Infertility refers to a normal couple of childbearing age having normal sexual life after marriage, in 1 year or more, without contraception, and without childbirth. 15% of married couples experience infertility, of which 30% of the incidence of male infertility. The basic condition for fertility is to have normal sexual function and to have normal sperm that can unite with the egg. Therefore, either anatomical or physiological defects of the sexual organs or disorders of the hypothalamic-pituitary-gonadal axis can lead to infertility.
The basic requirement for fertility is to have normal sexual function and to have normal sperm that can unite with the egg. Therefore, either anatomical or physiological defects of the sexual organs or disorders of the hypothalamic-pituitary-gonadal axis regulation can lead to infertility. Infertility refers to a normal couple of childbearing age having normal sexual life after marriage, in 1 year or more, without contraception, and without childbirth. 15% of married couples experience infertility, of which 30% of the incidence of male infertility. Generally, cohabitation after marriage for more than 2 years without any contraceptive measures and the woman is not pregnant, is called infertility.
Incidence
The incidence is about 10% of which the female factor alone is about 50%, the male factor alone is about 30%, and the male and female total is about 20% Clinically, male infertility is divided into two categories: sexual dysfunction and normal sexual function, and the latter can be further divided into azoospermia, oligospermia weak spermia, sperm weakness and sperm count normal infertility based on semen analysis results.
Spermatozoa
In recent years, as people’s awareness of human reproductive problems increases and the rapid development of male science, the detection rate of male infertility has gradually increased, which has attracted the high attention of male scientists.
Disease Etiology
Treatment of infertility
1, chromosomal abnormalities: common are male pseudohermaphroditism, Creutzfeldt-Jakob syndrome and XYY syndrome.
2, endocrine diseases: the cause is gonadotropin deficiency. The common ones are selective hypogonadotropic hypogonadism, i.e. Kallmann’s syndrome; selective LH deficiency and FSH deficiency, adrenocortical hyperplasia, hyperprolactinemia, etc.
3, reproductive tract infections are more common: In recent years, with the increased incidence of sexually transmitted diseases, the incidence and severity of reproductive tract inflammatory diseases such as prostatitis, epididymitis, orchitis, urethritis have increased, seriously affecting male fertility.
4, obstruction of the vas deferens: affects sperm transport.
5, testicular spermatogenesis abnormalities: common in cryptorchidism, varicocele, toxins, magnetic field, high heat and trauma and other physical and chemical factors can cause testicular spermatogenesis disorders.
6.Sperm structure abnormalities and seminal plasma abnormalities: affect sperm motility, energy acquisition and acrosome reaction, etc.
7, immune infertility: male own anti-sperm immunity and female anti-sperm isoimmunity can cause male infertility.
8, male sexual dysfunction, impotence, premature ejaculation, non-ejaculation and retrograde ejaculation can all cause male infertility.
Causes of infertility in women
More and more urban women are suffering from infertility because of the following reasons.
1, abortion: In recent years, premarital sex has become a common phenomenon, according to a survey, 40% of women have a history of one or more abortions before giving birth. According to clinical indications, two out of 10 miscarriages will have varying degrees of infertility. Abortion can lead to gynecological inflammation and endometrial damage, resulting in infertility. Therefore, experts recommend not to take abortion measures as far as possible, even if you have to abort, you should choose a regular place.
2, gynecological diseases: urban women generally have children later, the older they are, the more gynecological diseases, such as gynecological inflammation, uterine fibroids, ovarian cysts, etc. can lead to infertility.
3, stress: urban women’s life is generally stressful, too much pressure will lead to endocrine disorders, which will lead to infertility.
4, weight loss: urban women are mostly thin for beauty, not knowing that too thin body fat is too little, fat content should reach at least 22% of body weight to maintain a normal menstrual cycle, but also have the function of fertility, less than this value, will affect pregnancy.
