1, abnormal semen (1) When the sperm density in semen is lower than 0.2× 109/ml, the woman's chances of pregnancy are reduced, leading to infertility. This kind of infertility can be divided into permanent and temporary. The former is found in patients with congenital testicular developmental disorder or severe lesions of testis and seminal vesicle. The latter is more common in frequent sexual life, leading to spermatogenic failure, which is generally azoospermia rather than azoospermia.
(2) Poor sperm quality Too many sperm (more than 20%) are inactivated or dead, or sperm motility is poor or abnormal sperm exceeds 30%, which often leads to infertility.
(3) Sperm with abnormal physical and chemical properties will soon solidify into a gel after being ejected, and completely liquefy within the next 15 ~ 30 minutes. If semen does not coagulate or liquefy completely after injection, it often indicates that the seminal vesicle or prostate is diseased. Infection of reproductive tract by bacteria and viruses can also cause changes in semen composition, leading to infertility.
2. Spermatogenesis disorder (1), testicular diseases, testicular tumors, testicular tuberculosis, testicular syphilis, nonspecific inflammation, testicular atrophy after trauma or torsion of spermatic cord, testicular loss, etc. , can cause spermatogenic dysfunction and infertility.
(2) Chromosome abnormality can cause poor differentiation of testis and other sexual organs, leading to true hermaphroditism and congenital testicular hypoplasia. Autosomal abnormalities can lead to metabolic disorders of gonads and spermatogenic cells.
(3) Spermatogenic dysfunction Long-term consumption of cottonseed oil can affect spermatogenic autoimmunity and also cause spermatogenic dysfunction.
(4) Occult varicocele, huge hydrocele and other local diseases affect the external environment of testis, or lead to infertility due to factors such as temperature and pressure.
3. Sperm-egg binding disorder (1) Obstruction of vas deferens Congenital absence of vas deferens such as atresia, vasectomy, chronic inflammation of vas deferens and its surrounding tissues, etc.
(2) Retrograde ejaculation: the bladder neck has been operated or injured, or the urethra is deformed due to scar contracture after operation. After bilateral lumbar sympathectomy or abdominal perineal surgery for rectal cancer, pudendal nerve injury caused by diabetes, enlarged spermatic cyst and severe urethral stricture, some drugs will change the sympathetic nerve function that dominates the bladder.
(3) Abnormal external genitalia, such as congenital absence of penis, penis too small, male pseudohermaphroditism, hypospadias or hypospadias, acquired penis inflammation or injury, scrotal edema, huge hydrocele of testis, etc. For example, impotence is one of the reasons for male infertility, because sperm can't normally shoot into vagina and meet eggs.
④ Male sexual dysfunction, impotence, premature ejaculation, no ejaculation, etc.
4. Systematic factors (1) Mental and environmental factors Sudden changes in the living environment lead to long-term mental stress, engaging in high altitude, high temperature, ultra-intense work, and engaging in radiation work.
(2) Malnutrition with serious nutritional factors, lack of vitamin A and vitamin E, lack of trace elements such as zinc and manganese, disorder of calcium and phosphorus metabolism, chronic poisoning of toxic substances such as mercury, arsenic, lead, ethanol, nicotine and cottonseed oil, and chemotherapy.
(3) Endocrine diseases: pituitary dwarfism, obesity, reproductive failure syndrome, hypopituitarism, congenital gonadal hypoplasia, congenital infertility syndrome, hyperprolactinemia, pituitary adenoma or intracranial infection, birth injury, etc.
Male infertility symptoms: 1, low sperm motility. People with low sperm motility tend to have worse complexion, and other symptoms are also obvious: dizziness, backache and leg weakness, chest tightness and irritability, and poor sleep.
2, semen does not liquefy Male semen does not liquefy, which hinders the activity of sperm, making sperm poor and immature, unable to produce sperm vitality, leading to infertility. Symptoms are mostly caused by renal insufficiency and cold and dampness.
3. Congenital anemia, nutritional deficiency and chronic illness are all causes of anemia. Usually the face is obvious: sallow and pale; In short, it looks dull and bloody; Often dizziness, loss of appetite, weakness of limbs, chest tightness, tinnitus, chills, insomnia, and poor spirits. In addition, the total sperm count and sperm motility of these patients are low.
4. The number of sperm in azoospermia patients is small or large and fine, and there is no sperm movement ability at all, which makes the woman pregnant. Reason: Generally, there are congenital defects or acquired injuries (masturbation, sexual transition, overwork, long illness, etc. ); The patient's qi is weak, the heart is insufficient, and the blood circulation can't be promoted, which leads to the lack of blood nutrition and water in the internal organs and can't play its normal function. Renal insufficiency, deficiency of kidney qi, poor sperm biochemistry and blocked hematopoiesis.
The diagnostic criteria of male infertility are 1, medical history, past history, trauma and operation history, sexual life history, birth control history, marriage history, contact history of drugs and physical and chemical factors, female urinary tract symptoms and gynecological examination.
