As a man, do you know how your “testicular reserve function” is? “Testicular reserve function” is a new concept that was recently introduced at a male academic conference, providing a new way of thinking for clinical assessment of the potential ability of the testes to produce sperm and secrete androgens, optimizing the treatment strategy for male infertility and also serving as a management assessment method for male reproductive health. Poor testicular reserve means low fertility “I’m ‘good’ at that, so how can it be my problem if I can’t have children?” A multi-center study by the WHO reported that 20% of infertility factors were attributed to the male partner, 27% to both partners, and 15% to unknown causes, so it can be assumed that male factors are responsible for no less than 50% of infertility. And male sexuality is not the same as fertility, sexual function is very strong in men may also be completely infertile. Suggestion: For a man who is planning to get married or has infertility, if he wants to know his fertility, he may want to go to the hospital and ask his doctor to evaluate his testicular reserve function. Testicular reserve function (i.e. testicular reserve), which refers to the quantity and quality of sperm that can be produced consistently by the testes, as well as the potential to secrete androgens, reflects the function of the testes more comprehensively. Doctors can also give advice on pregnancy planning or appropriate treatment based on the level of testicular reserve in men. The new concept has five levels of testicular reserve function for men, from 0 to 4. Men with a testicular reserve score of 4 can produce sperm in normal quantity and quality, and these men can conceive naturally without the use of complementary measures. Men with a testicular reserve score of 3 may require Western and Chinese medication to complete their fertility plan. Men with a grade 2 may require artificial insemination or medication to complete their fertility program. Men with a level 1 score will need IVF technology to complete their fertility plan. The doctor will also make a judgment and give a recommendation based on the specific circumstances of the evaluation as to which generation of IVF technology to use. Testicular reserve is also related to sexual function and male menopause For men in their 40’s and 50’s, it is important to know their testicular reserve, even if they have completed their reproductive journey, to help them know if their physical and emotional problems are related to “menopause”. Menopause is not exclusive to women, but also to men. The decline in androgen production in men after the age of 50 has tended to advance in recent years due to poor lifestyles and increased environmental pollution. The decline of androgens will lead to a series of organ and system dysfunctions, which will affect the physical, mental, psychological and sexual functions of men, and eventually impair the quality of life of men, which is called “male menopause”, scientifically known as “delayed hypogonadism”. The symptoms of male menopause are complex and lack specificity. For example, some people may feel tired, have less energy, lose memory, sleep less, have less interest in their surroundings, and have less ability to work. Some patients have dizziness and panic attacks, chills in the extremities, and pain in unspecified areas, but no abnormal findings on physical examination. Depression, anxiety, irritability, and nervousness are also more common and often affect the patient’s relationship with family or colleagues. The majority of patients who come to urology or male medicine present with reduced libido, erectile dysfunction, heartburn, and great frustration and distress. In fact, it is the changes in sexual function that cause some patients to begin noticing their other symptoms. If your androgens are below normal and you are experiencing some of the symptoms mentioned above, you may be diagnosed as experiencing “male menopause” and your doctor may recommend testosterone supplementation if these symptoms are already causing problems in your life and work. Static and dynamic assessment of testicular reserve So how to assess testicular reserve capacity? The assessment of testicular reserve function should be done from multiple perspectives and in a variety of ways across the board. These include general conditions, static and dynamic testing, and drug induction. General conditions include age, testicular size, abdominal circumference, lipids, blood glucose, blood pressure and other factors. Usually men have the highest sperm density between the ages of 30 and 34 years old, and at ages older than 40 years old, sperm density has a negative correlation with increasing age. Doctors will recommend color ultrasound examination of the testicles, which not only can directly understand the volume of the testicles, but also the blood supply and texture of the testicles. Those with sparse texture have poor sperm production ability, while those with dense texture have good sperm production ability. Static testing includes routine semen analysis, endocrine testing, etc. Dynamic testing means taking semen several times in succession for testing to understand the dynamic changes of semen indicators; the ratio of sex hormone testing to calculate the testosterone secretion index; drug induction means using induction methods such as the combination of HCG+HMG for stimulation test, and the response after the drug will reflect the reserve function of the testes; testicular biopsy will be considered only when necessary due to the possibility of bringing about certain damage to the testes .