“There are three unfilial things, and there are no descendants.” Previously talked about infertility is always attributed to the woman’s responsibility, with the development of modern medicine, nearly 20% of infertility is caused entirely by male factors, 30% to 40% is caused by common factors of both sexes, therefore, the male factor accounts for half of the infertile couple. The male compatriots have a tight heart, not to blame the wife, reflect on their own problems! The following professional physician will detail the male infertility of those things! What is male infertility? According to the World Health Organization (WHO), if a couple has been living without any contraception for more than 1 year and the woman is infertile due to the male factor, it is called male infertility. New diagnostic methods and rapid advances in assisted reproductive technology over the past decade or so have opened up new avenues of treatment for infertile couples. It is due to advances in assisted reproductive technology that the male aspect of evaluation in infertile couples is often overlooked. Patients with treatable male infertility, such as varicocele, genital tract obstruction, and infections are often overlooked. The etiology of infertility is complex, with no causative factor identified in approximately 44% of male infertility patients. Ideally, the treatment of infertility patients should be able to identify the specific cause of infertility, and try to adopt specific treatment for the cause. However, in the absence of a clear cause, empirical treatment as well as artificially assisted reproductive technology (ART) remain important therapeutic tools. Is the incidence of infertility high? The conception rate for normal couples is about 20% to 25% per month, 75% for six months, and about 90% for one year. A 1-year prospective study showed that about 15% of couples fail to conceive, with male factor infertility accounting for 50% of the cases. And the incidence of infertility is increasing year by year, on average, every 10 couples 1-2 couples can not get pregnant, having children is really not as easy as imagined! Common environmental factors affecting male infertility, is there any hit? 1, physical factors (1) heat Certain high-heat environments, such as boiler rooms, saunas, bakers and welding, etc., may damage male fertility. (2) Microwave Animal studies have shown that microwave exposure may affect the spermatogenic function of male testes, but there is still a lack of research on microwave exposure and male reproductive health, and further studies are needed to confirm this effect. (3) Noise Studies in which animals were exposed to noise showed disruption of the estrous cycle and increased early fetal mortality, and animal studies in Jalali found that noise had a negative effect on sperm concentration and viability in males. (4) Radiation It is well established that radiation can affect human health, and the mechanism of action of radiation on the reproductive system may include impaired spermatogenesis, DNA damage to sperm cells, and gonadal hormone disruption. (5) Anesthetic gases Chloromethane (chloroform) and trichloroethane have been shown to cause abnormal sperm morphology. Natural metals are widely distributed in low concentrations in the human environment, and generally do not pose a health concern. However, the use of metals in industrial processes may produce occupational hazards and widespread environmental pollution, and may be harmful to reproductive health if applied without restriction. Harmful heavy metals: boron, mercury, cadmium, lead. 3, chemical factors Each year, industrial production will produce a large number of chemical agents, many of which are harmful to human health, if not properly controlled, will cause global environmental pollution. Unfortunately, only a few of the many chemical agents have been systematically studied, and some of them are harmful to reproductive function, such as: bromochloropropane preparations, pesticides, insecticides, vinyl chloride, carbon disulfide. 4. Effects of environmental hormones on the male reproductive system Some active compounds in the environment may have harmful effects on the male reproductive system. For this reason, compounds present in the environment that resemble or antagonize natural steroid hormones are called environmental hormones. It is now recognized that there are four main groups of environmental hormones that interact directly with steroid receptors: environmental hormones, environmental anti-estrogens, environmental anti-progestins, and environmental anti-androgens. Environmental estrogens include natural phytoestrogens and synthetic compounds. Synthetic compounds such as pesticides, herbicides, polychlorinated biphenyls (PCBs), a variety of plastic agents and surfactant degradation products are compounds with estrogenic effects. Recently recognized as anti-estrogen, anti-progesterone and anti-androgen compounds are: anti-estrogen dioin, anti-progesterone carbamate insecticides and anti-androgen polyaromatic hydrocarbons, Lin-Uron, Vinclozin and DDT, a metabolite of PIP’-DDE and so on. 5, smoking and infertility Smoking can not only induce lung cancer, leading to cardiovascular disease, and can affect male fertility. Research in recent years has confirmed that smoking can interfere with the hypothalamic-pituitary-gonadal axis function, reduce semen quality, leading to oligospermia and weak spermatogenesis, and may even induce varicocele, affecting fertility, and is one of the main factors of male infertility. Uncover the causes of male infertility? 