Awareness of male infertility and standardization of diagnosis and treatment

  The global incidence of male infertility is increasing every year due to the decline in human sperm quality management. However, the causes are unknown due to the lag in basic research, while the vigorous implementation of reproductive technologies (ART) has also hindered the conventional treatment of male infertility.  I. The exploration of the field of male reproduction has gradually deepened and it was found that genetic abnormalities have always been the biggest obstacle to effective treatment of male infertility, and researchers from various countries have now discovered that mutations in genes such as tRNA may be associated with low sperm motility. Therefore, stem cell technology, that is, the transformation of stem cells into germ cells, has gradually become a hot spot for solving male infertility.  (a) Accurate understanding of the definition of infertility and male infertility The definition of male infertility: regular sexual cohabitation for 1 year without fertility, the cause of which is the male partner. Special emphasis is placed on the rationale for defining the duration of infertility as 1 year because after 1 year the couple will have a significantly lower rate of spontaneous pregnancy, a significantly higher probability of receiving infertility treatment, and a significantly higher probability of reproductive dysfunction. Studies have shown that men who do not achieve natural fertility within the first year of marriage have a 50% natural pregnancy rate in the second year of marriage and a 5% rate after 5 years.  It is important to note that, in theory, fertility may still exist in patients with low fertility. The concept of “infertility” should be relative sterility. Because the probability of spontaneous pregnancy in untreated couples with low fertility is 20-40% after 2 years, the existence of infertility can be largely clarified only after adequate examination of both partners.  The vast majority of infertile couples still have a probability of natural pregnancy, and male factor sterility or male infertility cannot be simply defined with a one-sided understanding of the terminology.  (ii) Comprehensive understanding of the interplay of male infertility The diagnosis of male infertility is often difficult and requires a comprehensive evaluation that includes female related conditions. Infertility is a matter for both partners, not a single individual problem, so the diagnosis of “male infertility” should not be made lightly, but should be referred to as “infertile couple”.  (The first thing you need to do is to take a look at the results of the semen analysis. It should be understood that a serious abnormality in the semen analysis can only indicate that the male is more likely to be a factor that has a greater impact on infertility and can indicate the extent of the condition, but cannot give a diagnosis of the cause. It is important to note that semen analysis results can predict fertility potential. However, in no case can they be directly related to whether or not to have children, but only to inform their probability of fertility.