What Is Azoospermia?

Azoospermia means that no sperm is found in multiple semen tests (usually more than 3 times). This disease is one of the causes of male infertility. When necessary, testicular biopsy, spermography, and endocrine hormone radioimmunoassay can be done to help identify obstructive or congenital azoospermia. Azoospermia is usually due to congenital deficiency, weak endowment, loss of kidney essence, and loss of life; or due to acquired disorders, too much damage, spleen loss of life, lack of essence and blood; damp heat, stasis, and occlusion of the sperm tract; or Suffering from the gills first, Shaoyang's epidemic poison flows down to Jueyin, while the remaining poison is nostalgic, sperm worms are difficult to produce and lead to azoospermia. Dialectics first distinguishes between reality and reality. Deficiency syndrome is mostly caused by kidney deficiency, often accompanied by hyposexuality, impotence, premature ejaculation, backache and knee weakness. Evidence is mostly caused by stasis fever, often accompanied by normal or hypersexual libido, testicular swelling and pain, and blood sperm. The total treatment method is tonifying the kidney and replenishing essence, clearing heat and removing blood stasis.

Male reproductive system

A semen test found no sperm, which we call azoospermia. As one of the most intractable infertility problems, azoospermia has caused severe pain to patients and has caused numerous problems for doctors. "No sperm was found in the sperm ejected 3 times in a row, which is called azoospermia." Azoospermia accounts for about 15% -20% of male infertility patients. The causes are numerous and can be divided into two categories. The first is testicular dysfunction, called primary azoospermia or non-obstructive azoospermia. The second is that the testicular spermatogenesis is normal, but because the insemination duct is blocked, sperm cannot be discharged from the body, which is called obstructive azoospermia.

Chinese name

Azoospermia

Foreign name

Azoospermia

Types of

Male infertility

Cause

No spermatogenic cells, blocked vas deferens, etc.

Types of

Pre-testicular, testicular, post-testicular

Introduction to azoospermia

Azoospermia means that no sperm is found in multiple semen tests (usually more than 3 times). This disease is one of the causes of male infertility. When necessary, testicular biopsy, spermography, and endocrine hormone radioimmunoassay can be done to help identify obstructive or congenital azoospermia. Azoospermia is usually due to congenital deficiency, weak endowment, loss of kidney essence, and loss of life; or due to acquired disorders, too much damage, spleen loss of life, lack of essence and blood; damp heat, stasis, and occlusion of the sperm tract; or Suffering from the gills first, Shaoyang's epidemic poison flows down to Jueyin, while the remaining poison is nostalgic, sperm worms are difficult to produce and lead to azoospermia. Dialectics first distinguishes between reality and reality. Deficiency syndrome is mostly caused by kidney deficiency, often accompanied by hyposexuality, impotence, premature ejaculation, backache and knee weakness. Evidence is mostly caused by stasis fever, often accompanied by normal or hypersexual libido, testicular swelling and pain, and blood sperm. The total treatment method is tonifying the kidney and replenishing essence, clearing heat and removing blood stasis.

Male reproductive system

Common causes of testicular spermatogenic dysfunction are: no testis. Testes are the only place to produce sperm. Without testicles, sperm production is impossible to talk about. Since there is no testis and no therapeutic value, there is no need to take any medicine at all; bilateral cryptorchidism. In this case, the testes do not reach the scrotum that they should have. They stay in the abdominal cavity because the temperature is much higher than the scrotum. There is no way to produce sperm, and sperm will also occur. This condition can be treated by surgery. It should be noted that the earlier the treatment time, the better the effect; congenital seminiferous tubular hypoplasia (also known as Kline-Felter syndrome), which is also the cause of development. Although there is no problem with the location of the testes, sperm production is also problematic.

In real life, you should avoid all factors that increase the temperature of the testes; eat cottonseed oil. The oil contains a component called gossypol, which can inhibit sperm production, so people use it as a contraceptive for men, but if men who plan to give birth eat more, sperm reduction or even disappearance will occur. If you eat too much cottonseed oil, it will be difficult to return to normal after stopping; varicocele. This condition will seriously affect the blood supply of the testes, and then affect the spermatogenic function of the testicles. A large number of sperm will even decrease or disappear. Prompt surgery or medication (mild) is expected to restore fertility in most patients.

Causes of azoospermia

1. Endocrine diseases, hyperhypophysis or hypothyroidism, pituitary tumors, hyperadrenalism or hypothyroidism, hyperthyroidism or hypothyroidism.

