Oligozoospermia is one of the main causes of male infertility or reduced fertility. In fact, oligospermia is a collective term for oligospermia and weak spermatozoa. Oligospermia refers to a decrease in the number of sperm in semen, while weak sperm refers to poor sperm motility or even inactivity. In recent years, due to environmental pollution, unclean diet and changes in lifestyle habits, the quality of almost all men worldwide is declining. On the one hand, the decline of male sexual ability, on the other hand, the general decline in the quality of male semen. At present, the country has fully liberalized the “two-child policy”, most of the 80s and 70s male compatriots are ecstatic and excited. The most important thing is that you can get a good idea of what you want to do. I see about half of the patients in my clinic for oligozoospermia. Many patients have many questions about the cause, diagnosis, treatment and usual precautions for oligozoospermia, however, in the usual consultation, due to the large number of patients, doctors often do not have time to answer one by one, in order to facilitate the majority of patients, save consultation time, reduce the patient’s doubts, now combined with “male infertility diagnosis and treatment guidelines of Chinese and Western medicine” and my treatment experience, on the oligozoospermia clinical FAQ unified The answers are as follows.
1.If infertility is suspected to be caused by poor semen quality, what tests should be done at the clinic?
Semen routine is the simplest and most effective way to check semen quality.
2. How many semen tests should be done and how long between each test? What is the effect of too long or too short a time?
The results of normal male semen tests tend to fluctuate up and down, and are affected by many factors, such as the number of days of abstinence, diet, smoking, fatigue, and staying up late. Therefore, it is clinically recommended to have two to three tests and abstain from sex for 2-7 days before each test. I personally advise my patients to abstain from sex for 5 days at a time for each test, so that the test results are more comparable before and after. Each sperm from generation to maturity to decline and finally extinction time is about 73 days, if the abstinence time is too long sperm in the body storage time is too long, the discharge of sperm from the mature stage into the decline, then the test results are often low sperm vitality. And if the abstinence time is too short, the sperm production is insufficient and the number of sperm in the semen tends to decrease.
3. Can the diagnosis of oligozoospermia be confirmed if the semen test results are sometimes good and sometimes bad?
As mentioned earlier, semen routine is affected by many factors, therefore, good and bad semen test results cannot confirm the diagnosis of oligozoospermia. It is recommended to avoid adverse factors that affect sperm quality, such as regular life before the test, appropriate number of days of abstinence, avoid straining and staying up late. If the above factors are avoided and the semen routine is abnormal for two to three consecutive times, the diagnosis of oligozoospermia can be made.
4.What are the precautions before semen examination?
The first thing is to pay attention to the number of days of abstinence, abstinence for 5 days to do the most accurate test results; in addition, a few days before sperm extraction to avoid fatigue, staying up late, drinking alcohol, etc.; then is not to use condoms during the process of sperm extraction, semen specimens should not be contaminated by urine, water, etc., semen must be sent for testing within half an hour after removal.
5, after the diagnosis of oligozoospermia generally need to do what tests to clarify the cause?
It is necessary to do ultrasound of the reproductive system (testes, epididymis, spermatic cord, prostate gland, seminal vesicle gland), sex hormone six, prostate routine, thyroid complete set, etc. after the diagnosis of oligozoospermia is confirmed. If the semen test is severe oligospermia or azoospermia, genetic tests including karyotype analysis and Y chromosome microdeletion are also necessary. If necessary, a testicular aspiration biopsy can be done to determine whether it is primary azoospermia or obstructive azoospermia.
6.How long do I have to wait for the appointment for each of these tests? How long will it take to get the results after the test?
No appointment is needed for any of the above tests, they can be done on the same day. The results of reproductive system ultrasound will be available in 10 minutes, the results of sex hormone six and thyroid complete set will be available in the morning and afternoon, the results of chromosome karyotype analysis will be available in about half a month, the results of Y chromosome microdeletion will be available in about 5 days, and the results of testicular puncture biopsy will be available on the same day.
7.Is Chinese medicine or Western medicine good for the treatment of oligozoospermia?
