Oligozoospermia is one of the most common causes of male infertility and the treatment, too, is difficult. First, we need to understand what is oligozoospermia? The term oligozoospermia refers to infertility in which sperm density and motility are lower than normal. So, what is the normal value of density? The World Health Organization’s semen standard states that the sperm density of men is not less than 20 million/ml per ejaculation, and if it is lower than 20 million/ml, it is called oligospermia. And sperm motility is divided into four levels: a, b, c and d. Level a and b are forward-moving sperm, which need to be greater than 50%, and if less than 50% of sperm in level a+b, it is called weak spermatozoa.
Understand what is less weak sperm, next, let’s understand the causes of this symptom. The causes of oligo-weak spermatozoospermia in men are the following.
1, reproductive tract infection chronic infection of the accessory genital glands, namely the epididymis, seminal vesicles, prostate and other inflammatory diseases caused by seminal plasma variation, affecting sperm activity and survival, and can affect the various laboratory indicators in the semen.
2, endocrine abnormalities male normal sperm function depends on the normal function of the hypothalamus-pituitary-gonadal axis, any one of these links is impaired, will affect the sperm function, other diseases such as thyroid, adrenal gland will also affect the function of the gonad and cause less sperm.
3, varicose spermatozoa varicose veins, due to poor venous reflux causes excessive temperature in the scrotum and testicular tissue hypoxia, vasoactive substances increase, thus affecting the testicular spermatogenic function, causing a decrease in sperm motility can reduce sperm vitality.
4, chromosomal abnormalities chromosomal aberrations have a serious impact on sperm density, activity rate and morphology.
5, autoimmune reproductive immunology research found that male autoimmunity can affect fertility, anti-sperm antibodies make sperm agglutination or braking, reduce sperm motility, at the same time, can also affect the production and transport of sperm.
6.Excessive scrotal temperature, radiation damage, chemical drugs and medication can cause oligospermia.
7.Cryptorchidism is one of the important reasons affecting semen quality. Therefore, if the sperm density is low and cryptorchidism exists, early treatment is necessary.
8, testicular development is hindered, testicular spermatogenic epithelium is not fully matured or damaged and thinned, resulting in poor sperm quality and reduced vitality.
In life, there are many factors that affect sperm quality, specifically.
1, food packaging and cosmetics
According to a press release from the German Research Association, the global decline in male sperm count over the past few decades may be related to a chemical called phthalates.
Phthalates are a class of chemicals that can play a softening role. It is commonly used in toys, food packaging, vinyl flooring, wallpaper, cleaners, lubricants, nail polish, hair sprays, soaps and shampoos, and hundreds of other products. Studies have shown that phthalates can interfere with endocrine secretion, causing a reduction in the number of male sperm, low motility, abnormal morphology and, in severe cases, testicular cancer, making them the “culprit” of male reproductive problems.
Among cosmetics, nail polish has the highest phthalate content. It enters the body through women’s respiratory system and skin, endangering the reproductive system of their future male children.
Phthalates can also enter the body through food and water packaged in plastic containers, such as the inner coating of food cans, recyclable milk and mineral water bottles. Studies have shown that the higher the fat content of canned foods, the more susceptible they are to contamination, such as pork, anchovies, and sardines. Fetuses, infants and adolescent children are the most sensitive to it and the most vulnerable to health violations.
To reduce the risk of phthalates to humans, it is usually best not to use Styrofoam containers to soak instant noodles and not to use plastic containers containing polyvinyl chloride to heat food in the microwave oven. The correct approach is to put the food into heat-resistant glassware or ceramic utensils to heat.
2.Car exhaust
Car exhaust contains a lot of harmful substances, such as sulfur dioxide, carbon dioxide, etc.. Prolonged exposure to these substances will cause cumulative damage to the human body, which not only affects reproductive health, but also may increase the incidence of tumors and other diseases.
The most serious is that the dioxin contained in car exhaust is an extremely strong environmental endocrine disruptor, which can cause changes in the testicular morphology of men, reduce the number of sperm and reduce sperm production capacity.
3, smoking, alcohol
Smoking has always been a major enemy of health, and the impact on semen is equally obvious. Early foreign studies have shown that smokers have significantly lower semen quality compared to non-smokers, with higher sperm malformation rates and an increase in the number of white blood cells in semen. Nicotine and polycyclic aromatic hydrocarbons produced in tobacco can cause testicular atrophy and sperm morphological changes. Alcohol has a direct effect on both the human liver and the male testes. Studies have found that patients with chronic alcoholism develop testicular atrophy, leading to decreased semen quality. Therefore, men must avoid regular excessive alcohol consumption.