2. Congenital testicular abnormalities.

3, testicular lesions. Such as testicular trauma, inflammation, torsion and testicular vascular disease.

4. Hereditary diseases. Such as autosomal or sex chromosomal abnormalities, Kirschner's syndrome and so on.

5, blocked vas deferens.

6, radiation damage and drug damage to the testicular spermatogenic cells cause azoospermia.

Azoospermia predisposing factors

1. Congenital seminiferous tubule hypoplasia: It is a cause of patient development. The patient's testicular position is not abnormal, but there are problems with sperm production. If the disease is found in time, there is hope for cure if the disease is not too serious.

2, genital damage: external factors cause testicular torsion, damage, spermatic cord torsion, etc., or because of hernia repair surgery or prostate surgery trauma, etc., can also affect testicular function, resulting in patients with sperm production disorders.

3, radioactive factors: if in the presence of strong radiation or electromagnetic waves, it will have a great impact on men, and only prevent it.

4. Local high temperature of the testicles: Taking a long time to take a sauna, a hot bath, or high temperature of the testicles due to other factors will affect the male sperm production. In this case, most patients have symptoms such as oligospermia or excessive sperm death. People need to pay attention to avoid all factors that can increase the temperature of the testes.

5. Varicocele: This condition will seriously affect the testicular blood supply of men, and then affect the spermatogenic function of men's testicles. It will also lead to a large reduction or disappearance of sperm. Such patients can be recovered in a timely manner in most patients Reproductive function.

6, hypogonadism: such patients are relatively rare in clinical, but only a few people will have this phenomenon.

Pathology classification of azoospermia

Azoospermia can be divided into 2 categories:

sperm

First, the cause of azoospermia due to obstruction of the tract: it is due to the obstruction of the insemination tube, which prevents the sperm from being discharged from the body. Common reasons are:

1. Absence of congenital vas deferens, trauma and ligation of vas deferens.

2. Gonorrhea epididymitis, epididymal prostate tuberculosis and caseous necrosis.

3. Ejaculatory ducts are blocked.

4. The testicles that cannot produce spermatozoa are reduced in size, soft in texture, and lack of elasticity; while those with obstructive azoospermia have more normal, full, and elastic testicles.

Second, the cause of spermatozoa azoospermia: the male obstructive tract of the non-obstructed sperm is caused by testicular spermatogenesis dysfunction, unable to produce sperm. Common causes:

1. Congenital malformations such as no testicular deformities, cryptorchidism, and testicular hypoplasia.

2. Testicular atrophy caused by testicular trauma, vas deferens artery trauma, testicular torsion, mumps combined with orchitis.

3. Taking chemical drugs or radiation sickness for a long time.

4. Endocrine disorders such as hypogonadism and hypopituitarism.

5. Vitamin A, C, E and complex B deficiency.

When identifying which type of azoospermia a patient belongs to, first of all, a medical history collection and physical examination should be performed, and special attention should be paid to the development of secondary sexual characteristics and reproductive organs to determine whether there is endocrine dysfunction.

Testicular volume is measured. The average testicular volume of a normal Chinese adult is 12-25 ml. Those with a testicular volume of less than 10 ml are usually accompanied by spermatogenic dysfunction. Examination of the epididymis found thickening, nodules and hardening, which means obstruction; when the epididymis enlarges and swells, it indicates that there is obstruction in the distal end.

Azoospermia

The determination of follicle stimulating hormone in blood is of great significance in the differential diagnosis of azoospermia.

Blood FSH levels are lower than normal, generally pre-testicular, and elevated blood FSH levels should be considered as primary testicular failure. Post-testicular azoospermia, blood FSH levels are generally normal. When FSH is significantly elevated, the testis must be in an irreversible or severe spermatogenic disorder.

For testicular hypofunction caused by hypothalamus and / or pituitary dysfunction, hormone replacement therapy can be used. For testicular azoospermia, only those with no elevated FSH have hope for treatment. For post-testicular azoospermia, patients with local epididymal obstruction and obstruction of the upper vas deferens can be surgically relieved. However, with the improvement of assisted reproduction measures, IVF technology has become more and more mature, and the second-generation IVF can be completed by extracting sperm from the epididymis or testes.

Classification of azoospermia

Common causes of azoospermia

1. No spermatogenic cells. Many azoospermia contain only podocytes in the vas deferens. There are many reasons for this, including the administration of cytotoxic drugs, radiation, or some factors during the fetal period.

2. Primary testicular insufficiency. This may be due to genetic defects, undescended testicles, physical damage to the testicles, testicular insufficiency caused by adolescent mumps, and affect fertility.