5.The treatment of women suffering from infertility
If the cause of the disease is in the female reproductive organs, sensitive antibacterial drugs should be selected for treatment and to prevent recurrence, such as: endometrial inflammation. Progestin or danazol can be used to treat endometriosis and female hormones to treat uterine dysplasia. Surgery is used if there is uterine malformation, abnormal uterine position, tumor, cervical canal laceration, and cervical endocervical insufficiency. However, surgery should be considered with caution. If the uterus is in an abnormal position, surgery is not actively advocated because of unsatisfactory results, except for posterior flexion due to uterine adhesions.
For ovarian tumors or uterine fibroids that may affect pregnancy, surgery should be performed to remove the tumor. In cases of uterine adhesions after miscarriage, abortion or delivery, although the adhesions can be separated and a contraceptive ring can be placed for 2-3 months to reduce the adhesions, the pregnancy rate after treatment is still low and there are more complications during pregnancy and delivery. For endocrine disorders, if the cause is abnormal ovarian function, artificial menstrual cycle treatment with estrogen and progestin can be planned, but the hormone status in blood should be measured frequently to evaluate the efficacy. If the cause is in the thyroid gland, adrenal gland or pancreas, treatment should also be given accordingly.
Drug effects
Drugs that cause male infertility.
First, dozens of sleeping pills are inhibited libido, or even loss of libido, and can reduce testosterone production in men, penile erection difficulties, non-ejaculation and female menstrual disorders or amenorrhea.
Second, the drugs that affect ejaculation. Such as the management of hypertension drugs can make the drug users ejaculation volume reduction, or even not ejaculate. Some drugs can inhibit the ejaculatory reflex, making it delayed ejaculation.
Third, hormonal drugs. The application of estrogen, progesterone and other drugs can inhibit the secretion of pituitary gonadotropin, which in turn can inhibit the spermatogenic function of the testes.
Fourth, the family of antibiotics erythromycin, spiramycin, methicillin and other macrolide antibiotics, will reduce the frequency of organic division of testicular cells, sperm are killed, killed, the surviving sperm vitality is significantly weakened. The use of large amounts of gentamicin can cause men’s sperm cells mitosis is blocked, the concentration of DNA in spermatogenic cells is reduced, resulting in the cessation of spermatogenesis.
V. Anti-hypertensive drugs Compound antihypertensive tablets, reserpine, methyldopa, buckling and other antihypertensive drugs can affect erectile function, causing decreased libido, impotence, non-ejaculation, menstrual irregularities.
Sixth, anti-ulcer drugs such as methocarbamol and Tegretol can inhibit male and female libido and can cause male and female frigidity and male impotence.
Seven, drugs that directly inhibit sperm production. Such as insecticidal drugs, but it also has the effect of inhibiting spermatogenesis. Other drugs, such as dinitropyrroles, nitrofurans, anti-cancer alkylating agents and the newly studied cotton phenol extracted from cotton seeds, have a strong inhibitory effect on the spermatogenic function of the testes.
Eight, drugs that affect the maturation of sperm. Such as anti-androgen compounds, although the impact on testicular sperm function is not significant, but these drugs have a direct effect on the testicular born sperm, so that sperm can not mature and lose the ability to fertilize.
Pathophysiology
Treatment of infertility
1, spermatogenic dysfunction refers to reproductive disorders caused by primary hypogonadism due to testicular varicocele lesions or interstitial lesions. Such as congenital testicular dysplasia, Klinefelter’s syndrome, cryptorchidism, varicose veins within the spermatic cord, testicular trauma. Testicular inflammation and testicular torsion leading to atrophy can cause spermatogenic dysfunction. Abnormal function of hypothalamus and pituitary gland, radioactive substances and inhibitory spermatogenic drugs can also affect the production and maturation of sperm.
2, vas deferens obstruction epididymis, vas deferens to the ejaculatory duct is the output sperm channel, if these channels are blocked, sperm can not pass and cause infertility. The common causes of obstruction are congenital vas deficiency or atresia, gonorrhea, tuberculosis and other inflammatory diseases of the reproductive tract.
