Poor testicular reserve is low fertility “I’m ‘very good’ at that, how can it be my problem that I can’t have children?!” Many men, when they learn that they have been married for many years and have not been able to have children is their own reasons, it is generally difficult to accept. WHO a multi-center study shows that: in infertile couples, 20% of the infertility factors are entirely attributable to the male partner, 27% of the couple and both sides of the related, and 15% of the reasons are not known, so it can be assumed that men’s factors are caused by infertility is not less than 50%. Moreover, male sexuality is not the same as fertility, and a man with strong sexual function may also be completely infertile. For a man who is planning to get married or have infertility, if you want to know your fertility, you may want to go to the hospital and ask your doctor to evaluate your testicular reserve function. Testicular reserve function (or testicular reserve), which refers to the quantity and quality of sperm that can be consistently produced by the testes, as well as their potential to secrete androgens, is a more comprehensive reflection of the function of the testes. Doctors can also give advice on pregnancy planning or treatment according to a man’s testicular reserve function. The new conceptualization of testicular reserve function in men is based on a five-point scale from 0 to 4. Men with a testicular reserve score of 4 have a normal quantity and quality of sperm production and can conceive naturally without the use of assisted conception techniques. Men with a testicular reserve score of 3 may need to be treated with western and Chinese medications before they can complete their fertility program. Men with a score of 2 may need artificial insemination or medication if they are to complete their fertility program. Men with a grade 1 score will need IVF to complete their fertility program. The doctor will also make a judgment and give advice on which generation of IVF to use based on the specifics of the evaluation. Testicular reserve is also related to sexual function and male menopause For men in their 40s and 50s, even if they have already completed their fertility program, it is important to know their testicular reserve function to help them know if their physical and emotional problems are related to “menopause”. Menopause is not exclusive to women, but to men as well. Men experience a decline in androgen secretion after the age of 50, but in recent years this time has tended to advance due to poor lifestyles and increased environmental pollution. After the decline of androgen, a series of organ and system dysfunctions will occur, which in turn affect the male body, mental and psychological and sexual functions, and ultimately damage the quality of life of men, which is called “male menopause”, scientifically known as “delayed hypogonadism”. The symptoms of male menopause are many and complex and lack specificity. For example, some people may feel tired, lose concentration, lose memory, sleep less, lose interest in things around them, and have a reduced ability to work. Some patients have dizziness and panic attacks, cold extremities, and pain in unspecified areas, but no abnormal findings on physical examination. Depression, anxiety, irritability, and nervousness are also common, often affecting the patient’s relationship with family or coworkers. Most patients who come to the urology or men’s department exhibit decreased libido and erectile dysfunction, and are very frustrated and distressed when their heart is not in it. In fact, it is changes in sexual function that cause some patients to become aware of their other symptoms. Testicular reserve assessment reflects the production of androgens. If your androgens are lower than normal and you are experiencing some of the symptoms mentioned above, it is possible to diagnose that you are 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 do you assess testicular reserve? Testicular reserve function is assessed holistically from multiple angles and in multiple ways. This includes general condition, static and dynamic testing, and drug induction. The general condition includes factors such as age, testicular size, abdominal circumference, blood lipids, blood glucose, and blood pressure. Sperm density is usually highest in men between the ages of 30-34, and age greater than 40 has a negative correlation between sperm density and increasing age. Doctors will recommend color ultrasound for testicular examination, which can provide a direct understanding of the volume of the testes, but also the blood supply and texture of the testes; those with a sparse texture have poor spermatogenesis, and those with a dense texture have good spermatogenesis. Static testing includes routine semen analysis and endocrine testing. Dynamic testing refers to taking semen several times in a row for testing to understand the dynamic changes of semen indexes; the ratio of sex hormone testing calculates the testosterone secretion index; drug induction refers to the use of induction methods, such as the use of a combination of HCG + HMG to stimulate the test, and the response to the use of drugs will reflect the reserve function of the testes; due to the possibility of bringing about a certain amount of damage to the testes, testicular biopsy will be considered only when necessary Testicular biopsy will be considered only when necessary due to the potential for some testicular damage. Further clarification of the testicular reserve function will help to improve the diagnosis and treatment of male infertility, as well as the prevention and management of male reproductive health in general.