3. Endocrine disorders. Common ones include: hyperhypophysis or hypothyroidism, pituitary tumors, hyperadrenalism or hypothyroidism, hyperthyroidism, hypothyroidism, etc., which can affect sperm growth and cause azoospermia.

4, blocked insemination pipeline. Blockage of the vas deferens is the number one cause of azoospermia. Obstructive azoospermia can be caused by hypoplasia of the congenital epididymis or other parts of the vas deferens (including the vas deferens). Some of these cases appear to be hereditary.

Clinical factors for azoospermia

I. Disease factors.

The emergence of azoospermia is related to some andrological diseases. When the disease compresses the vas deferens, it is easy to cause it. The cause of azoospermia may also be that some diseases oppress the internal spermatic vein, which leads to obstructive and non-obstructive azoospermia.

Second, living habits.

The reason for the high incidence of azoospermia in young people is related to the strong blood supply in the scrotum. Experts from Hangzhou Guangren Hospital pointed out that young and middle-aged people have strong sexual function. If they stand for a long time, they will easily increase abdominal pressure, which is one of the factors that cause azoospermia.

Third, environmental factors.

The emergence of azoospermia is also related to the male living environment. If men often work and live under the environment of radiation, high temperature, and toxic gas, spermatogenic cells in the testes will be damaged, and in severe cases, azoospermia will be caused.

Azoospermia western medicine

Classification of azoospermia

Non-obstructive NOA; testicular spermatogenesis disorder, unable to produce sperm or only a small amount of sperm, resulting in no sperm in the semen. It can be broken down into:

(1) Hereditary diseases: autosomal or sex chromosomal abnormalities that affect sperm production in the testes, such as Klinefelter syndrome.

(2) Congenital testicular abnormalities: abnormal testicular development or abnormal testicular position can cause spermatogenesis disorders.

(3) Testicular lesions: such as testicular trauma, inflammation, torsion, and testicular vascular disease.

(4) Endocrine diseases, pituitary hyperfunction or hypothyroidism, pituitary tumors, adrenal hyperfunction or hypothyroidism, hyperthyroidism or hypothyroidism, can affect spermatogenesis and cause azoospermia.

(5) Severe systemic diseases and malnutrition can cause azoospermia.

(6) Radiation damage and drugs, especially cytotoxic drugs, cause damage to testicular spermatogenic cells, which can cause azoospermia in severe cases.

Azoospermia

Obstructive OA: No sperm in semen is caused by obstruction of the insemination duct. The patient's secondary sexual characteristics, sexual desire, and sexual function were normal, testes developed normally, and spermatogenesis occurred, but no sperm was discharged due to obstruction of the insemination duct. Causes include:

Congenital malformations, including epididymal head ectopic, epididymal ductal atresia, vas deferens absent or undeveloped;

Infection with gonococcus, tuberculosis and other bacterial infections can cause epididymis and vas deferens obstruction;

The epididymal cyst compresses the epididymal duct and causes obstruction;

The injury blocked the insemination pipeline.

Causes and lesions of obstructive azoospermia:

The composition of the insemination tube: testicular output tubule epididymis head, body, tail vas deferens ejaculation duct urethra.

Causes of vas deferens obstruction:

Congenital factors: Congenital abnormalities in any part of the entire insemination tube from the testis to the ejaculation tube can be caused, and they are common in the epididymis.

(1) Abnormal epididymis hypoplasia, epididymal head atrophy, epididymal atresia, obstruction of epididymal ridge and epidermal vas deferens, epididymal cyst.

(2) Vascular hypoplasia is congenital absence or atresia of bilateral vas deferens.

(3) The seminal vesicles are not developed or absent.

(4) Congenital atresia or stenosis of the prostate and ejaculatory duct hypoplasia.

(5) Müllerian or mesial duct cysts.

Acquired factors: reproductive tract infections, severe testicular, vas deferens, prostate, seminal vesicle-specific and non-heterosexual infections can all cause obstructive azoospermia. Epididymal infections are common, of which gonococcal infections are the most common, which often invades the epididymal tail and rarely infects the epididymal head. Obstructive azoospermia caused by tuberculosis infection is difficult to restore its fertility through reoperation; trauma, injuries in the vulva and groin and compression of postoperative scars, and scrotal and perineal trauma can cause obstruction of the vas deferens and ejaculation duct . Vasectomy; tumors, tumors of the epididymis, seminal cord, seminal vesicles, and prostate, such as those that invade or oppress the vase or ejaculate.