4, estrogen
Estrogen can have a significant impact on the male reproductive system, including affecting the level of androgens, triggering structural changes in testicular tissue, causing testicular cancer, reducing the number of sperm in semen, causing gynecomastia, and leading to endocrine disorders. Short-term use of estrogen-containing drugs by men does not significantly affect the reproductive system, but long-term exposure to estrogen-containing items in life can cause greater harm to reproductive health. For example, some men casually use female cosmetics in their skin care. Some of these cosmetics developed specifically for women contain certain estrogen, and long-term use can damage male reproductive health and cause hypogonadism.
5, trace elements
The trace elements associated with male fertility mainly include zinc, selenium, copper, calcium and magnesium. Zinc is an important element in the reproductive system, lack of zinc will affect the development of male reproductive organs and secondary sexual characteristics during puberty, reduce the mobility of sperm, weaken the body’s immune function, making men vulnerable to prostatitis, epididymitis and other infectious diseases. And selenium deficiency will increase the concentration of peroxide in the body, causing damage to the male reproductive system and testicles. Therefore, men should usually eat more food containing higher zinc and selenium, such as milk, corn, black rice, black beans, etc.
6.Temperature
High temperatures can produce damage to the testicles, but how high the temperature and how long the exposure to this temperature will affect the testicles is still debated in the academic community. In animal studies, the fertility of males was reduced after being exposed to 38.5°C for 55 minutes. In reality, men should try to avoid staying in a hot environment for too long, such as taking sauna baths and soaking in hot water.
7.Drugs
Drugs such as anti-cancer, hormones and antibiotics can impair male gonadal function, causing a decrease in sperm quantity and quality, or by affecting the endocrine function of the gonads, leading to sexual dysfunction. The impact of drugs on male fertility is affected by the type of drug, dose, course of treatment, the age of the patient and other factors. Generally, the higher the dose of drugs used, the longer the course of treatment, and the younger the patient, the more serious the damage to fertility and the longer the time needed to restore fertility.
At present, the society is flooded with sexual health products, some of which contain sex hormones or similar ingredients that may affect the normal sperm production function of the testicles, unmarried infertile people should be extra careful when choosing.
8, noise
With the development of modernization, the impact of urban noise on health is more prominent. Noise is a kind of environmental pollution. In recent years, some experts have proposed the “environmental hormone” theory, pointing out that there are chemicals in the environment that can affect the endocrine function of the human body like hormones, noise is one of them. It will make the human endocrine disorder, resulting in abnormal semen and sperm. Long-term noise pollution can cause male infertility; for women, it can lead to miscarriage and fetal abnormalities.
9, radiation
Radiation has been determined to have a clear impact on human health. Large doses of radiation can cause changes in testicular tissue structure, increase the rate of sperm malformation, reduce the number of sperm, sperm density and other important indicators. However, there are no definite research results on whether small doses of radiation can cause infertility. Whether the electronic devices we use everyday, such as cell phones and computers, can cause infertility is highly controversial in the academic community. However, men should usually try to reduce contact with radiation sources to protect their fertility.
10, drugs
There are many people who take drugs in our country, and some drugs, such as marijuana and cocaine, have an effect on semen quality. Marijuana can lower the level of androgens in the blood, sperm density, leading to male breast development; cocaine will make the sperm density drop.
For these factors above, we should take high vigilance, pay attention to and avoid them in time.
To treat oligo- and weak spermatozoa, the focus should be on identifying the cause, and on the basis of identifying the cause, treating it symptomatically.
How can we clarify the causes of oligo- and hypospermia, so as to treat the causes? Firstly, semen should be checked for 3 consecutive times, and if the sperm density in each ejaculate is less than 20 million per ml and the motility is less than 50%, this is the diagnosis. Secondly, the male patient’s seminal plasma biochemical indexes (zinc, fructose, glucosidase, elastase, etc.), prostate fluid, serum endocrine hormones, ultrasound of the reproductive system, chlamydia, anti-sperm antibodies, chromosomes, etc. are checked to find out the possible causes.
Only when the cause is identified and the right treatment is given is it possible to cure oligo- and hypospermia. If it is caused by varicose veins, then it should be treated surgically in time; if it is an inflammation of the reproductive organs, then it should be actively eliminated; if it is a lack of certain nutrients, then it should be supplemented in time; if it is caused by endocrine factors, then endocrine treatment should be performed.
