1. What is oligozoospermia? Oligozoospermia is defined as sperm concentration or/and sperm viability below the standard value. Due to the differences in semen testing methods and inconsistencies in reference standards among domestic laboratories at present, there are certain differences in the diagnosis of oligozoospermia. Although some laboratories have referred to the latest WHO 5th edition criteria, considering the current status of domestic laboratory tests, most still recommend using the WHO 4th edition criteria, i.e. sperm concentration <20×106/ml, total viability <70%, a <25% or a+b <50%. 2.How to determine oligozoospermia? To determine oligozoospermia, semen concentration and viability are important reference indicators, but only if the semen examination meets certain requirements. Abstinence time: The length of abstinence can affect the judgment of oligozoospermia. Generally speaking, 2-7 days (5 days is recommended) before the sperm examination without ejaculation (including ejaculation and seminal emission), too long may affect the sperm viability and too short may affect the sperm concentration. Number of examinations: Since sperm concentration and viability are inherently volatile, one examination does not fully reflect the overall situation, and it is recommended that 2-3 examinations be performed as standard to objectively assess the quality of sperm. Precautions for sperm retrieval: The following conditions should be avoided before semen examination: ① cold or fever; ② urinary tract or reproductive tract infection; ③ sauna or hot spring; ④ heavy smoking and alcohol abuse; ⑤ recent consumption of a large number of drugs; ⑥ recent exposure to toxic substances or rays. 3.Is oligozoospermia equal to male infertility? The probability of conception is significantly lower for men with oligozoospermia. In fact, some men who have had children also have oligozoospermia. If a man and woman have regular sex for 1 year or more and still have not impregnated the woman with normal fertility, the possibility of male infertility should be considered. 4.If oligozoospermia is considered, what causes need to be investigated? What are the considerations for the examination? Routine screening for causes: genitourinary infection, sex hormone abnormalities, varicocele, abnormal testicular development or injury, low testicular spermatogenic function, chromosomal abnormalities, Y chromosome AZF region deletion, etc. Reports of routine test results can be obtained on the same day or within 7 days, while chromosomal tests may take 3-5 weeks to obtain reports. Blood tests require fasting from 8-10 am (especially for sex hormone tests), and it is recommended to fast from 10 pm the night before the test. 5.What genitourinary disorders can cause oligozoospermia? Congenital hypogonadism, cryptorchidism, and small testes are the main causes of congenital testicular spermatogenesis disorders. Testicular tuberculosis, testicular atrophy (caused by viral mumps), testicular tumors and varicocele can cause secondary testicular spermatogenesis disorders. Severe bacterial prostatitis, epididymitis, orchitis, urethritis, and various viral infections of the reproductive tract can affect male fertility. All of these genitourinary system diseases can lead to the occurrence of oligozoospermia. It is important to note that chronic prostatitis is usually not the direct cause of oligomenorrhea, unless severe bacterial prostatitis has led to the occurrence of leukocyte seminosis. 6. What endocrine diseases can cause oligozoospermia, can diabetes and hyperthyroidism? Gonadotropin-releasing hormone (GnRH) deficiency (e.g., Kallmann syndrome), selective luteinizing hormone (LH) deficiency and follicle stimulating hormone (FSH) deficiency (e.g., pituitary dysfunction), and hyperprolactinemia (prolactinoma) can all lead to decreased spermatogenesis. In addition, adrenocortical hyperplasia can inhibit pituitary secretion of FSH and LH, which can also lead to reduced spermatogenesis. Long-term diabetes can damage testicular blood vessels and spermatogenic cells, which can reduce sperm production and vitality; severe hyperthyroidism or hypothyroidism may also affect sperm production leading to oligozoospermia. 7.How much does sexual function affect oligozoospermia? There is no direct correlation between sexual function status and oligozoospermia. Impotence belongs to penile cavernosal filling dysfunction, premature ejaculation belongs to the problem of poor ejaculation control, while oligozoospermia belongs to the problem of spermatozoa. The relationship between sexual dysfunction and oligozoospermia is like a gun and a bullet, the problem of the gun (penis) and the problem of the bullet (sperm) are independent of each other. Of course, sexual dysfunction and spermatozoa can also occur at the same time, such as in patients with endocrine disorders. 8.Does masturbation, too frequent or too little sex cause oligospermia? The frequency of masturbation and sexual intercourse will not lead to weak spermatozoa. The testicles produce sperm continuously, so masturbation and frequent sex will not lead to sperm depletion, nor will it stall the sperm production process, nor will it damage the sperm-making function of the testicles themselves. If you don't have sex for a long time, it may lead to too much and too long sperm storage in the epididymis and affect the sperm vitality, but if you resume regular sperm discharge, the sperm vitality problem can be improved. 9. Which occupational exposure factors are likely to cause oligozoospermia, and can it be improved after stopping occupational exposure? Smoking, alcohol abuse, mental stress, frequent hot baths, frequent late nights and overexertion can cause low sperm motility, and people in the workplace with these factors need to pay special attention. The quality of sperm can also be improved if the working environment is improved. Some special industries, such as exposure to radiation (welding, radar, radiology, etc.), chemical or industrial reagents (paints, dyes, pesticides, heavy metals, etc.) will have a greater impact on reproductive function and may lead to permanent or irreversible sperm damage. 10.Which drugs can cause oligospermia and whether sperm quality will recover quickly after stopping the drugs? The effect of many chemical drugs on sperm quality is still uncertain, and it is recommended that men with fertility requirements should use less or no chemical drugs during their reproductive years. The drugs that clearly affect sperm include chemotherapy drugs, some hormonal drugs and some antidepressants, etc. The recovery of sperm quality after stopping the drugs depends on the drugs used, the time of use and other factors. 11. Can the cause of oligozoospermia be found? Must the cause be clearly identified before treatment can be carried out? About 70% of male infertility is unexplained, and a significant proportion of oligozoospermia is also unidentified, clinically known as idiopathic oligozoospermia. The fact that the cause of spermatozoa cannot be found does not mean that it cannot be treated. Some drugs that promote sperm production, improve the sperm production microenvironment and antioxidants still play a positive role in improving spermatozoa. 12.If I need to treat oligozoospermia, how should I use the medication and review it? Since the cycle of sperm production is about 3 months, if medication is needed, it is recommended to take 3 months as the treatment cycle and to review the semen once a month. The follow-up examinations mainly involve semen examination and blood sampling.