dollars more to check for these. I once met a 26-year-old girl whose physical examination showed that her AMH was slightly lower than the reference value. She cried at home for a whole week. After three months of continuous monitoring, her ovulation was completely normal. It did not affect pregnancy at all. It was purely an individual difference.

There are some pitfalls that you really need to talk about in advance. Don’t believe the “99 Yuan Comprehensive Reproductive Health Screening” gimmick outside. It is most likely for drainage. If you go in, it will either tell you that you have severe inflammation and need treatment, or it will trick you into buying a pregnancy preparation package that costs tens of thousands. Not to mention the money spent, it may also give you random drugs. You also need to make some preparations before going for the test: Boys should abstain from sex for 3-7 days before the semen test. Don’t stay up late and don’t drink alcohol before the test, otherwise the results will be inaccurate. ； Girls need to have their sex hormones checked on an empty stomach, preferably on the 2nd to 4th day of their menstrual period. For gynecological ultrasound checks, it is best to wait until just after menstruation to avoid physiological cysts interfering with the results.

Many people also ignore the reproductive health screening of middle-aged and elderly people, always thinking that they don’t need to care about it when they are older and have no need for reproduction. There used to be a 56-year-old aunt who had postmenopausal bleeding for half a month. She thought it was "rejuvenation". She was embarrassed to tell her family that she delayed the check-up for three months and was diagnosed with early-stage endometrial cancer. If the bleeding was checked as soon as possible, the prognosis would be much better. There are also many elderly men who always think that frequent urination and urgent urination are a normal phenomenon of old age. In fact, a prostate ultrasound and a PSA test can diagnose the problem. Early intervention can avoid many sins.

To put it bluntly, reproductive health is a part of overall health. There is no need to hide your illness or be overly nervous. Find a specialist in a regular hospital and explain your situation and needs clearly. The examination prescribed is the most suitable for you. Don’t scare yourself by looking at Baidu entries, and don’t be fooled into paying IQ tax by messy institutions.