“Little Li, you’ve been married for three years, when are you going to have a baby?” “Xiao Li, you should have a baby when you’re young, it’s not good for the kids or the adults when you’re older.” “Li, take this is the secret recipe I want, take the package you have a fat baby!” During the Spring Festival this year, Mr. and Mrs. Li’s seven aunts and eight aunts bitterly persuade the two people to give birth, in fact, the couple is also anxious to go to the hospital to check out the results of the husband’s sperm Lee has a problem, the worse is that after many rounds of tests, have not been able to find out the cause of the disease clearly. As a matter of fact, these patients are not few, and it is estimated that more than two-thirds of them cannot find the causes of poor sperm quality that are clearly identified by the World Health Organization (WHO). However, not finding the cause does not mean that there is no cause, human spermatogenesis has more to do with inborn factors, it is like some people are born with strong bouncing ability, some people are born to do things slower, so the treatment is greater, the European urology guidelines even pointed out that there is no recommended drugs. Should we just give up on treatment and go for IVF? The good news is that even bouncing ability can be improved with some training. After a period of treatment, Li’s semen quality has improved significantly, want to know how Li was treated? First, the hormone regulation Many patients hear hormone will hear “radical” color change, worried about whether the side effects are very big ah? In fact, the current treatment is mainly hormone regulation rather than the use of hormones themselves. Commonly used drugs are: clomiphene citrate, tamoxifen, etc., many male compatriots to get these drugs to view the manual is very puzzling, clearly written that this is an anti-estrogen ah and the treatment of women’s diseases, how to the men used, is it the doctor prescribed the wrong medicine? Don’t worry, see below to tell you the principle of the role of this drug. 1, anti-estrogen drugs anti-estrogen drugs is the treatment of idiopathic oligospermia is one of the most commonly used drugs. These drugs promote the secretion of gonadotropins by the pituitary gland by blocking the negative feedback inhibitory effect of estrogen, which in turn increases the levels of FSH and LH in the serum and stimulates the production of testosterone in the mesenchymal cells, which is conducive to the production of spermatozoa. However, sex hormone levels need to be checked regularly during the medication period to ensure the effectiveness of the medication. Meanwhile, testosterone levels are within the normal range, once testosterone levels are too high will inhibit spermatogenesis. Anti-estrogenic drugs are commonly used in the treatment of idiopathic male infertility, partly because they are relatively inexpensive, and partly because they are a safe drug to take orally. However, it is necessary for clinicians to grasp the indications for the use of medication, do not self-medicate arbitrarily, and is not applicable to a longer period of treatment. 2, aromatase inhibitors These drugs have the effect of inhibiting the conversion of androgens into estrogens, thereby increasing testosterone levels and promoting sperm maturation and increased sperm count. Some scholars use aromatase inhibitors to treat idiopathic male infertility patients with low T/E2 ratio, after correcting the T/E2 ratio with the drug, semen quality was significantly improved. A randomized, placebo-controlled study has also shown that this type of drug therapy is not considered helpful in improving semen quality. Clinical options include anastrozole and letrozole, which are more expensive than the previously mentioned clomiphene, and clinical indications need to be taken into account. Through the control of the indications of male doctors and sex hormone monitoring, many patients with idiopathic oligospermia have significantly improved sperm count, while the use of hormone regulation therapy under professional guidance can ensure the safety of the drug. Second, antioxidant treatment This is a term that is often heard, including in many women’s beauty treatments. So why is antioxidant therapy also beneficial to sperm? Sperm being a living cell in the body, isn’t it easier to think of it like the skin cells on your face? Excessive oxygen free radicals (ROS) in semen can damage sperm through oxidative stress leading to lipid peroxidation, while antioxidants in seminal plasma have the ability to scavenge ROS, which prevents sperm damage. Based on this principle, clinical oral administration of antioxidants may reduce oxidative stress damage and improve male fertility. Vitamin E and vitamin C are well recognized antioxidants with important roles in the treatment of dyszoospermia and poor semen fluidization. Vitamin E has been extensively documented for the treatment of idiopathic male infertility. Sperm density, sperm motility and percentage of normal morphology spermatozoa can be increased by vitamin C treatment. Coenzyme Q10, another antioxidant, has also been used in clinical treatment. After treatment with coenzyme Q10, patients showed significant improvement in sperm density, viability and sperm morphology, decreased serum FSH and LH levels and increased acrosome reaction. Acetylcysteine also has a strong antioxidant effect, acetylcysteine daily oral 600 mg, after 3 months of continuous use of the drug, can increase the patient’s semen volume and sperm viability, reduce the semen viscosity, but on sperm density and the percentage of normal morphology of sperm did not have a significant improvement in terms of spermatozoa. See here, is not the urge to immediately go to see if the wife’s mask contains the above ingredients. Third, other types of drug treatment 1, levocanidin In the human body, levocanidin is a derivative of lysine by methylation and further modification of the epididymis for the secretion of the substance, mainly in the form of free state and acetylation. It is secreted by the epididymis and exists mainly in free and acetylated forms. It increases sperm energy and enhances sperm viability during sperm transport by the epididymis, and also has a certain antioxidant capacity to prevent oxidative damage in order to protect spermatozoa. Currently, levocanidin is widely used as a nutritional additive in the clinical treatment of idiopathic male infertility. Some patients and friends will express disdain when they hear about nutritional additives, thinking that such treatment is only a supplement. But in fact idiopathic oligospermia is not a disease, because there is no clear damage ah. Enhancement of substances conducive to spermatogenesis and reduce sperm apoptosis, are conducive to improving semen quality. 2, Hexetone Theobromine is a methylxanthine derivative, as a non-selective phosphodiesterase inhibitor, can block the conversion of cAMP to AMP, increase cellular glycolysis and ATP production. The initial use of hexoketone colchicine in male infertility patients was based on the potential of this class of drugs to improve the testicular microenvironment and promote sperm metabolism and other functions. A recent study found that sperm density, viability, percentage of normal morphology sperm and acrosome reaction were significantly increased in patients treated with hexoketone theobromine 400mg orally twice daily for 24 weeks. 3.Other Other empirical drug treatments include: zinc/selenium supplementation, thyroxine, arginin, and so on. However, if the patient is not deficient in these substances, then these medications are less effective or have no therapeutic effect. Idiopathic male infertility has a higher coefficient of difficulty in treatment due to its unknown etiology, and medications should not be used for less than 3-6 months so that a complete spermatogenesis cycle is covered. Better results can often be achieved by combining medications. How to control the principle, dosage and duration of medication needs to be based on the doctor’s clinical experience, just like the use of traditional Chinese medicine is also a kind of empirical treatment. Experienced doctors can better control the medication, but still need to be linked to assisted reproduction technology at the right time.