3, semen abnormalities semen quantity and quality abnormalities can affect fertility.
4, immune factors due to the male body produces anti-sperm antibodies, and catastrophic reproductive fight within the sperm will kill and cause infertility, is autoimmune infertility. When the reproductive tract injury, infection, obstruction, the impact of certain drugs, testicular local heating and cooling, as well as congenital genetics and other factors, the human body can produce anti-sperm antibodies.
5. Abnormalities of the prostate gland, prostatic enzymes and abnormal function of the seminal vesicles can cause infertility.
Diagnostic tests
Infertility
Through detailed medical history and comprehensive physical examination, it is not difficult to clarify the cause of infertility in general, but in some cases a series of specialized tests are required to achieve the diagnosis of the cause.
(a) Medical history examination can clarify the diagnosis in some cases through detailed medical history examination. For most cases, the history can provide clues for further examination. The medical history inquiry mainly includes the following contents. Sexual history, with or without sexual dysfunction. Marital history, whether consanguineous marriage, the presence of familial hereditary diseases. If you are not the original couple, you should also ask about your past fertility history in order to understand whether the man is infertile and his primary or secondary infertility. To understand whether there are systemic and genitourinary diseases that affect fertility. This includes congenital, inflammatory, vascular, endocrine, nutritional metabolic and febrile diseases. The presence or history of frequent, urgent, painful urination, white mucus flowing from the urethra, dripping pus, and hematospermia clearly suggest inflammation of the genitourinary organs that affects fertility. Those who suffer from enuresis, especially persistent enuresis in late adolescence, may have abnormalities in the nerve supply to the bladder and prostate, with the possibility of retrograde ejaculation. Find out if there is a history of trauma and surgery that affects fertility. External forces can directly traumatize the testes. Surgery in the groin area or scrotal area such as hernia repair, high ligation of varicocele, and sheath ectoplasty may damage the testes or the blood supply to the testes. Lumbar sympathectomy as well as cystoplasty may cause retrograde ejaculation. Ask if you have been exposed to radioactive substances or drugs and medications that can affect sperm production or reproductive function. Find out about personal habits, hobbies, and work and living environments. Excessive smoking and alcoholism, nicotine intoxication can affect sexual function and spermatogenesis. Occupational stress, fear of fatherhood, marital discord and other mental disorders not only cause sexual dysfunction but are equally harmful to sperm survival. Men with infertility from cotton-producing areas should be asked if they regularly consume crude raw cottonseed oil, a preparation that affects spermatogenic function. Underwear that is too tight so that the testicles are close to the abdomen, frequent hot sitz baths and high-temperature operating environments can interfere with scrotal heat regulation and affect spermatogenic function.
(B) Physical examination includes systematic physical examination and examination of reproductive organs
1. Systematic physical examination pays attention to body shape, nutritional status, whether it is particularly thin or too obese, whether there is hypertension, abnormal endocrine performance. Pay attention to the characteristics of secondary sexual characteristics such as voice tone, laryngeal nodes, beard and type of forehead hairline (if the forehead hairline is slightly rounded, there may be insufficient testosterone secretion), breast development and the distribution of axillary and pubic hair.
2. Examination of reproductive organs
(1) Penis development: the presence of severe prepuce or urethral stenosis, the presence of urethral epispadias or hypospadias, and the presence of penile cavernous fibrous sclerosis.
(2) Scrotum (and groin area): presence of surgical scars, presence or recovery of sinus traces. Whether the scrotal skin is thickened and whether there is a huge sphincter or hernia. If the scrotum is empty it indicates cryptorchidism or absence of testes. Whether varicocele is present.
(3) Testes: whether the size, location and texture are normal, and whether there are nodules. Testicular size can be determined by directly measuring its length, width and thickness, or by using pre-prepared testicular models of different sizes and the testicles of the person being examined to directly read the testicular volume. Most normal adult males have a testicular volume >15ml, if <11ml it indicates poor testicular function.
