The name is weak sperm motility, and it is the most common type of low sperm quality. Clinically, we refer to grade a sperm <25% or a+b <50% as weak spermatozoa (grade a sperm is fast linear motion; grade b sperm is slow linear motion; grade c is non-linear motion; and grade d is immobile sperm and may be dead sperm). The latest WHO 5th edition criteria are PR (forward moving sperm) <32% or total viability (PR+NP) <40% (including forward moving sperm or non-forward moving sperm). However, clinicians currently prefer to use the older version to determine this.
What causes can lead to weak spermatozoa?
1. Reproductive system infection: Semen is composed of spermatozoa and seminal plasma. Spermatozoa are produced by the testes and are allowed to mature in the epididymis. Seminal plasma is secreted by the epididymis, prostate, seminal vesicles, and urethral bulb glands, which are important components of seminal fluid and are the basis for sperm nutrition, energy acquisition, and movement. Inflammation of the reproductive tract, whether infectious or non-infectious, can reduce the vitality and viability of sperm, resulting in the formation of weak sperm, leading to infertility.
2.Congenital factors: Due to incomplete testicular development or poor epididymal development, resulting in low sperm count or poor sperm viability.
3, endocrine factors: sperm production in the testes is regulated by many hormones of the endocrine system. Testosterone level, thyroid hormone level, lactogen, etc. If the secretion of these hormones is disordered, it will lead to less sperm or weak sperm.
4, varicocele: it is one of the common causes of weak sperm. It is mainly related to the increased temperature of the scrotum due to seminal varicose, poor blood circulation and the formation of more harmful metabolites that adversely affect the testicles.
5, immune factors: due to damage or inflammation of the reproductive tract, an anti-sperm antibody is produced, which can bind to sperm, thus limiting the swimming of sperm.
6, environmental factors: working in a hot environment (such as chefs), radiation (electromagnetic radiation such as cell phones, computers; X-ray radiation, etc.), pollution from heavy metals in the environment, as well as environmental hormones, can affect the spermatogenic function of the testes. In addition or some drugs, especially chemotherapy drugs, immunosuppressants, etc.. Some Chinese herbs can also affect sperm vitality, such as lei gong teng, snake bed seeds, etc.
7, bad habits: smoking, alcoholism, carbonated drinks, etc. Smoke contains harmful substances that damage sperm, making sperm damaged. Through electron microscopy, a large number of long-term smokers, their sperm expression membrane will be erosion, reducing sperm vitality and survival rate. The birth rate of malformed children in men who smoke more than 10 cigarettes a day is as high as 2.1%. In men who smoke more than 20 cigarettes per day, the number of sperm is significantly reduced, and sperm movement posture and morphology are impaired. Also smoking in men increases the rate of miscarriage in pregnant partners to 60%. Alcohol can cause testicular atrophy and lower testosterone levels in the body, which can affect sperm production and lead to infertility. Also, alcohol is toxic to the normal development of germ cells, and heavy alcohol consumption can directly damage sperm.
What tests are needed for weak sperm?
1, through specialist physical examination and scrotal ultrasound, to rule out testicular and epididymal hypoplasia and varicocele resulting in oligozoospermia;
2.Culture of microorganisms to exclude weak spermatozoa caused by infection;
3, the examination of anti-sperm antibodies: at present, there are two kinds of anti-sperm antibodies, semen and blood examination, the former has high specificity (good clinical significance), but low sensitivity (low detection rate); the latter has lower specificity, but high sensitivity. The clinical application can be complementary.
4, seminal plasma biochemistry: seminal plasma fructose, alpha glycosidase, carnosine, etc., can determine the function of each accessory gonad.
5.Sex hormones can be done to exclude the influence of endocrine system on sperm.
6.Serious weak sperm that has not been treated for a long time needs chromosomal and genetic testing to eliminate chromosomal causes and genetic problems;
In recent years, the fertility centers have also been carrying out some new tests to complement the detection of the cause of some weak spermatozoa, but there are still a significant number of patients for whom the cause is not clear.
Diagnosis and treatment of weak spermatozoa
The diagnosis of weak spermatozoa is not difficult and can be made by semen routine, but it needs to be distinguished from dead spermatozoa. Necrospermia is defined as having more than 40% inactive sperm. The former focuses on the survival of sperm; the latter focuses on the motility of sperm. Therefore, if the number of immobile sperm is excessive, we need to distinguish between dead or weak sperm by eosin staining.
In terms of treatment, on the basis of finding the cause of the disease, treatment for the cause can often achieve better results. Of course if it is some genetic defect, then it may be necessary to have a baby through assisted reproductive technology.
If the cause is not clear, in general, we consider it from two angles, one is to consider inflammation, and if anti-inflammatory treatment is effective, then continue. Secondly, we consider the function of the accessory gonads, especially if the function of the epididymis is poor, then supplementation such as levocarnitine. While treating, we need to consider several aspects, taking into account anti-inflammatory, antioxidant, nutrition, etc.
The efficacy of TCM for weak spermatozoa is generally satisfactory. According to the difference between deficiency and reality, we tonify its deficiency, drain its reality, dissolve its stasis, clear its essence, and improve sperm vitality through Chinese herbs or some proprietary Chinese medicines to help pregnancy.
The reproductive condition of their female partner is also very important in the treatment of weak sperm patients. If the sperm (seed) is weaker, but if the female partner’s soil (uterus and ovaries) is fertile and the water flows smoothly (fallopian tubes), this can also lead to pregnancy. Therefore, it is very important for the couple to investigate and treat together.