2, general physical examination, pay attention to whether there is a special body shape, whether there is systemic disease. Pay attention to penis development, urethral orifice, testicular size, the relationship between epididymis and testis, and whether there are lesions in spermatic cord (such as varicocele and vas deferens). ), pay attention to the prostate and seminal vesicle in rectal digital examination, perform prostate massage technique and smear examination.
3, semen check abstinence for 3-7 days, using masturbation or in vitro sperm collection method, check within 65438 0 hours.
Normal reference value: accurate 2-6ml, gray or yellowish, completely liquefied in 5-20 minutes, PH7.2-7.8, sperm density 50 million -65438+ 1 100 million /ml, sperm viability 60%, sperm motility 75% (grade 6), sperm abnormality rate 30%, total sperm count /ml. If the number of sperm is 20 million/ml, the fertility is extremely poor.
To diagnose male infertility, at least the following points should be made clear: ① Male infertility or female infertility, or both of them have infertility factors; (2) Male infertility is absolute infertility or relative infertility; ③ Primary infertility or secondary infertility; ④ If it is male infertility, we should try our best to find out the exact cause of male infertility so as to take effective treatment measures according to the cause.
The examination and diagnosis methods of male infertility generally include detailed medical history inquiry, physical examination, semen examination, endocrine examination, immunological examination, chromosome examination, X-ray examination, testicular biopsy, semen biochemical examination and so on. Through the above clinical and laboratory evaluation of male infertility, the diagnosis and classification were carried out according to the diagnostic criteria of 1999 World Health Organization on male infertility.
The treatment of male infertility is 1, and chorionic gonadotropin is commonly used in drug treatment.
2. Surgical treatment of varicocele with abnormal semen requires high ligation of spermatic vein, while cryptorchidism or testicular hypoplasia can be treated with testicular descent fixation to promote testicular spermatogenesis.
3. Keep the vas deferens unobstructed, actively treat sexual dysfunction and maintain normal sexual life. Patients with congenital absence of vas deferens, obstruction of vas deferens and vasectomy should be actively treated by surgery.
4. To improve sperm function, those with reproductive tract inflammation should be actively treated with antibiotics; Vitamin E, vitamin C and zinc preparations can all improve sperm function.
5. Artificial insemination includes donor sperm artificial insemination and husband sperm artificial insemination. In recent years, in vitro assisted reproductive technology has developed rapidly, especially intracytoplasmic sperm injection technology, which has been used to treat oligozoospermia, asthenospermia and azoospermia and achieved good results.
6, Chinese medicine treatment For varicocele 1 degree, semen infection (including prostatitis, seminal vesiculitis, epididymitis, vas deferens), immune male infertility, traditional Chinese medicine treatment is adopted, or promoting blood circulation to remove blood stasis, or clearing liver and tonifying kidney, or tonifying kidney and replenishing essence, or soothing liver and regulating chong.
Prevention and Prevention of Male Infertility Male infertility begins with male underwear, which is the closest contact with scrotum and penis. Tight men's underwear is popular now. Generally, the front design is double-layered, and the scrotum and penis are wrapped together. For a long time, the crotch has been exposed to high temperature and humidity for a long time, which has become a hotbed of viruses and bacteria. Long-term high temperature and high humidity under the crotch are the potential focus of common male diseases such as prostatitis, varicocele, seminal vesiculitis and scrotal eczema. Prostatitis, varicocele and seminal vesiculitis are common diseases of male infertility. Experts suggest that underwear with good ventilation and heat dissipation can give scrotum an independent nursing space, avoid friction and extrusion between scrotum and inner thigh, isolate penis and scrotum, reduce the pressure on scrotum, and keep crotch in a ventilated and heat dissipation environment for a long time.
1, it is necessary to master certain sexual knowledge, understand male physiological characteristics and health care knowledge. If you find abnormal changes in the testis, such as swelling, hardening, unevenness and pain, etc. , must make a diagnosis and give treatment in time.
2. Vaccinate on time, have good personal hygiene habits, and prevent various infectious diseases that endanger male fertility, such as mumps and sexually transmitted diseases.
3. If you are in frequent contact with radioactive substances, high temperatures and poisons, you must work in strict accordance with the operating procedures and protection regulations. Don't be careless. If you want to have children in the near future, you'd better leave this job for half a year to regenerate.
Testis is a very fragile organ, and its optimal working temperature is about 2 degrees lower than human body temperature. If the temperature is high, it will affect the production of sperm, so avoid any factors that can increase the temperature of testicles, such as riding a bicycle for a long time, taking a hot bath, wearing jeans and so on.
5, to change bad habits, quit smoking and drinking, don't eat too greasy things, otherwise it will affect your sexual desire. In addition, we should pay attention to avoid contact with toxic substances in our lives. For example, clothes brought back from dry cleaners should be put away for a few days, because dry cleaning agents will affect male sexual function.
6. Paying attention to the pre-marital physical examination and finding abnormalities early can avoid the pain after marriage. After marriage, you should always communicate with your wife about the problems encountered in your sexual life, cooperate with each other and understand each other, so as to avoid a lot of mental impotence or premature ejaculation.