In popular terms, for the following reasons:

(L) Some people have innate spermatogenesis, this abnormality is found in the study of chromosomes and genetic genes, or learned through biopsy

Azoospermia

. Can also be found after multiple semen examinations.

(2) Sperm cannot be produced due to orchitis, mostly due to mumps, and other infections can also cause this disease.

(3) The path through which the sperm passes appears to be impeded, causing the sperm to ejaculate. For example, gonorrhea sometimes causes the vas deferens to be blocked.

(4) No testis or cryptorchidism, epididymal cyst, or injury.

(5) The ability of the testes to produce sperm decreases due to advanced age. But it varies from person to person, and some people are still fertile in their 70s.

(6) Other factors, such as malnutrition, industrial hazards, radiation exposure, febrile diseases, allergies, and bad habits such as tobacco addiction.

Azoospermia traditional Chinese medicine

Azoospermia is divided into true azoospermia and pseudo azoospermia. Some patients with true azoospermia have no conscious symptoms and have normal sexual life. After years of infertility after marriage, there are no azoospermia after examination or testicular biopsy. This disease cannot be cured, and the woman must be conceived by artificial insemination. However, there are also patients who have been suffering from chronic illness and fatigue, kidney deficiency who cannot produce spermatozoa, or those with vas deferens who are blocked, and have sperm that cannot be discharged. They can be treated with drugs and have a certain effect. Testicular tuberculosis and testicular atrophy are also difficult to cure.

1. Insufficient kidney essence : evidence shows that there is little thin semen, weakened or normal sexual desire, less complexion, fatigue, dizziness, tinnitus, frequent urination, pale tongue, thin pulse, and weak pulse. Expelling kidney and filling essence, and using raw marrow to cultivate Dan (ginseng, Ophiopogon, Cistanche, Yam, Yam meat, cooked land, mulberry, antler, wolfberry, turtle gum, dodder, angelica, purple river carp, fish bream).

2. Sperm tract obstruction : evidence shows that qi and blood are abundant, young and strong, testicles are of normal size and texture, less abdominal pain, or no sensation, or have yellow crossing, such as drenching, yellow tongue coating, and pulse strings. The rule is to clear the heat and clear the stasis and to clear the collaterals, and use the Tongqiao Huoxue Decoction to add or subtract (red peony, angelica, peach kernel, safflower, Sichuan achyranthes, Wang Buling, Lutong Yinhua, dandelion). Or with external application. If the drug causes azoospermia (such as Tripterygium wilfordii), appropriate treatment after stopping the drug may also cure.

Azoospermia diagnosis

Azoospermia test method

1. Endocrine examination: Serum FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), PRL (Prolactin), T (Testosterone), DHT (Dihydrotestosterone) can help to distinguish between primary testicular failure or subsequent testicular failure Primary testicular failure.

2. Obstructive test: It can detect seminal plasma neutral a-glucosidase and refined berry sugar, because the former is produced by the epididymis and the latter is produced by the seminal vesicles. Detect the difference in concentration between the two, combined with the amount of semen and the change in pH (normal ejaculation volume is 2--8 ml at a time, pH value is 7.2-8.0, of which seminal fluid accounts for 70%, seminal vesicle fluid pH is alkaline) Determine whether the obstruction is in the epididymis, vas deferens, or in the seminal vesicles and ejaculation ducts.

3. Testicular biopsy: Testicular biopsy can clearly diagnose the spermatogenic status of the testes. Because of its trauma and other factors, the World Health Organization is cautious. Recommended only in patients with azoospermia with normal testicular volume and normal blood FSH.

Diagnosis of azoospermia

Examination for patients with azoospermia mainly includes 3 aspects: detailed inquiry of medical history, physical examination and laboratory examination.

1. Inquire about the medical history in detail. Knowing the medical history of the patient in detail, knowing the patient's past reproductive history, sexual maturity age, and history of congenital diseases, etc. will help clear diagnosis and search for potential causative factors. At the same time, it is also necessary to determine whether the patient is OA or NOA. help. For example, a history of olfactory loss or visual imbalance may suggest that the patient may have pituitary lesions; a history of epididymitis, groin, or scrotal surgery suggests a greater likelihood of OA; a history of cryptorchidism or spermatic cord torsion, a history of chemotherapy, and NOA More likely; in addition, some drugs can also cause azoospermia, including alcohol, alkylating agents, allopurinol, anabolic steroids, ciloxitin, cocaine, colchicine, gentamicin, neonatal Mycin, furanotoin, spironolactone, azosulphacil salicylate, tetracycline family, etc.

