What Factors Affect Male Fertility?

Male infertility, also known as male infertility. It refers to infertility caused by male factors. Generally, the cohabitation of a woman who has lived together for more than 2 years after marriage without taking any contraceptive measures and the woman is not pregnant is called infertility.

Male infertility

Male infertility, also known as male infertility. It refers to infertility caused by male factors. Generally, the cohabitation of a woman who has lived together for more than 2 years after marriage without taking any contraceptive measures and the woman is not pregnant is called infertility.

The incidence rate is about 10%, of which the female factor is about 50%, the male factor is about 30%, and the male and female factors are about 20%. Clinically, male infertility is divided into two types: sexual dysfunction and normal sexual function. The semen analysis results can be further divided into azoospermia, oligozoospermia, spermatozoa, sperm weakness, and normal infertility of sperm count.

In recent years, with the increase of people's understanding of human reproductive problems and the rapid development of andrology research, the rate of male infertility has gradually increased, which has attracted great attention from male scientists.

Chinese name

Male infertility

Definition

Infertility caused by male factors

Cause

Severe azoospermia

Signs and symptoms

Historical history of surgery

The onset of this disease is complicated. Many diseases or factors can cause male infertility. According to the results of semen examination, it can be classified as azoospermia, severe oligospermia, oligospermia, sperm count, normal infertility, polyspermia, and spermia.

The causes of male infertility are summarized as follows:

1. Common chromosomal abnormalities are male pseudohermaphroditism and KXYY syndrome

2.The cause of endocrine diseases is gonadotropin deficiency, commonly known as selective hypogonadotrophic hypogonadism, namely Kallmann's syndrome; selective LH deficiency and FSH deficiency; adrenal hyperplasia; hyperprolactinemia, etc.

3. Reproductive tract infections are more common. In recent years, with the increase in the incidence of sexually transmitted diseases, genital tract inflammations such as prostatitis, epididymitis, orchitis, and urethritis have increased in severity and severely affect male fertility.

4. Obstruction of insemination tube affects sperm transport

5. Testicular spermatogenic dysfunction is common in cryptorchidism varicose vein toxin magnetic field hyperthermia and trauma physical and chemical factors can cause testicular spermatogenic disorders

6. Sperm structural abnormalities and seminal plasma abnormalities affect sperm motility and acrosome reaction, etc.

7. Anti-sperm immunity produced by immune-sterile men and anti-sperm allogenesis produced by women can cause male infertility

8 Male sexual dysfunction, impotence, premature ejaculation, non-ejaculation and retrograde ejaculation can cause male infertility

Medical history

Past illness history, injury history, operation history, sexual life history, birth control history, birth history, marriage history, history of exposure to drugs and physical and chemical factors, urinary tract symptoms and gynecological examination of the woman

2. Physical examination

Including the general system of the nervous system and reproductive system, focus on the development of secondary sexual characteristics, testicular size and texture of the genital organs, testicular epididymal spermatic cord and vas deferens, and the condition of the prostate. Know whether there are hypospadias, cryptorchidism, varices, etc.

3.Semen check

Abstinence for 3-7 days

Normal reference value: Semen 2-6ml off-white or pale yellow 5-20 minutes Completely liquefied PH7.2-7.8 Sperm density 50 million-100 million / ml Sperm viability> 60% Sperm viability> 75% (> grade 6 ) Sperm deformity rate 130 million / sperm count per sperm <20 million / ml fertility is extremely poor

1 semen analysis

Includes routine semen and cervical mucus penetration tests to understand the condition of sperm and seminal plasma

2. Determination of reproductive endocrine hormones

Use radioimmunoassay to measure serum testosterone (T) luteinizing hormone (LH) follicle stimulating hormone (FSH) and prolactin (PRL) to determine the functional status of the gonad axis

3 special inspections

Such as chromosome analysis, immunology, insemination angiography, and testicular biopsy to help identify the cause of infertility

1. Obstructive azoospermia has normal testis size but no sperm; testicular biopsy shows that the arrangement of spermatogenic epithelial cells has a more active spermatogenic process; spermography can identify the obstruction site

2.The spermatogenic cells are not developed. The testis is normal in size but there is no sperm in the semen. Testicular biopsy shows that there are only columnar support cells in the seminiferous tubules.

