In recent years, with the continuous development of industrialized society, the gradual deterioration of environmental pollution, and the further intensification of social competition, infertility has been growing year by year. According to statistics, infertility accounts for 10-15% of couples of childbearing age.
This not only affects the harmony of couples and family happiness, but also affects the harmony and stability of society. For a long time, due to historical limitations, there is a great misunderstanding of infertility, which used to be attributed to the female side of the problem, completely ignoring the male factor. In recent years, due to the development of science and technology, people have gradually realized that the male partner accounts for 50% of the many factors of infertility.
Due to the complexity of the fertility mechanism, male and female factors are equally divided, and different couples have different reasons. Therefore, China’s first post-doctoral doctorate in Chinese and Western medicine, Professor Jin Baofang pointed out that infertility must be out of the diagnosis and treatment of misconceptions, as far as possible to identify the causes and take targeted measures, in order not to take detours, less detours, as soon as possible to achieve the purpose.
1. Normal sexual function does not mean normal reproductive function
Because of the peculiarities of female anatomy and physiology, many women will have more or less gynecological discomfort, coupled with the historical subordination of women, so many men will be the cause of infertility attributed to the female, a reason for men to cheer up is “I’m fine, I have no problem”.
Male sexual function and reproductive function are two completely different concepts, two separate and completely different mechanisms, and it is obvious that many men who have given birth have sexual dysfunction, right? On the contrary, patients with azoospermia have a strong sexual desire, normal erections, normal ejaculation during intercourse, but no sperm in the semen.
2, there is a history of pregnancy and childbirth, does not mean that there has been fertility
There have been infertility couples for many years, has been seeking female consultation, the reason is even “my husband has no problem, his past girlfriend has been pregnant many times” or “my husband had a child in his first marriage”. Experts remind, infertility is divided into primary infertility and secondary infertility, the so-called secondary infertility is the history of fertility and conception history and now can not make the woman pregnant.
In the past, the normal fertility, after many years of azoospermia is also found in the clinic. In one case, a male patient from Anhui province, who had impregnated 3 girlfriends before the age of 25, was infertile for 5 years after marriage, and was found to have a deficiency in the spermatogenesis gene. Most of these people are congenitally spermless or have severe oligospermia, weakness or teratospermia, but experts speculate that although this person has a spermatogenesis gene deficiency, there is still a spermatogenesis compensatory function in the body, and this compensatory function is lost after a certain age, so it is naturally impossible to have children after getting married at the age of 25 and having no sperm.
3.The routine semen examination cannot fully reflect the fertility function
Many women seeking treatment for infertility often indicate that all tests on the male partner are normal and it must be my problem. And the normal in the mouth of many patients is only the normal semen routine analysis. Due to the delayed development of male science, most hospitals do not have a specialized male establishment or corresponding examination equipment, and most hospitals are only able to carry out routine semen examination.
In fact, there are many indicators that affect male fertility, in addition to semen routine, sperm function, immune factors (mainly anti-sperm antibodies), chromosomes, etc. are decisive factors, any of which is a problem, when the semen routine check is completely normal, it is also impossible to have children.
4, less, weak sperm is not absolute infertility
Male infertility is also divided into absolute infertility and relative infertility, many men once or more check, determined to be less, weak sperm, they insist on treatment, while ignoring the possible existence of (female) absolute factors, wasting time and money. Theoretically, as long as there is a morphologically intact and well-moving sperm, it is possible to get pregnant, only with less chance. However, it is still possible for the average patient with low or weak spermatozoa to relax and increase the chances of conception. By improving the sperm condition through treatment, of course, the chance of pregnancy will be greatly increased.
But never see the disease treatment, and ignore the female party further examination there is a patient in northern Jiangsu, 9 years after marriage, due to oligo- and weak sperm treatment for 7 years, footprint almost all over China, sperm condition is not much improved. At the initial consultation, the female partner agreed to the examination only at the strong request of the specialist. The results showed that the female partner had bilateral fallopian tube incompetence. The male partner not only wasted 7 years of time and money for nothing, but the mental stress almost broke him. So when the expert gave him a full analysis, the man bawled his eyes out.
5, fully consider the woman’s fertility status, choose the right way to have children
According to the latest research data, a normal couple, the monthly chance of pregnancy is only 20-25%, the annual chance of pregnancy is about 85%, and for women at the age of 35, the chance of pregnancy than 25-year-old women fell by half, to the age of 38 fell by another half. Whereas in the past it was thought that a woman had the possibility of becoming pregnant as long as she had normal menstruation, recent studies have shown that a significant percentage of women, 7 or 8 years before menopause, have already lost their reproductive function.
It is very important for male doctors to master the fertility pattern of women and to establish the rules of treatment for different infertility couples. In the above mentioned couple in northern Jiangsu, the male partner had mild oligospermia and weak spermatozoa and the female partner had bilateral proximal incompetence of the fallopian tubes. Although it is said that the tubes can be recanalized through imaging access technology (recanalization rate can reach more than 90%), the natural pregnancy rate is only about 35% and the chance of ectopic pregnancy is 5-6 times higher than normal, not to mention that the female partner is 37 years old. In view of this situation, experts recommended direct IVF, which resulted in a successful outcome.
6. Azoospermia is not a sure thing
Since the world’s first IVF case was born in 1978, assisted reproduction techniques have been widely carried out, allowing many patients with severe oligospermia, weak sperm or even azoospermia to have the opportunity to have their own offspring.
However, not all patients with azoospermia have this opportunity. First, further tests should be performed to determine if there are chromosomal abnormalities? Is there a deletion of the spermatogenesis gene? Is it obstructive azoospermia? After it is determined that IVF can be performed, it should also be actively treated in order to obtain more and more qualified sperm through epididymal or testicular puncture for the maximum success rate of IVF.
7. Unknown cause is not incurable
As we all know, the treatment of any disease should be clear about the cause, then we can take targeted treatment to achieve satisfactory results. But because of the late development of male science, basic research is insufficient, and even disconnected from the clinical, many male infertility can not find the absolute cause, which brings great inconvenience to the treatment, but also to the community of some completely from their own interests of bad hospitals and bad doctors to take advantage of the opportunity.