2. Physical examination Physical examination plays an important role in finding the underlying pathogenic factors of azoospermia. By examining the whole body of the patient, you can understand the patient's hormone levels, previous surgery history, and whether there are abnormalities such as smaller testicle volume, testicular masses, epididymal bowl nodules, absent vas deferens, and varicocele. Through anal digital examination, you can understand the condition of the prostate and seminal vesicles.

3.Laboratory inspection

1. The result of semen examination is the basis for the diagnosis of azoospermia. Two semen samples are usually collected after 2-3 days of abstinence. The amount of semen is also important (normally> 1.5mL). In clinical examinations, the main reason for the small amount of semen is incomplete collection of semen. Therefore, 2 specimens are routinely collected.

2. Endocrine examination For patients with azoospermia, FSH and T examination of serum should be performed first. If the values are normal, no further endocrine examination is necessary. If the value of T is below normal levels, LH and prolactin tests should be performed. At present, some scholars believe that inhibin B is produced by testicular support cells and can directly reflect the testicular spermatogenic function than FSH. Therefore, inhibin B should also become a routine test for male infertility patients.

3. Genetic Examination In 1996, Van and Assche reported that 13.7% of azoospermia patients had abnormal karyotype. Since then, researchers have performed chromosome tests on azoospermic patients. The purpose of genetic inspection is twofold: first, it can diagnose some genetic diseases, such as Klinefelter syndrome, chromosome translocation, inverted mutation, etc .; second, it can make some infertility through sperm extraction technology and intracytoplasmic sperm injection Patients recover their fertility. If a patient has a chromosomal abnormality, the abnormality may be passed on to the next generation.

4. Testicular biopsy Testicular biopsy is helpful to distinguish OA and NOA. At the same time, some potential lesions of the testis can also be found, such as intertubular germ cell tumor, Frank seminoma and so on. There are two main methods of testicular biopsy: scrotal incision biopsy and puncture biopsy. Both have advantages and disadvantages. The former has greater damage to the testis, but it can obtain a larger amount of tissue, which is conducive to the correct pathological diagnosis of H. The latter is easy to operate and has less damage to the testis, but the tissue obtained is less. May affect diagnosis. Some researchers have found that in patients undergoing bilateral testicular biopsy, 28% of patients have inconsistent testicular test results on both sides. Therefore, when conditions permit, the testicle live gun should be sampled on both sides as much as possible to avoid errors.

Genetic factors for azoospermia

90% of male infertility is caused by spermatogenic disorders and clinically manifests as azoospermia or oligospermia. In azoospermia or oligozoospermia patients, about 15% of people have chromosomal abnormalities, which are manifested as small deletions on the long arm of the Y chromosome. These deletions are also known as azoospermia factors.

Azoospermia

Assisted fertility technology, the exact name is single sperm injection in the ovary. If the relevant gene is not checked during use, sperm with a related gene deletion may be injected into the egg. If it develops into a boy in the future, it will grow up It may become azoospermia or oligospermia in the future. In this way, it will bring new troubles and misfortunes to future generations. To avoid this, genetic tests are performed on patients with azoospermia or oligozoospermia of unknown cause, especially azoospermia.

An azoospermia test can not only clarify the cause, avoid traumatic tests such as testicular biopsy, or some ineffective treatments, but more importantly, avoid inheriting defective genes to the next generation.

Hereditary factors are the main causes of male infertility, and chromosomal abnormalities are closely related to the occurrence of azoospermia and severe oligozoospermia. Spermatogenesis is controlled by a number of genes that are expressed in an orderly manner. Aberrations in the number of chromosomal structures can affect the function of these genes, which in turn affects spermatogenesis. The most common karyotype that causes azoospermia is 47, XXY. 47. XXY appears azoospermia, which is caused by the increase in the dose of genes involved in sex determination on the X chromosome, which affects the coordinated expression of the "regulatory string pattern" of sex determination. Some autosomes also have many genes that affect spermatogenesis. When translocations cause gene breaks or deletions, they can lead to oligospermia and azoospermia. The same sex chromosome is related to sexual differentiation. The Y chromosome is present, and the undifferentiated gonads develop into testes. However, when the Y chromosome structure is abnormal, it can produce certain clinical effects to varying degrees. Causes testicular hypoplasia or sexual developmental malformations, causing sperm production disorders, reducing or losing sperm production, producing azoospermia or severe oligospermia. Further research is needed. Chromosomal abnormalities not only affect spermatogenesis, but on the other hand, even through assisted reproduction and fertility, it is easy to form gametes with unbalanced chromosomes, leading to pregnancy failure. It can be seen that chromosomal examination is necessary for patients with oligospermia and azoospermia, which cannot be ignored. In 1976, Tiepolo and Zuifaidi first proposed that multiple genes on the Y chromosome are involved in spermatogenesis. After many years of research, it was found that a key fertility-related factor region exists on the male-specific Y chromosome, called the AZF region. At present, it is believed that there are four spermatogenic subregions (AZFa, AZFb, AZFc, AZFd) in the AZF region. The sites contained in each subregion play different roles in different stages of male germ cell development. The patient presents with oligospermia, asthenospermia or azoospermia, which causes infertility.