3.The seminiferous seminiferous tubules are normal in size but soft and often accompanied by decreased libido.Sperm in semen can be secondary to non-specific inflammation mumps. Testicular torsion or application of estrogen can also be caused; testicular biopsies of spermatogenic cells and Sertoli cells disappear, seminiferous tubules, hyaline degeneration, lumen atresia disappears

4.Spermatogenic cell maturation disorders Testicle size Normal texture Sperm examination is due to the occurrence of oligospermia is related to the environment with certain harmful substances (such as lead) industrial smoke (such as gasoline) high temperature and spermatic cord varicose veins; testicular tissue inspection showed spermatogenic process There are very few spermatogenic cells that stop developing in the seminiferous seminiferous tubules

5. Klinefeltersyndrome (Klinefeltersyndrome) testes are small and the amount of soft semen is small. Sperm capsid biopsy shows irregular interstitial cell clumps, occasionally supporting cells.

6. Testicular development is obstructed. The testis is small and the amount of sperm is small. Azoospermia, such as prepubertal pituitary gland secretion of gonadotropin is insufficient. Testicular biopsy shows that the seminiferous tubules are composed of undifferentiated primitive support cells and primitive spermatogenic cells. Testicular biopsy of testicular atrophy in patients with testicular atrophy caused by pituitary lesions after puberty or receiving excessive androgen or estrogen treatment. Early changes in the intrinsic membrane thickening and spermatogenesis.

7. Testicular fibrosis. Testicles become smaller and azoospermia in the seminal fluid may be related to infection in the testicles. Testicular biopsy shows multiple small scars scattered in the interstitial space.

1, abnormal semen

Most men are infertile due to abnormal semen and sperm. When there is no sperm or too few sperm, the sperm density in the semen is less than 200 million / ml, the woman's chance of conception is reduced, and when it is less than 20 million / ml, infertility is caused. Such infertility can be classified as permanent and temporary. Oligospermia, dyspermia, azoospermia, etc. are common, and it is found that early diagnosis and treatment are required.

2.Spermatogenesis disorders

What causes male infertility? Spermatogenesis is one of the reasons. Men's testicles suffer from diseases, chromosomal abnormalities, and sperm dysfunction. They also include local diseases such as recessive varicocele, giant hydrocele and other diseases that affect the local external environment of the testes, or due to temperature and compression And other reasons, causing infertility.

3.Vas deferens obstruction

Infertility in some men is caused by obstruction of the vas deferens. Imperfect vas deferens can prevent sperm and eggs from properly combining, affecting fertilized egg formation, and infertility.

4, systemic factors

The body suffers from other diseases and can cause male infertility. Such as sudden changes in the living environment, leading to long-term mental stress; performing high-altitude, high-temperature, ultra-intensive labor, and engaging in radiation work, nutritional factors, endocrine diseases, etc.

Treatment principles

1. etiology treatment;

2. Endocrine therapy;

3. Non-specific treatment;

4. Surgical treatment;

5. Artificial insemination

Medication principle

1. Infertility caused by genital tract infection is mainly treated with antibiotics and anti-inflammatory drugs supplemented with drugs that improve sperm motility

2. Azoospermia and azoospermia and idiopathic infertility should be mainly treated with sex hormones for endocrine therapy

3. People with low sperm motility are mainly treated with drugs that improve sperm motility.

4. Sterile varicose vein infertility duct obstruction and hypospadias caused by hypospadias infertility patients should be treated with endocrine drugs and other auxiliary drugs

5. absolute infertility (such as azoospermia) should be artificial insemination

Treatment includes two aspects: cause treatment and symptomatic treatment:

1 Promote spermatogenic function of the testes

Drug treatment: chorionic gonadotropin 1500 2000U intramuscular injection 3 times a week; clomiphene 50mg orally once a day for 3 months

Surgical treatment: those with varicocele with abnormal sperm routine need high spermatic vein ligation for cryptorchidism or testicular insufficiency. Testicular descent fixation can be performed to promote testicular spermatogenesis.

