Reproductive Health Code Liang Zhenhua

More than just indicators or templates, individual living habits, emotional states, and family needs are all integrated into the diagnosis and treatment plan to help patients find the reproductive health management path that best suits them.

I was particularly impressed by Zhou, a 32-year-old Internet operator who received a consultation last week. Polycystic ovary syndrome is accompanied by insulin resistance. He went to three hospitals and was directly prescribed ovulation-inducing drugs. After taking it for two months, the follicles grew, but the endometrium was as thin as paper, and it was impossible to get pregnant. When she sat in Liang Zhenhua's clinic, her eyes were swollen, and she said she would just go for in vitro fertilization if it didn't work.

Liang Zhenhua turned over her checklist, and without rushing to prescribe medicine, she first asked about the details of her life for more than half an hour: Do you often stay up until two or three o'clock to change your plan? Do you drink milk tea at least three or four times a week? Have you had many arguments with your husband recently about not being able to conceive? After asking, she was only prescribed a small amount of insulin sensitizer, and three lines were written at the bottom of the prescription: go to bed before 12 o'clock, abstain from milk tea, and take 20 minutes a day to go downstairs for a walk.

Xiao Zhou was quite unhappy at the time, feeling that he could not afford to delay at 32 years old. As a result, he carried out the test honestly for two months. Before he could be scheduled, he tested the parallel bars. When he came with the report sheet, he smiled from ear to ear and said that he would have known better that he would not have to suffer so much.

In fact, in the field of reproductive health, there have always been two completely different ideas of diagnosis and treatment. There is no absolute right or wrong, but they are just suitable for different groups of people.

One is the "efficiency-first" group, which advocates initiating medical intervention as soon as possible as long as it meets clinical indications, following procedures for ovulation promotion, artificial insemination, and in vitro fertilization, so as to shorten the pregnancy preparation time as much as possible. This is especially suitable for patients over 38 years old with a significant decline in ovarian reserve. After all, eggs wait for no one. If you are late, you may miss the best fertility window.

The other is the "basics first" group, which advocates adjusting basic issues such as endocrine, living habits, and emotional state first, and then starting medical intervention to minimize the impact of drugs and invasive procedures on the body. It is more suitable for young patients without clear organic lesions. Although it seems slow, the subsequent success rate is higher and the risks during pregnancy and childbirth are smaller.

Liang Zhenhua never takes any side. He always says that "diagnosis and treatment plans are prescribed for people, not for guidelines." Two years ago, there was a 41-year-old patient whose AMH (anti-Mullerian hormone, reflecting the level of ovarian reserve) was only 0.4. It was perfectly fine for her to follow the in vitro fertilization process according to the guidelines. However, as soon as she heard about the need for injections and egg retrieval, she had insomnia all night long, and her menstruation was irregular for half a month. Liang Zhenhua did not force her to enter the cycle. He first arranged for her to receive psychological counseling once a week, along with a small amount of hormone adjustment. He waited until her condition was stable before entering the cycle. Implantation was successful in the first try. The child is now almost two years old.

Of course, not everyone agrees with his idea. Some patients think he is "too boring". He obviously can do something quickly, but he insists on spending time asking those parents who have nothing to do with the examination. This is a waste of time.

There was a 38-year-old patient before. At that time, the AMH value was 1.1 and one side of the fallopian tube was blocked. Liang Zhenhua suggested that she adjust her hypothyroidism and sleep schedule for 3 months before ovulating. She felt that she couldn't wait, so she turned to another doctor to directly stimulate ovulation. After 3 consecutive times of ovulation, the follicles either failed to grow or she could not get pregnant even after ovulating. After struggling for half a year, she came back to see him again. Liang Zhenhua didn't say anything, but adjusted her thyroid function for two months first, and waited until the thyroid stimulating hormone dropped to a reasonable range before boosting it again, and she got it right the first time.

To be honest, he has seen this kind of thing too much, and he doesn’t make excuses. He just says a few words to the patient every time he receives a consultation: "You just want to plant crops. The seeds are of average quality and the soil is not fertile. If you sow seeds in a hurry, won’t your work be in vain in the end?" He often talks about the four core factors of reproductive health. Heart: seeds (egg and sperm quality), soil (endometrial condition), channels (fallopian tube patency), climate (endocrine and emotional state), none of them will work. Many doctors only focus on the first three, but the "climate" that most affects the success rate is often ignored.

There are orange candies in the drawer of his consulting room all year round. When he encounters a patient who cries as soon as he comes in, he will first hand him a candy and wait for two minutes before talking about the problem. The first thing many people say when they sit down is, "My tests are all normal, why can't I get pregnant?" He usually doesn't get the test sheet first, but first asks, "Are you under a lot of stress recently? Do you and your wife have a close relationship with each other during the ovulation period, as if they have completed a task?"

Last year, there was a young couple. They had a full body check-up, and there was no problem. They had been trying to conceive for two years and they still couldn’t get pregnant. When I asked them, I found out that their parents called each other every week to make progress. They set alarm clocks every time they had sex, and they were not interested at all. The "prescription" Liang Zhenhua gave them was very simple: they took their annual leave and went on a trip for half a month, forgetting about pregnancy, and just have fun as they wanted. As a result, they got pregnant in the second month after they came back, and they brought him specialties from tourist places.

Many people come to him to ask for the so-called "reproductive health code", thinking it is some exclusive secret recipe or undisclosed diagnosis and treatment technology, but in fact it is not that mysterious.

To put it bluntly, we don’t treat patients as a collection of inspection indicators. What do you like to eat, do you like to stay up late, is there a lot of work pressure, is your relationship with your husband good, and what are your expectations for having children? These things that seem to have nothing to do with the checklist are precisely the core "passwords."

After all, reproductive health is never something that can be solved by just taking medicines and injections. You have to understand your own body first, and then find the right path that suits you, which is better than anything else.