It is generally believed that the proximal deletion of the Y chromosome (involving AZFa and AZFb) represents a severe spermatogenic disorder mainly with Sertoli cell syndrome, and the distal deletion of the Y chromosome (involving AZFd and AZFc) can leave island-like growth factors. Fine normal area. In patients with azoospermia, AZF gene testing is generally no longer performed in patients with small testes or testicular biopsy without sperm. In short, carrying out chromosome and AZF testing can comprehensively evaluate the genetic defects of male infertility, so as to better explain the cause of the disease, provide genetic counseling and guide clinical diagnosis and treatment.

Clinical manifestations of azoospermia

1. There are no sperm in semen for more than 3 times.

2.Immunological examination can determine whether immune infertility

3. Vasectomy can confirm the presence or absence of obstruction of the tract and its obstruction.

4, testicular B timeout can be found in testicular gross lesions, testicular biopsy can provide a more reliable basis for diagnosis and treatment.

5. After sperm centrifugation and sedimentation, no sperm was found in 3 times, and azoospermia can be diagnosed.

6. During the physical examination, the testicular volume is less than 10 ml, and the texture is abnormally soft, suggesting that the testicular function is poor.

7, most patients are due to many years of marriage, and under the premise of not taking contraceptive measures, unable to make his wife pregnant, but came to the hospital for infertility examination and found to have azoospermia.

Azoospermia test

In the clinic, when there is no sperm during the examination, it should be re-examined to determine whether there is an error in the examination. If the patient does not find sperm after multiple semen examinations, this can be diagnosed as azoospermia. It should be noted that the semen of the patient is not different from the semen of normal people, and there are no abnormalities in the sexual life process, sexual pleasure and ejaculation process, but there is no sperm in the semen.

Once azoospermia is determined, further tests are not required to indicate that you have lost fertility since then. In clinical practice, azoospermia is roughly divided into two categories. One is due to the testicular spermatogenesis dysfunction, which means that there is no processing plant to produce products, so there is no product supply; the other is the spermatogenic function of the testes. Normally, a qualified product can be produced, but the sperm produced by the testes cannot be excreted due to the blocked insemination tube. This condition is called obstructive azoospermia.

If the disease is found in time, the condition is not very serious, and there is hope for treatment; viral orchitis caused by mumps, and gonorrhea, syphilis, and testicular tuberculosis. In this case, the testicles have been damaged by the day after tomorrow, infringing on their spermatogenic function, and there may also be azoospermia or very few sperm. In this case, the key is prevention. Once infection is found, the cause should be eliminated in time to prevent the disease from getting worse; genital damage. External injury causes testicular damage or torsion, spermatic cord torsion, etc., or hernia repair surgery, trauma to prostate surgery, etc., will also affect testicular function and cause sperm production disorders. This situation is mainly to prevent and take effective measures in a timely manner; radiation exposure. Sperm are very fragile. If they are exposed to strong electromagnetic waves and radiation, they will be destroyed. The cause can only be prevented; local high temperature of the testes. Frequent and prolonged hot baths, saunas, or other factors that increase testicular temperature will affect sperm production, but this is mostly the case of fewer sperm and excessive sperm death.

The main causes of obstructive azoospermia are: congenital absence of bilateral vas deferens; reproductive tract damage, such as unrepaired urethral injury; surgical spermatic cord damage and failure to detect and repair in time; reproductive system inflammation such as epididymitis, Tuberculosis, prostatitis, seminal vesiculitis, etc. can cause obstruction of the vas deferens; benign seminal vesicle tumors such as seminal cysts.

Diagnosis of azoospermia

After the semen was centrifuged, the sediment was examined by microscopy. No sperm was found on three occasions, and the azoospermia was confirmed. The etiology needs to be further clarified.

