Reproductive Health Clinic Dr. Zhang Haoru

She will not just prescribe a full set of examinations, focus on hormone indicators and impose standardized diagnosis and treatment plans, nor will she casually label patients who have been preparing for pregnancy for less than a year as "infertile". She will always sit down and listen to you talk about the worries you have hidden for a long time, and then give you an implementable plan that can adapt to your work rhythm and living habits. This is the core feature of her 12 years of clinical reproductive experience, which has been passed down by word of mouth to nearly 10,000 patients.

When I accompanied a friend to her clinic last Wednesday, I happened to meet a 28-year-old girl with a 3-year history of polycystic ovary syndrome. She had just been married for half a year and was anxious to have a child. When I visited another hospital, the doctor directly prescribed ovulation-stimulating drugs and asked her to start monitoring ovulation that month. The girl sat there crying with the medicine box in her hand, saying that she had just switched jobs to an Internet company and had to work night shifts three or four days a week. She didn't even have time to eat, and she couldn't spare the time to go to the hospital every other day for monitoring. Zhang Haoru poured her a cup of warm water, looked over her previous examination report, and did not let her take ovulation-stimulating drugs. He only gave her a simple work and rest adjustment schedule, asking her to first adjust the frequency of night shifts to no more than two times a month, control the habit of drinking two cups of milk tea a day, and review her hormones after three months. "You are only 28, and your ovarian function is very good. There is no need to rush to catch up with the progress in the past two or three months, and make yourself so tired that you will not be able to get pregnant."

In fact, this approach to diagnosis and treatment has always been controversial in the reproductive field. One group is "indicator first": as long as the patient's hormone level meets the intervention indications, medical intervention such as ovulation stimulation and artificial insemination should be started as soon as possible to shorten the pregnancy preparation cycle as much as possible. It is especially suitable for older patients with reduced ovarian reserve function. According to clinical data, the success rate is not low. Zhang Haoru herself recognizes the rationality of this plan. She still has notes in her drawer when she attended an academic conference last year and discussed with colleagues who adhere to the "indicator first" school. "If I encounter a patient over 35 years old and whose AMH is less than 1.2, I will also advise her not to wait and intervene when it is time. There is never a right or wrong in a medical plan, only whether it is suitable for the specific person."

Last month, a 36-year-old mother of two children came to see her. Her AMH was only 0.38. She went to three hospitals and all recommended direct IVF. She also wanted to try whether she could prepare for pregnancy naturally. Zhang Haoru did not deny her idea. While prescribing a gentle ovarian conditioning plan for her, he also helped her connect to the pre-test tube examination channel of the reproductive center in advance. They walked simultaneously without wasting time. In the second month of conditioning, the patient became pregnant naturally before entering the IVF cycle. It is now almost 12 weeks. Of course, not all patients are so lucky. Last year, there was a 29-year-old girl whose fallopian tubes were blocked and she still couldn’t conceive after half a year of treatment. Zhang Haoru directly helped her sort out all the past examination reports. The thick stack was neatly stapled, and sticky notes were posted on every page where there were questions, so that she could take them to the IVF center without having to do repeated examinations, which saved a lot of money and time.

Dr. Zhang always has two boxes of mint candies and a bag of ginger tea on his clinic table, both of which are prepared for patients who come to check their sex hormones on an empty stomach. Many people feel dizzy after having their blood drawn, and they can recover by taking a piece of sugar. Her patients' WeChat notes are always marked with messy little details: "I am allergic to progesterone soft capsules, so I need to be prescribed dydrogesterone", "I like to eat ice, so I have to remind him to eat less every time I come here", "My husband has weak sperm, and we need to persuade them to quit smoking", which are clearer than the patients themselves remember.

Some people also say that she is not doing her job properly. After all, the reproductive clinics of many hospitals only deal with infertility patients who want to have children. She is good. One-third of her appointments are reserved every week for patients who do not want to have children: teenage girls with severe menstrual cramps come to prescribe painkillers, girls in their early twenties come to consult how to take short-acting contraceptives, and aunts who are about to go through menopause come to ask how to relieve dryness in the reproductive tract during menopause... She accepts them all. Some colleagues advised her that it was not necessary. There were not enough numbers in the first place and they were allotted to non-core patients. On the contrary, Zhang Haoru feels that reproductive health should not only revolve around "having children". "If the girl's dysmenorrhea and polycystic cysts are treated early, and she will avoid detours in future pregnancy preparations, why is it not a matter of reproductive medicine?"

My friend told me last time that she had been trying to conceive for a year without getting pregnant. Calculating her ovulation period and having sex with her husband seemed like she had completed her KPIs. Zhang Haoru didn't prescribe any tests for her, so he handed her a tissue and listened to her cry for more than 20 minutes. In the end, he just said: "Don't count the days this month. Find a place to play with your husband for a week and don't think about pregnancy." As a result, the two of them went to Sanya for a trip and got pregnant the second month after returning. "My baby is now half a year old. Every time I go to get vaccinated, I have to go to Dr. Zhang's clinic to give her two wedding candies."

Nowadays, Zhang Haoru’s account is becoming increasingly difficult to obtain. Some people come to the hospital to queue up at three in the morning. She just applied with the hospital this week to add two more afternoon public welfare consultation numbers every week. There is no registration fee. She specializes in answering questions for those who have a bunch of test reports and don’t know who to look for, or who are too embarrassed to ask about reproductive issues. She always said that reproductive health should not be a secret that people are ashamed to share, and people should not have to go to the hospital five or six times to figure it out. "I can work for two more hours and help a few people avoid detours. It is worth it."