The methods of treating oligozoospermia are.
1, general treatment: prohibit smoking, alcohol and eat less stimulating food, do not overwork.
(1) Schilkhorn contains a variety of trace elements, especially zinc and selenium. 1 tablet each time, 1 time daily;
(2) Vitamin E 0.1g/tablet, 1 tablet each time, once a day.
2. Etiological treatment.
(1) antibacterial and anti-inflammatory drugs semen analysis, when WBC>1 / HPF suggests the possible existence of reproductive tract infection, antibiotic treatment should be given to eliminate the white blood cells in the semen, to select antibacterial and anti-inflammatory drugs according to bacterial culture and drug sensitivity test, mycoplasma or chlamydia infection can choose one of the antibiotics, such as memantin a tetracycline, azithromycin, doxycycline and erythromycin, gonococcal infection can be used Ceftazidime and other pioneer antibiotics. For mycoplasma and chlamydia infections, a medication schedule of 10 to 14 d is appropriate, requiring the couple to take the medication at the same time. Since some antibiotics have an effect on sperm viability while sterilizing. The particular larger dose, combined with a longer course of antibiotics, a shorter period of time after stopping the drug, sperm vitality is not seen to increase, sometimes worse than before the drug, in addition to sperm malformation also increased. Therefore, it is necessary to take contraceptive measures when taking antibiotics.
(2) For those with poor semen liquefaction, homemade liquid sperm powder, 4.3g/time, 3 times/day, for 1 month as a course of treatment
(3) For those with positive anti-sperm antibodies, use homemade liquid sperm powder, 2.5g/time, 3 times/day, and take it for a course for 1 month.
3.Hormone therapy.
For those with normal or below normal reproductive hormones can be used respectively
(1) Gonadotropin-releasing hormone (GnRH): Dabigia 0.1mg/time, intramuscular injection, continuous use for 1~2 months.
(2) Gonadotropin: hCG 2000 units/dose, 3 times a week, intramuscular injection; HMG 75 units/dose, 2 times a week, intramuscular injection; hCG + HMG, continuous use for 2 to 3 months.
(3) Low-dose androgens: testosterone undecanoate 40mg/time, 1-2 times/day, for 2-3 months.
(4) Anti-estrogen therapy: clomiphene, tamoxifen.
4. Chinese medicine treatment.
(1) Fate and fire failure type of Right Return Pill with added flavor, Chinese medicine can be used to choose Gui Ling Ji.
(2) Kidney essence deficiency type Wu Zi Yan Zong Wan plus flavor, homemade Sheng Jing San.
(3) Qi and blood deficiency type Ten Perfect Tonic Soup with added flavor, and Chinese herbal medicine can be used to supplement Zhong Yi Qi Pill or Gui Lu Tonic Kidney Pill.
(4) Yin deficiency and fire type Zhi Bai Di Huang Wan.
(5) Damp-heat infiltration type gentian diarrhea liver soup, the Chinese medicine can be used to choose the eight correct combination.
5.Surgical treatment.
For oligospermia caused by varicocele, cryptorchidism, etc., it can be treated by surgery.
6.Assisted reproductive technology.
(1) artificial insemination of husband’s semen (IUI): for patients with oligozoospermia, sperm can be optimized and then enter the uterine cavity, which can improve sperm vitality and the density of sperm with good vitality, which is a simple, effective and economical method;
(2) In vitro artificial insemination (IVF): for infertile men with sperm viability above 30%, IVF can be considered, and can be the first choice if the patient is in good condition, or can be used when the above treatment is not effective.
(3) Intracytoplasmic sperm injection (ICSI): For infertile men with very poor sperm motility or very low sperm count, IVF can be used when fertility is not resolved despite conventional IVF treatment.
This method can be used when fertility is not resolved despite conventional IVF treatment. This is a better treatment for patients with weak spermatozoa or low sperm count with very poor semen quality.
7.Other therapies
Including sexual life guidance: including guidance on the method, time and frequency of sexual intercourse; adjustment of dietary structure: to ensure a balanced intake of various nutrients and avoid being too obese or thin; change of lifestyle habits: smoking and alcohol abuse have been shown to have a negative impact on sperm quantity and quality, and quitting these habits and strengthening physical exercise are beneficial to sperm quality improvement.