(4) The relationship between the epididymis and the testis, and the presence of nodules or fibrosis in the epididymis.
(5) Vas deferens: presence or absence, smoothness and roundness, thickening or not, presence or absence of beaded nodules.
(6) Prostate and seminal vesicles: their size, texture, presence of nodules and tenderness (can be clarified by rectal palpation). In cases of hypogonadism the prostate is smaller and has a uniform texture. In patients with chronic inflammation, the prostate can be enlarged, normal or reduced in size, but the texture varies and inflammatory nodules can be palpated. The normal seminal vesicles cannot be palpated by rectal palpation, while in patients with chronic inflammation, the dilated and enlarged seminal vesicles can be found. If necessary, prostate massage is also feasible to obtain prostate fluid for bacteriological and cytological examination.
(c) Semen examination includes physical and biochemical characteristics, and is the most basic laboratory diagnostic item for male infertility. Proper instructions for semen collection should be emphasized, and the semen sent for examination should be all semen from one ejaculation 5 days after the subject has avoided sexual intercourse. Semen examination should be performed at least 3 times, and the parameters of each specimen may be significantly different, so the results of multiple examinations are more objective.
1. Physical examination
(1) Semen volume: 5 days after stopping sexual intercourse, 1 normal ejaculate volume is 1.5-6ml, average 3-5ml. ejaculate volume less than 1ml or more than 8ml can affect fertility.
(2) Color: Normal is grayish white, transparent after liquefaction. For those who have not ejaculated for a long time or have semen loss, semen may be light yellow. If the semen is yellowish-brown, it suggests inflammation of the reproductive tract. If it is red, it is hematosperm, and in addition to possible reproductive tract infection, tumors need to be ruled out.
(3) Semen liquefaction: fresh semen just ejaculated is thick and jelly-like, may have clots, and liquefaction occurs within 5 to 25 minutes (average 15 minutes). Too high or too low viscosity of semen affects the ability to transport active sperm and prevents conception.
(4) Semen pH: Semen includes seminal vesicle fluid (about 2.3 ml), prostate fluid, epididymal fluid, spermatozoa (about 0.5 ml) and urethral bulb gland and urethral gland fluid. The pH of semen reflects the relative content of these two secretions, with a normal value of 7.2 to 7.8. An abnormal pH of semen may indicate the presence of an accessory gland infection.
2.Microscopic examination
(1) Sperm count: To judge the fertility of adult men, the number of sperm count is a basic and important index. It includes two parameters.
(① sperm density, that is, the number of sperm per ml of semen, normal for 60 to 200 × 106/ml.
② Total number of sperm per ejaculation, normal is 100 million or more.
When the sperm density is lower than 20×106/ml, the conception rate will be significantly reduced; infertility with sperm density below 40×106/ml is often accompanied by abnormalities in other parameters. Clinically, sperm density below 20×106/ml or sperm below 40×106/ml in each ejaculation should be considered abnormal.
Polyspermia (spermatozoa >250 million/ml) can lead to mechanical obstruction of sperm motility and wandering. It accounts for 1 to 2% of infertility and has a high rate of spontaneous miscarriage in the spouse.
Male first, then female Simple, convenient and inexpensive
”It is simple and economical to check the husband first.” Experts summarize the first trick for infertility patients. Some people think that not having children is definitely the cause of the female partner, and always check the female partner around. In fact, experts say that the causes of infertility are extremely numerous, and overall infertility caused unilaterally by the wife accounts for 50%, unilateral male causes account for 30%, and common causes of both parties account for 20%.