During physical examination, pay attention to the development of secondary sexual characteristics and the development of external genitalia. If the testicular volume is less than 10 ml, the texture is abnormally soft, often indicating poor testicular function, palpation should pay attention to epididymitis, vas deferens, and nodules. Endocrine tests, serum FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), PRL (Prolactin), T (Testosterone), DHT (Dihydrotestosterone) can help to distinguish between primary testicular failure or secondary testicular failure Testicular failure.

Testicular B-ultrasound can detect gross testicular lesions, and testicular biopsy can provide a more reliable basis for diagnosis and treatment.

Infertility caused by azoospermia

1.Spermatogenesis disorders

Spermatogenesis disorder is an important cause of azoospermia, and it is also the cause of male infertility in azoospermia. The main causes of spermatogenesis disorders are: congenital malformations such as a testicular malformation, cryptorchidism, and testicular hypoplasia. Testicular atrophy due to testicular trauma, vas deferens artery trauma, testicular torsion, mumps combined with orchitis. X-ray irradiation. Endocrine disorders such as hypogonadism and hypopituitarism.

2.Sperm obstruction

Obstructive sperm transport causes dead sperm and causes male infertility, and indirectly becomes the cause of male infertility caused by azoospermia. The causes of sperm transport obstruction are: congenital absence of vas deferens, trauma of the vas deferens, and ligation. Gonorrhea epididymitis, epididymal prostate tuberculosis and caseous necrosis. Ejaculatory ducts are blocked. The testicles that cannot produce spermatozoa are reduced in size, soft in texture, and lack of elasticity; those with obstructive azoospermia have more normal, full, and elastic testicles.

Testicular spermatogenesis disorders are the most common factors of spermatogenesis disorders, mainly including: no testis; cryptorchidism; congenital seminiferous tubular hypoplasia; orchitis; testicular tuberculosis; genital damage: testicular damage, spermatic cord twisted radiation exposure Testicular local temperature is too high; consumption of cottonseed oil varicocele and hypogonadism. Obstruction of vas deferens: congenital absence of bilateral vas deferens; reproductive tract damage; inflammation of genital tracts: epididymitis, epididymal tuberculosis, prostatitis, seminal vesiculitis, etc .; benign tumors of the seminal vesicles: seminal cysts, etc.

Precautions for azoospermia

1. Reduce some common radiation exposure in life . Sperm are very fragile. If they are exposed to strong electromagnetic waves and radiation, they will be destroyed. The cause can only be prevented.

2. Pay attention to avoid genital damage in life and work . External injury causes testicular damage or torsion, spermatic cord torsion, etc., or hernia repair surgery, trauma to prostate surgery, etc., will also affect testicular function and cause sperm production disorders. This situation is mainly to prevent and take effective measures in a timely manner.

3. Avoid local high temperature of testis in life and work . Frequent and prolonged hot baths, saunas, or other factors that increase testicular temperature will affect sperm production, but this is mostly the case of fewer sperm and excessive sperm death. Avoid all factors that increase testicular temperature.

4, the usual situation of varicocele . This condition will seriously affect the blood supply of the testes, and then affect the spermatogenic function of the testicles. A large number of sperm will even decrease or disappear. Prompt surgery or medication (mild) is expected to restore fertility in most patients.

5. Minimize consumption of cottonseed oil in daily life . The oil contains a component called gossypol, which can inhibit sperm production, so people use it as a contraceptive for men, but if men who plan to give birth eat more, sperm reduction or even disappearance will occur. If you eat too much cottonseed oil, it will be difficult to return to normal after stopping.

Azoospermia harm

1. Damage the kidneys.

Azoospermia causes male friends to have weak spleen and stomach, as well as insufficiency of seminal blood. Causes kidney essence loss and endangers male fertility.

2. Causes the vas deferens to become blocked.

Due to damage. Or the accumulation of hot and humid, causing the male friend's vas deferens to be blocked, resulting in the sperm being unable to be excreted normally, which may easily lead to the male friend's injection of Jue Yin under the influence of wind poisoning, or lack of sperm.

4, leading to testicular spermatogenesis failure.

Usually it is due to congenital dysplasia of the testicles, and trauma or inflammation of the testicles, which interfere with the temperature regulation of the scrotum.

5. Affects the normal sexual life of men.

Because testosterone is the male hormone in men, it is secreted by testicular mesenchymal cells to maintain men's spermatogenic function, as well as second sexual characteristics, control physiological effects, etc. If abnormalities occur, it affects men's normal sexual life.