Most of the patients with oligozoospermia do not have organic lesions, and these patients are better treated with traditional Chinese medicine. The Chinese medicine is the crystallization of the traditional culture of the Chinese nation, is the medical predecessors of thousands of years of experience in the treatment of disease, the ancient books of Chinese medicine has a lot of treatment of less weak spermatozoa experience, such as “five son diffusion soup” “sperm soup” and so on, these formulas are in clinical use The effect of these formulas are in clinical use for many years, but of course, Chinese medicine treatment emphasizes the overall concept, evidence-based treatment, less weak spermatozoa patients also have to be based on specific evidence-based medicine, can not just use the kidney sperm drugs. Some patients with organic spermatozoa can choose western surgical treatment, such as varicocele can choose microscopic spermatozoa ligation, obstructive azoospermia can choose microscopic vasovaginal epididymal anastomosis, primary azoospermia can choose microscopic sperm extraction, and patients with severe spermatozoa can choose artificial assisted reproduction technology.
8.How often do patients with drug treatment need to be seen again and what tests are done at the follow-up?
The medication is usually followed up once every half month to once a month. It is recommended that the semen routine be rechecked once a month.
9.How long does it take to see the effect of drug treatment?
Because the survival cycle of sperm is about 73 days, the effect of medication can be seen only after one to two months.
10.How long does the course of drug treatment for oligozoospermia take?
It is generally recommended to take at least 3 months of medication. 3-6 months is more appropriate.
11.Does the lack of improvement in semen quality after one month of treatment for oligozoospermia mean that the treatment is not effective?
As mentioned earlier, the survival cycle of a sperm is about 73 days, therefore, it is possible that the semen quality does not improve after one month of treatment, which does not mean that the treatment is ineffective, but we must adhere to the course of medication.
12.How long does it take for a normal adult male to conceive if his semen is of normal quality?
This is affected by many factors, such as the health condition of the spouse, the frequency of intercourse, whether to pay attention to intercourse during ovulation, etc. According to large sample statistics, if both men and women are normal and have a normal sex life, the chance of conception within one year is about 60%.
13.Is it possible to conceive during the treatment of oligozoospermia? If conception occurs, will it affect the development of the child?
The medication for oligozoospermia mainly includes traditional Chinese medicine and western medicine, which have no effect on conception and can prepare for pregnancy during treatment. The sperm in semen is generally classified into a, b, c and d level according to their motility, and the number of sperm discharged by men each time is about 30 to 100 million, among so many sperm, the one that conceives will often be the class a sperm that runs in the forefront, so there is no need to worry about the development of the child after conception.
14.What should I pay attention to in terms of diet for patients with oligozoospermia?
The diet of patients with oligozoospermia is mainly based on clear and tonic products, less fried, fried, spicy products, and forbidden to eat cottonseed oil. At the same time, during the period of taking medicine, prohibit the consumption of seafood, bamboo shoots, rooster, dog meat, beef, mutton and other hairy products. Prohibit smoking and drinking.
15.What do men need to do before pregnancy?
(1) Improve lifestyle.
(1) Develop a good routine, go to bed early and get up early to ensure adequate sleep, and
(2) Eat regularly, pay attention to dietary hygiene and safety.
(3) Maintain a good mental state, avoid negative emotions, and avoid high-intensity work and study.
④ Quit smoking, drinking and other bad habits.
(2) Sexual life should also be moderate: you should not have excessive and frequent sexual life for the sake of fertility, and you should plan your pregnancy to ensure that you have sufficient physical strength and energy to complete conception during female ovulation.
(3) Stay away from high temperature: Research has found that the appropriate temperature for sperm production and survival is 1-2℃ below body temperature, i.e. below 37℃. High temperature will destroy the survival environment of sperm, while easily damaging the spermatogenic epithelium of the testes, affecting the production, quantity, quality, density and motility of sperm, thus leading to a lower chance of conception and a higher rate of fetal malformation.
(4) Strengthen exercise: jogging is preferred. Jogging can accelerate the blood circulation in the pelvis, thus ensuring the nutritional supply to the reproductive system so as to provide higher quality sperm.
(5) Have a comprehensive preconception examination.
(6) Actively treat underlying and reproductive system diseases.