If there is no abnormality in the cosmetic examination, the male partner should first have a semen test (about 100 yuan), which is the most basic test for infertile couples and is quick and non-invasive. The semen should be collected by the husband with no sexual intercourse for 3-7 days, and semen should be collected by masturbation method or in vitro ejaculation method, not by condom. Semen examination provides information on the number, morphology and motility of the male partner’s sperm, and can help determine or rule out most male causes. If all 3 semen tests indicate no sperm, a urological consultation should be sought promptly and a testicular biopsy should be done, and if there is mature sperm, IVF can be done. If the semen test is normal, basically the male partner can be ruled out as the cause of infertility, and then the female partner can be the cause.
Exclusion methods
1, the whole body examination: height, weight, blood pressure, pulse, body posture, appearance, the presence of male secondary sex characteristics, male endocrine dysfunction signs and other necessary testing and observation, while paying attention to cardiovascular, respiratory, digestive and nervous system signs of abnormalities.
2, reproductive system examination: is the focus of male infertility examination, including the examination of the penis, scrotum, testicles, spermatic cord, epididymis examination, etc. Abnormalities of the reproductive system that cause male infertility mainly include hypospadias, epispadias, occult penis, micropenis, and inflammation of the urethra, seminal vesicles and epididymis that can cause male infertility.
3, semen analysis and examination: is the main examination items for the diagnosis and treatment of male infertility, and is an important basis for evaluating the fertility of men. To ensure the accuracy and reliability of the examination, the patient should not have had sexual intercourse for three to five days prior to the examination. The examination of semen includes the examination of semen appearance, semen acidity, semen odor, semen coagulation and liquefaction, and semen volume.
4.Sperm examination: It is also an important examination item for the diagnosis and treatment of male infertility. The sperm quality full computerized automatic analysis equipment introduced by Hangzhou Guangren Hospital can provide accurate examination conclusions in a relatively short time. Sperm examination usually includes: sperm morphological examination, deformed sperm rate examination, sperm viability, sperm count and density examination, sperm acrosome enzyme determination, sperm immunohistochemical analysis, and if necessary, sperm function analysis (penetration, movement speed, etc.).
5, semen microbiological examination: male genitourinary system infection can not only cause inflammation of reproductive organs such as orchitis, epididymitis, prostatitis, etc., but also a common cause of male infertility. The pathogenic microorganisms that cause genitourinary system infections are bacteria, viruses, mycoplasma, chlamydia, fungi, etc. The methods of detection include smear examination, pathogen culture, antigen antibody test, etc. The main contents of the microbiological examination of semen are bacterial examination, virus detection, chlamydia mycoplasma detection, etc.
6.Prostate fluid examination: prostate secretion is a component of semen, but sometimes prostate fluid needs to be analyzed separately, which generally includes appearance examination, microscopic examination, biochemical analysis, etc.
7, testicular tissue biopsy: this test can be done for patients with semen analysis for no sperm, testicular volume less than 12 ml and primary testicular atrophy can be determined. For patients with moderate oligospermia, testicular biopsy can also be considered for patients whose sperm quality cannot be improved after a period of treatment. However, this examination has certain damage to the testicles, should strictly grasp the indications.
8, cytogenetic examination: mainly to identify whether there are congenital factors or chromosomal abnormalities caused by male infertility. The incidence of male infertility caused by chromosomal abnormalities is about 6%-15%. The common cytogenetic tests include: bulge microsomal examination, karyotype analysis, chromosomal aberrations, etc.
9, immunological examination: human semen contains a large number of antigenic components, including seminal plasma antigens, sperm antigens and antigens common to seminal plasma and sperm, in addition to the presence of blood type antigens with complex components, stronger antigenicity can cause their own, homologous or local immune response in the reproductive tract, inducing specific antibody production. The production of semen (sperm) antibodies is often a serious cause of infertility, so clinical attention is paid to the detection of antisperm antibodies.
10. Endocrinological examination: The main test is to detect the secretion status of androgens (mainly testosterone) in the testes, and it is clinically proven that endocrine abnormalities are also one of the common causes of male infertility. Endocrinological examination also includes follicle stimulating hormone (FSH) test, luteinizing hormone (LH) test, estradiol (E2) test, etc.