Common myths of azoospermia

1. Is azoospermia without ejaculation? The reason for not ejaculating is mainly not reaching orgasm or retrograde ejaculation, and retrograde ejaculation can be identified by sperm or fructose determination by centrifugation of urine after "ejaculation".

2. Sperm testing is azoospermia without sperm? After normal microscopic examination of azoospermia, semen centrifugation and microscopic examination are needed to confirm the determination. The single test result may have errors. Clinical diagnosis requires at least 2 to 3 centrifugal microscopic examinations to confirm the diagnosis of azoospermia. At the same time, retrograde ejaculation needs to be excluded. Among them, the technician's own operation level and sense of responsibility are also one of the influencing factors.

3. Direct testicular biopsy to determine the cause of azoospermia? Some hospitals prefer epididymal puncture directly to testicular biopsy for azoospermia patients. For those patients with obstructive azoospermia in which sperm can be found by epididymal puncture, direct testicular biopsy is relatively large and may lead to hypospermia after operation.

4. For patients with ejaculatory duct obstruction? Even if the diagnosis is clear, epididymal puncture is still required to confirm the presence of sperm before surgery, and blind surgery should not be performed, causing unnecessary waste.

5. For patients who lack one side of the vas deferens but have better testicular spermatogenesis, patients with the other side of the vas deferens who have poor testicular spermatogenesis can use an epididymal-contralateral vasectomy.

6, inactive sperm can not be ICSI ICSI technology requires live sperm for fertilization, but sperm obtained by puncture or biopsy may be inactive sperm. But this is not to say that ICSI cannot be performed, but that an experienced technician is needed to judge the life and death of sperm. Some assisted reproductive institutions have limited levels of technicians who believe that ICSI cannot be performed without inactive sperm, or that they cannot judge the life and death of sperm, which has caused many couples to lose their chances of giving birth.

Azoospermia diet therapy

1. Yam, white rice, sugar, and water. Peel the fresh yam and cut into pieces. Cook until rice is ripe, add rice to make porridge, and add sugar for a while.

2. 1 kg of sesame, white rice, honey and water. After cooking, add honey. This porridge can nourish liver and kidney, moisturize laxative and black hair, and has a more beautiful effect.

3. Animal kidneys: The kidneys of food animals have the effect of nourishing kidney and replenishing essence, which is a concrete embodiment of the theory of "supporting the internal organs with viscera" in traditional Chinese medicine. Because it is rich in protein, fat, multivitamins and some rare trace elements, it has both nourishing and strong functions.

4. Sea cucumber: it can nourish kidney and refine essence, nourish yin and aphrodisiac. Rich in trace elements such as iodine and zinc. Can participate in regulating metabolism and reduce blood lipids. The contained mucoproteins and other polysaccharide components have the functions of lowering lipids and anticoagulation, promoting hematopoiesis, delaying aging, nourishing the skin, and repairing tissues.

5. Shrimp: can craftsman kidney and aphrodisiac, detoxification through milk. Rich in protein, lipids, minerals, vitamins, especially rich in calcium and phosphorus, it is a good product for strengthening bones. The extract of shrimp also contains immune-enhancing substances.

Methods for preventing azoospermia

Among infertile patients, the frequency of azoospermia is 5% -20%. Azoospermia can cause male infertility and seriously endanger male health. Experts point out that you should immediately discard cigarettes, take medicine carefully, avoid intense running, and rest Do not take too long, do not have long-term abstinence, and urinate at night to prevent azoospermia.

I. Discard cigarettes immediately: For men who smoke more than one pack a day, sperm motility is always weaker than that of non-smokers. But after you quit smoking, you should pay special attention not to be anxious, because that will reduce testosterone and cause sperm reduction.

Second, take medicine carefully: drugs for treating depression, malaria and certain sores can affect sperm production. Therefore, when those drugs need to be used, they should be consulted in advance.

3. Avoid fierce running: Fierce running will reduce sperm vitality, so run in moderation, do not be too fierce, and the possibility of azoospermia will be reduced.

Fourth, do not take long breaks: find something light or heavy to do. Don't be lazy, but don't do heavy physical work. Take appropriate rest and physical work.

Five, long-term abstinence: If the genitals are often congested, the temperature of the scrotum will rise, resulting in reduced sperm motility. Therefore, abstinence should not be prolonged.

6. Get up at night to urinate: It is a good habit to urinate at night. It will be good for sperm production and reduce your chance of azoospermia.