1, pre-testicular etiology The endocrine etiology of male infertility is also known as pre-testicular etiology. The impairment of fertility in these patients is secondary to hormonal imbalances in the body: 2. Testicular etiology Testicular etiology can be divided into two categories: genetic abnormalities and other causes of testicular injury: 3. Post-testicular etiology Post-testicular etiology includes sperm transportation disorders, sperm motility or dysfunction, reproductive tract infections and sexual dysfunction: Diagnostic typing of male infertility? According to the WHO male infertility diagnostic procedure, male infertility can be briefly categorized into 4 major groups and 16 subgroups: 1) dysfunction of sexual intercourse and/or ejaculation 2) abnormalities of sperm and seminal plasma tests or not (1) unexplained infertility; (2) simple seminal plasma abnormalities; (3) male immunologic infertility. (3) Definition of etiology (1) medical factors; (2) systemic factors; (3) congenital anomalies; (4) acquired testicular injury; (5) varicocele; (6) accessory gonadal infectious infertility; (7) endocrine causes. Other causes (1) idiopathic oligozoospermia; (2) idiopathic weak spermatozoa; (3) idiopathic deformed spermatozoa; (4) obstructive azoospermia; (5) idiopathic azoospermia. If you are not pregnant after marriage, do you need to check if you are a gay or lesbian? What should be checked? When to check? After reading the above reasons for male infertility, it is recommended to have a checkup every six months. The details of the examination are listed for you as follows: 1. Physical examination (1) general examination (2) examination of reproductive organs 2. Laboratory examination The male spouse of an infertile couple should undergo appropriate laboratory examination, usually referred to as semen examination. All patients should have 2 to 3 times of semen analysis. (1) Semen examination (2) Biochemical examination of semen (3) Endocrine examination 3. Immunological examination Indications for immunological examination of sperms (1) Unexplained infertility; (2) Poor quality of post-coital test or analysis of cervical mucus; (3) Presence of some kind of organic disease in the patient (e.g., obstructive diseases of the reproductive system, infections and injuries of the reproductive system, etc.). 4, chromosome examination When the total number of sperms in each ejaculate is less than 10 million, or the testicular volume is small, then sex chromatin and karyotyping should be done. Men with Kirschner’s syndrome may sometimes lack typical physical signs, such as gynecomastia, a female form, and long lower limbs. If the patient has severe sperm malformation rate or his wife has a history of multiple miscarriages or teratogenesis, in this case should also do sex chromatin and karyotyping, there are abnormal development of the secondary sex characteristics and signs of gender dysphoria should do this test. 5, X-ray testicles, epididymis, vas deferens, seminal vesicles, ejaculatory ducts and urethra are not only the tubes for producing and transporting sperms, but these tubes can be divided into three parts radiologically: ① epididymis and vas deferens; ② vas deferens and seminal vesicles; ③ urethra and its appendages. 6, ultrasound of the reproductive system High-frequency ultrasound examination has important clinical application value in the etiological classification and diagnosis of male infertility, and can effectively guide the choice of treatment programs. 7, testicular biopsy and testicular histopathological examination Through the observation of reproductive pathology of testicular biopsy, the function of spermatogenesis or the degree of spermatogenesis disorders can be directly judged, and at the same time, quantitative scoring can be carried out on the ability of testicular steroid hormone synthesis and its disorders, so as to provide direct information for the diagnosis of male infertility, and provide a reliable basis for the selection of therapeutic measures and the assessment of the prognosis. Clinical significance of testicular biopsy pathology: if the testicular biopsy is normal and the semen examination is azoospermia, obstructive azoospermia should be considered first. In addition, the presence of retrograde ejaculation should also be considered. 8.Sperm function test Conventional semen analysis is still subjective in some aspects. In recent years, with the deepening of reproductive medicine research, many experiments have been carried out to determine sperm function. They include: ① sperm vitality; ② membrane integrity; ③ sperm morphology; ④ sperm binding to the zona pellucida; ⑤ acrosome morphology and acrosome reaction; ⑥ sperm-egg interaction assessment, including zona pellucida binding test, penetration test, etc.; ⑦ sperm binding to the egg membrane; ⑧ sperm chromatin depolymerization test. All these functional tests provide more information for predicting the in vitro fertility prediction of spermatozoa. 9, other tests (1) scrotal exploratory surgery; (2) male reproductive system bacteriology and exfoliative cytology; (3) other special examination methods; ① endoscopy such as urethroscopy urethroscopy and vesicoscopy to check the caruncle department for lesions, and sometimes ejaculatory ducts, vesicourethral insertion catheterization. ② Isotope examination such as isotope technetium for scrotal blood pool scanning is valuable for the diagnosis of occult varicocele, which is one of the common causes of male infertility. ③Scrotal ThermographyInfrared scrotal thermography can be used to detect varicocele. This is because patients with varicocele have an elevated scrotal temperature on the varicose side. If I want to do a preconception test, when is the right time? What is the purpose of the test? The right time for a preconception test: If a couple already has plans to have children, it is best to have a preconception test 3-6 months earlier than the expected pregnancy. This buffer time is so that in case any abnormality or problem that makes you unsuitable for pregnancy is detected, the doctor can have time to take appropriate treatment measures. In addition to preconception testing, the 3-6 month buffer period can also be used for nutritional enhancement, vaccinations, folic acid supplementation and physical fitness. The main purpose of pre-pregnancy testing is to help men and women who wish to have children to detect abnormalities and take timely action before pregnancy, to avoid any problems that may arise during pregnancy, to minimize birth defects in the baby, and to ensure a safe pregnancy. Pre-conception tests provide an objective and clear picture of whether the couple’s current physical condition is suitable for childbearing, what improvements can be made, and what defects the baby may face in the future can also be intervened in advance. For men, the main checkups are semen and reproductive system diseases. If the sperm is not vigorous enough, or if there is oligospermia, it can be improved by improving nutrition, quitting bad habits, and strengthening exercise. Low zinc levels in the body are a relevant factor in male infertility. Consider adding foods high in zinc such as lean pork and black rice to your daily diet. Heavy consumption of wine, beer and spirits can affect hormone levels, leading to a drop in testosterone levels, and can also affect the ability of the testes to mature sperm. In the case of azoospermia, some assisted reproductive techniques may be necessary.