Differential diagnosis
1. Obstructive azoospermia has normal testicular size. However, the semen is spermless; testicular biopsy shows disorganized arrangement of spermatogenic epithelial cells and more active spermatogenic process; sperm channel imaging can clarify the site of obstruction.
2.The spermatogenic cells are not developed and the testes are normal in size. However, there was no spermatozoa in the semen; testicular biopsy showed that there were only columnar supporting cells in the varicocele and no spermatogenic cells.
3.Transparent degeneration of varicocele testis is normal in size, but soft in texture, often accompanied by hypogonadism. There is no spermatozoa in the semen. It can be secondary to non-specific inflammation, mumps, testicular torsion, or the application of estrogen can also cause; testicular biopsy spermatogenic cells and supporting cells disappeared, the varicocele transparent degeneration, lumen atresia disappeared.
4.Spermatogenic cell maturation disorder The size and texture of the testes are normal, and the semen examination is less sperm. The cause is related to some harmful substances in the environment (such as lead), industrial fumes (such as gasoline), high temperature and varicocele; testicular tissue examination shows that the spermatogenesis process mostly stops at the spermatocyte stage, and there are very few spermatocytes for further development in the varicocele.
5, Klinefeltersyndrome (Klinefelter’s syndrome) testes are small and soft, semen volume is small without sperm. The hood biopsy shows irregular interstitial cell masses with occasional tubules made up of supporting cells.
6, testicular development obstruction performance testis small and soft, semen volume is small without sperm. If the gonadotropin secreted by the pituitary gland is insufficient before puberty, testicular biopsy shows that the varicose sperm ducts are composed of undifferentiated primitive supporting cells and primitive spermatogenic cells, lacking interstitial cells. If the testis is atrophied due to pituitary lesions or excessive androgen or estrogen treatment after puberty, the early changes on testicular biopsy are thickening of the lamina propria and degeneration of spermatogenesis, and the late sclerosis of the varicocele and atrophy of the interstitial cells.
7, testicular fibrosis testes become small and hard, and there is no sperm in the semen. It may be related to intra-testicular infection; testicular biopsy shows multiple small scattered scars in the interstitium.
Treatment options
Drug therapy
Including hormonal drug therapy and nutritional drug therapy
Drug treatment
1. Hormonal drug therapy selects cases of oligospermia or poor semen quality for treatment.
(1) Chorionic gonadotropin (HCG): the current clinically applied preparation contains interstitial cytokines (ICSH) and follicle stimulating hormone (FSH). It stimulates the production of spermatozoa by the testicular varicose ducts stimulating the development of mesenchymal stromal cells releasing testosterone and should be used in people with hypopituitarism, low FSH levels and secondary testicular spermatogenic dysfunction. The dose is 1000u, injected intramuscularly once every other day for 10 to 12 weeks as a course of treatment.
(2) Clomiphene: It is a synthetic female hormone derivative that competitively binds to estradiol receptors in the hypothalamus, inhibiting the feedback effect of estradiol on the hypothalamus and promoting the secretion of GnRH and pituitary gonadotropins in favor of spermatogenesis, using 25-50 mg daily orally for 25 days with a 5-day stop for 3-6 months.
(3) Testosterone: small doses of testosterone have a direct stimulation of spermatogenic epithelial cells, promote spermatogenesis and improve sperm vitality; high doses of testosterone, on the contrary, inhibit spermatogenesis, but once the drug is discontinued, a rebound phenomenon occurs in about six months, resulting in elevated gonadotropins and sperm counts exceeding the pre-treatment level, and lasts for several months. Testosterone can be administered in small doses: 10-15mg/d of methyltestosterone, 50mg/day of methyltestosterone (mesterolone), or 50mg/d of Flucrometerone; high dose testosterone can be administered as testosterone propionate 50mg 3 times a week for 12 weeks. Or testosterone enanthate, 200mg every 3 weeks, intramuscular injection, 9 weeks as a course of treatment.
