According to the World Health Organization (WHO) estimates, there are 60-80 million couples suffering from infertility worldwide, and about 10-15% of couples in China cannot have children, of which male factors account for 40-50%. Due to the effects of environmental pollution, drug abuse, the prevalence of sexually transmitted diseases, and poor lifestyle habits, male infertility has gradually increased in recent years, and infertility caused by reduced sperm count, low vitality, and excessive dead sperm is very common, and the situation is worrying. Because the causes of male infertility are very complex, patients also feel distressed about the treatment of infertility, on the one hand, do not go to the regular hospital treatment, on the other hand, the eagerness to seek medical treatment, for the various tests are bored, just hope that the doctor to give two pills, next year will be able to give birth. Some other patients feel that they are sexually strong and physically robust and will not be infertile. It is clear that most patients still lack common sense about infertility as a disease.
Development of anti-sperm antibodies
When inflammation occurs in the male reproductive tract, such as prostatitis, seminal vesiculitis, vasovaginitis or viral infection of the testicles, or damage from trauma, high temperature, or chemical drugs, this is when the body becomes hyper-immune and produces a substance called anti-sperm antibodies, and the umbrella of sperm ——blood-testis barrier is destroyed. The sperm titer of the antibody at the time of examination is high, which has actually wrapped a layer of anti-sperm antibody on the surface of the sperm.
The sperm with anti sperm antibodies enters the female reproductive tract and prevents the union of sperm with the egg because the anti sperm antibodies can make it difficult for sperm to pass through the cervix by adhering to the cervical mucus, and can also inhibit the overall activity of sperm, making it difficult for sperm to penetrate various barriers and hindering the fusion of sperm with egg cells. Such sperm, even when united with the egg, can be difficult to consolidate, the result of which can affect the developing embryo or even lead to embryonic death and miscarriage.
Congenital Sexual Organ Anomalies
Some congenital anomalies of the sex organs are difficult to correct, but they can be corrected if detected in time and operated on early in childhood. However, due to the lack of knowledge or shyness to go to the hospital for examination, some patients miss the opportunity of treatment, resulting in reduced fertility or infertility.
Cryptorchidism is a common congenital organ abnormality in urology, that is, the congenital absence of testicles in the scrotum, which includes incomplete testicular descent and ectopic testicles. The most common clinical condition is incomplete testicular descent, which means that the testicle does not descend to the bottom of the scrotum after birth and stays somewhere on the way down, even including staying in the abdominal cavity. When the testicle stays in the abdominal cavity and is in relatively high temperature, the testicle growth is hindered and gradually atrophies, so that it cannot produce sperm and lacks fertility. What is more troublesome is that the chance of malignant tumor increases greatly when the testes stay in the abdominal cavity, and cryptorchidism causes 25 times more cancer than normal people. Therefore, cryptorchidism should be highly valued and corrected early. As long as parents pay a little attention to their children’s genitals and check whether their children’s testicles are two, it is easy to find out whether they are cryptorchid. Generally speaking, if they do not drop after 1 year old, they should go to the hospital for surgery.
Reminder: The testicle is a very delicate organ, and its main function is to produce sperm, and the spermatogenic cells that produce sperm have high requirements for temperature. It is afraid of high temperature and wants the temperature inside the scrotum to be relatively constant at a level slightly lower than the body temperature. If the temperature around it 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.
Abnormal vascular structure of the spermatic cord
Abnormalities in the vascular structure of the spermatic cord account for about 30% of infertility cases. The spermatic cord is located in the plexus of veins in the scrotum and groin of men, and is connected to the great vessels in the upper abdomen, and the blood supplying the testes needs to return to the great veins in the spermatic cord.
In clinical practice, varicocele is found in patients as young as 5-6 years old. In varicocele, the blood flow in the spermatic veins slows down and the local temperature of the testes increases due to stasis in the venous plexus, which affects sperm production. If toxins from the left renal vein flow to the testes, they cause testicular atrophy, leading to sperm deformities, decreased motility, and in severe cases, decreased sperm count and reduced fertility.
Anyone who has obvious symptoms of varicocele, or who has been infertile for a long time or has abnormal semen needs surgery regardless of the severity of the symptoms, and early treatment is the best. It is also important to choose a professional doctor to perform the surgery.
Reminder: In the early stage of the disease, patients often have no symptoms, but as the degree of varicocele increases, there will be a feeling of swelling in the scrotum, which is aggravated by activity, and in severe cases there will be pain. Patients have a feeling of swelling in the testicles after standing for a long time. Protect the testicles, have a regular sexual life, avoid indulgence, and do not soak in hot water for too long when bathing.
Hormonal abnormalities
Infertility due to hormonal abnormalities accounts for about 5-10% of infertility patients. High prolactin, follicular estrogen, and luteinizing hormone can lead to abnormal testicular development, affecting sperm activity and even causing impotence. In addition, pituitary tumors occur in some patients, and their secretion of pituitary hormones causing male hormone abnormalities can also cause male infertility. Pituitary tumors are common intracranial tumors, and their incidence has been on the rise in recent years. Patients with abnormal pituitary gland function and hormone secretion disorder can cause male infertility.
Reminder: Usually men with hormonal abnormalities will have a fat body, so infertile patients with a fat body can have their blood drawn to check whether their hormone levels are normal.
Reproductive tract infections
Infections cause male infertility in 50% of infertility patients. Infections of the male reproductive tract often cause orchitis, epididymitis, prostatitis, vesiculitis, urethritis, etc. The pathogens that cause genital tract infections include gonococcus, Mycobacterium tuberculosis, viruses, mycoplasma, Chlamydia trachomatis, and trichomonas, among which mycoplasma and chlamydia cause the most common genital tract infections.
All reproductive tract infections can affect sperm production, sperm vitality and sperm transport, and have a great impact on male fertility, but most patients are not aware of the seriousness of the infection, and often stop taking medication when their condition improves slightly during treatment. The problem is that it is not treated thoroughly and the condition is not cured.
Reminder: In recent years, the incidence of sexually transmitted diseases is increasing year by year, which not only makes the male genital tract infection high-risk group rapidly expanding, causing great harm to men’s health. Therefore, prevention and thorough treatment of reproductive tract infections is an important countermeasure to reduce the incidence of male infertility.
According to the World Health Organization, the three major diseases that threaten men’s health in the 21st century, in addition to cardiovascular diseases and cancer, the third biggest killer is urological male diseases. Male diseases are increasing at an annual rate of 3%.
In China, 25% of men have sexual dysfunction or psychological disorders, 10% of couples have infertility and infertility, and 6.5% of adult male patients. Male diseases are developing at a younger age: 52% of men over 40 years old have erectile dysfunction, and 90% of men over 60 years old experience prostate disease. What is more worrying is that 90 out of 100 patients with male diseases are unwilling to see a male doctor.
Now there are three major misconceptions about men’s health in society: one is that men’s health is only sexual health; the second is that men’s mental health is neglected; the third is that reproductive health is not very relevant to men or even irrelevant. At present, there is a serious shortage of male sexually transmitted diseases, male specialist medical institutions, a large number of patients do not receive formal treatment, many people do not have a basic awareness of health care and believe in the wandering doctors and false advertising; many male patients are missed, misdiagnosed, especially in the treatment of sexual function diseases and sexual aspects for the most. Bad living and eating habits, such as staying up late, alcoholism, spicy and salty food, are becoming more and more serious threats to men’s health.