2 Keep the insemination pipeline unobstructed

Actively treat sexual dysfunction and maintain normal sexual life. For those with congenital vas deferens, such as vas deferens and vas deferens, they should be actively treated.

3Improve the function of sperm

People with inflammation of the genital tract should be actively given antibiotics; vitamin E, vitamin C, and zinc preparations such as protein zinc complex can improve sperm function. For immune infertile people, using condoms can eliminate and reduce sperm antigen stimulation to women. Short-term application of doses and artificial insemination with sperm washing are helpful for the treatment of immune infertility

4 Artificial Insemination (AI)

Including donor sperm artificial insemination (AID) and husband sperm artificial insemination, two major types of in vitro artificial assisted reproduction technology have developed rapidly in recent years, especially intracytoplasmic sperm injection (ICSI) has been used to treat oligozoospermia and spermatozoa. And azoospermia achieved better results

Vaccination should be done on time. Good personal hygiene habits to prevent various infectious diseases that harm male fertility, such as mumps sexually transmitted diseases, etc.

It is necessary to master certain sexual knowledge to understand the physiological characteristics and health care of men. If it is found that the testes have different changes than usual, such as: swelling and stiffness, unevenness, pain, etc., it must be diagnosed and treated in time.

If you are constantly exposed to high temperature and poisonous radioactive materials, you must strictly follow the operating regulations and protective regulations. Do not be negligent. If you want children in the near future, it is best to leave this kind of work for six months before giving birth.

The testicle is a very delicate organ. Its optimal working temperature is about 1 degree lower than a person's body temperature. If the temperature is high, it will affect sperm production. So any factor that can increase the temperature of the testicle must be avoided, such as: riding a bicycle for a long time Take a hot bath, wear jeans, etc.

Change bad habits. Quit smoking and drinking. Don't eat too greasy things or it will affect your sexual desire. Also, pay attention to avoid contact with toxic substances in your life. For example, clothes taken from dry cleaners should be stored for a few days. Affects male sexual function

Pay attention to pre-marital medical examinations. Early detection of abnormalities can avoid pain after marriage. After marriage, often communicate with your wife about problems encountered in sexual life. Cooperate with each other and understand each other. Many spiritual impotence or premature ejaculation can be avoided.

The first point is to get rid of some bad habits in life and strengthen the physique. If smoking or drinking is the best, the patient should quit, quit drinking, avoid spicy, etc., and develop a good life pattern in normal life, balanced Nutrition in the body for proper physical exercise.

The second point is that the husband and wife must cooperate well in daily life, have a harmonious sex life, have regularity, and do not over frequency.

First, male patients usually actively participate in physical exercise, adhere to daily activities, cultivate their wide range of hobbies, achieve a combination of work and rest, and appropriately relieve tension, so that the quality of sperm can be gradually improved.

Second, men try to avoid bad habits, have a healthy and fair diet, eat more nutritious foods, such as fresh vegetables and fruits, but never smoke or drink, you must be familiar with it in your mind The importance and necessity of quitting smoking.

Third, male patients need to perform self-psychological adjustment, relax their mentality in time to ease and eliminate anxiety. Do something that can express your feelings, such as reading favorite books and participating in group activities.

Fourth, we must pay attention to maintaining family harmony, which will help eliminate tension in work and life. The husband and wife cooperated to meet their needs. Can greatly improve the chance of conception!