2, nutritional drug therapy efficacy is not exact, the following drugs may be beneficial for infertility of unknown etiology.
(1) adequate protein and vitamins A, B and E.
(2) glutamic acid (glutamicacid) 0.6-2g, orally, 3 times a day, 2-3 months for a course; or arginine (arginine) 2-4g / d orally.
(3) Supplementation with certain trace elements, such as administration of zinc preparations may be beneficial.
Surgical treatment
I. Laparoscopic high ligation
”Laparoscopic high ligation” is the best technique to treat infertility caused by varicocele. This technique involves laparoscopic ligation of the spermatic vein, combined with intelligent computerized navigation imaging system and microscopic technology, as long as a double silk ligation is performed 2-3 cm above the inguinal canal’s internal ring opening in the retroperitoneum, thus blocking the reflux of sperm-damaging substances and simultaneously reducing testicular temperature and venous pressure, thereby improving semen quality and advancing the natural conception rate.
Sperm optimization technology
The “sperm in vivo optimization technology” mainly treats infertility caused by male sperm semen problems, and is very effective in treating male infertility such as oligospermia, weak spermia, dead sperm, azoospermia and semen non-liquefaction infertility. It can well regulate human endocrine, improve the environment of intra-testicular and epididymis, promote blood circulation, enhance the sperm production function of testes, promote sperm production and maturation, improve sperm density and sperm vitality, so that sperm can gain motility and fertilization ability.
III. Total vas deferens anastomosis
”This technique adopts microsurgical vasectomy, which can quickly and efficiently unblock the blocked vas deferens, thus achieving the purpose of curing azoospermia. And this technology has a very high rate of vas deferens unblocking, so the cure rate for azoospermia is also very high.
Combination of Chinese and Western medicine therapy
The “combination of Chinese and Western medicine therapy” is mainly for infectious infertility and immune infertility and other infertility. For infectious infertility using anti-infection drug treatment or anti-microbial treatment technology and other combined Chinese and Western medicine treatment; for immune infertility, the use of Chinese medicine evidence-based treatment, immunotherapy, sperm washing technology and other methods. Combination of Chinese and Western medicine therapy is very effective for the treatment of many kinds of male infertility, and patients can choose with confidence.
Other methods
1, corrective intercourse techniques for oligospermia choose spouses around the ovulation period sexual intercourse, may improve the rate of conception. In cases where the semen volume is too high but the sperm concentration is low, the segmented ejaculation technique is used to remedy the problem, i.e. only the beginning part of the ejaculation is ejaculated into the vagina, because about 90% of cases have higher sperm concentration and better sperm vitality in the first 1/3 part of the ejaculation.
2, artificial insemination using the husband’s own semen for artificial insemination, in some cases of spermatozoa and weak sperm may result in pregnancy, but this method is more suitable for men with sexual disorders or genital malformations.
3, male immune infertility treatment, there are three methods to choose from.
Prevention
(1) Artificial insemination with sperm from a sperm donor;
(2) immunosuppressive therapy preferred adrenocorticosteroids, currently used in low-dose continuous therapy: prednisone (prednisone) 15mg / d for 3 to 12 months. High-dose intermittent therapy: methylprednisolone (medrol) 96mg/d for 5 to 7 days, one course of treatment per month. Or cycle therapy: prednisolone (prednisolone) 40mg to 80mg/d for 9 menstrual cycles on days 1 to 10 of the wife’s menstrual cycle.
(3) Sperm treatment: The antigens present on the surface of the sperm are removed by filtration or washing, and then artificial insemination is performed, which is expected to result in pregnancy. However, the results are not satisfactory because it is difficult to remove sperm surface antigens without damaging the sperm cells.
(4) Zinc supplementation: The physiological role of zinc in the human body is quite important. First of all, zinc is an important component of many enzymes necessary for a series of biochemical reactions in the body and has a significant impact on metabolic activities in the body. Zinc deficiency can lead to decreased taste and appetite, reduced nutrient intake, and affect growth and development. In recent years, zinc has also been found to influence pituitary gonadotropin secretion, promote gonadal development and maintain normal gonadal function. Spermatozoa are rich in zinc, a trace element that plays an important role in maintaining the reproductive function of male political parties. Because zinc is a necessary substance for sperm metabolism and can enhance the vitality of sperm, it is necessary to eat more zinc-rich foods such as oysters, shrimps, clams, shellfish, animal liver, pecan nuts, cow’s milk, beans, bran and lotus seeds. The zinc content of oyster meat is the highest among all things, so focus on intake helps sperm nucleic acid and protein metabolism, and can improve sexual performance. However, the amount of zinc should never exceed 15 micrograms per day, as overdosing can affect the role of other minerals in the body. 120 grams of lean meat contains 7.5 micrograms of zinc. However, the effect of dietary supplements varies from person to person and is not always very good. Therefore, it is important to choose a zinc supplement that is highly effective, easily absorbed and safe without side effects.
Prognosis and prevention
It is important to keep up with vaccinations and good personal hygiene habits to prevent various infectious diseases that endanger male fertility, such as mumps and sexually transmitted diseases.
It is important to acquire certain sexual knowledge, understand male physiological characteristics and health care knowledge, and if you find any changes in the testicles that are different from the usual ones, such as swelling, hardening, unevenness, pain, etc., you must seek timely medical treatment.
Strengthen exercise
If you are often exposed to radioactive substances, high temperatures and poisons, be sure to work in strict accordance with the operating rules and protective regulations, do not be negligent, if you want to have children in the near future, it is best to be able to get out of such work for six months before having children.
The testicles are a very delicate organ, its optimal working temperature is about 1 degree lower than the human body temperature, if the temperature is high, it will affect the production of sperm, so any factors that can raise the temperature of the testicles should be avoided, such as: long bike rides, hot baths, wearing jeans, etc.
Change bad habits, quit smoking and drinking; do not eat too greasy things, otherwise it will affect your libido; also pay attention to avoid contact with toxic substances in life, such as: take back clothes from the dry cleaners to place a few days before wearing, because the dry cleaning agent will affect the male sexual function.
To pay attention to the premarital medical examination, early detection of abnormalities, you can avoid the pain after marriage. After marriage, you should often communicate with your wife about the problems encountered in sexual life, cooperate and understand each other, so that many mental impotence or premature diarrhea can be avoided.
Health Tips
Infertility is closely related to diet. Moderate consumption of the following foods can help increase sperm count and improve sperm activity
1, animal offal. Animal offal contains more cholesterol, which is an important raw material for the synthesis of sex hormones, and animal offal also contains about 10% of adrenocorticotropic hormones and sex hormones, which can promote the division and maturation of spermatogenic cells. Therefore, moderate consumption of liver, kidney, intestines, belly, heart and other animal offal is conducive to improving the secretion of androgens in the body, increasing the number of sperm and promoting reproductive function.
2, food rich in arginine. Arginine is a necessary component of sperm composition, foods such as: eel, catfish, loach, sea cucumber, cuttlefish, octopus, silkworm pupae, chicken, frozen tofu, nori, peas, etc. Such foods help the formation of sperm and improve the quality.
3, it is advisable to eat food containing zinc. The body is indispensable for a trace element, it has an important role in the maintenance of the normal structure and function of the male reproductive system. The food rich in zinc are oysters, beef, chicken, liver, egg yolk, peanuts, pork and so on.
4, more food containing calcium food. Calcium ions can stimulate sperm maturation and improve male fertility. Such as shrimp, salted eggs, dairy, egg yolk, soybeans, kelp, sesame paste, etc. contain more calcium.