A large part of infertility clinics are for patients with low spermatozoa, and patients ask a lot of different kinds of questions. I often give patients a not very appropriate metaphor, normal sperm is like a thousand horses (and all are elite soldiers) across a log bridge, and finally one or two rushed to the other side of the victory. The sperm with oligospermia is like a defeated soldier, just like the old and weak, the number is small, walking hard, as you can imagine, it is difficult to go to the other side of the victory. 1, which reproductive system diseases can lead to oligozoospermia? According to the different links affecting male fertility, male sperm quality abnormalities can be divided into pre-testicular factors (endocrine factors), testicular sexual factors (chromosomal and Y chromosome abnormalities, cryptorchidism, mumps orchitis, varicocele and other etiologies causing testicular damage and post-testicular factors (history of urological surgery, medically induced vasectomy, seminal vesiculitis, etc.). There are also some systemic diseases, high fever, uremia, chronic liver disease, etc. Among them, endocrine factors, chromosomal abnormalities and cryptorchidism are the main causes of testicular spermatogenic disorders. 2, prostatitis can lead to less weak sperm? The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The actual tadpoles that are not fully hatched are not able to swim on their own. We also encounter patients who have their semen frozen, and the sperm is inactive after deep freezing, and only regains its vitality after thawing. The sperm quality of patients with cryptorchidism can be normal, depending on the ability of their testicles to produce sperm, for example, the testicles of patients with cryptorchidism are small, equivalent to the small size of the factory, poor production capacity, the number of products made is less, and the quality is relatively poor. 4, urethral obstruction, cystitis and other urinary system diseases can lead to less weak sperm? Some patients with ejaculatory duct cysts can cause oligozoospermia because they block the ejaculatory ducts, simple cystitis will not lead to oligozoospermia, some patients with retrograde infections can affect sperm abnormalities if they are followed by orchitis and epididymitis, for example, some factory drains do not flow back into the factory, leading to The factory is contaminated, which affects the quality of products produced in the factory (testicles). 5.What endocrine diseases can cause oligospermia, diabetes and hyperthyroidism? Endocrine abnormalities are mainly caused by pre-testicular factors. The main ones are hypothalamic-pituitary lesions and fertility-related hormone abnormalities. Hypothalamic lesions include idiopathic hypogonadotropic hypogonadism, Kallmann’s syndrome (general azoospermia), selective LH deficiency syndrome (fertility azoospermia syndrome) and selective FSH deficiency syndrome, etc. Pituitary lesions include pituitary insufficiency, hyperprolactinemia, hemochromatosis, etc. Fertility-related hormone abnormalities The main hormonal abnormalities include androgen abnormalities (exogenous supplementation or tumor-induced androgen excess, congenital androgen synthesis deficiency, androgen conversion to dihydrotestosterone abnormalities and androgen receptor abnormalities), exogenous estrogen increase, thyroid hormone abnormalities and glucocorticoid excess, and some patients with chimeric Creutzfeldt-Jakob syndrome can manifest as oligospermia. Patients with hyperthyroidism may show hypoactive libido and decreased sperm motility, and temporary decrease in sperm count and motility after iodine 131 treatment. Diabetic patients with stable blood sugar generally do not affect sperm quality, diabetic patients with poor blood sugar control, some complications, severe lesions patients with disorders of glucose metabolism, affecting the testicular factory manufacturing sperm, equivalent to the factory’s energy system malfunction, sperm need insufficient energy, affecting sperm vitality, disorders of glucose metabolism can also lead to impaired synthetic testosterone, which can cause a decline in sperm quality and quantity. 6.Does impotence and premature ejaculation cause oligozoospermia? There is no direct link between impotence and premature ejaculation and spermatozoa. Some studies have shown that drugs such as sildenafil (Viagra), pharmacologically speaking, can promote sperm capacitation and improve sperm vitality, and the use of antidepressants (sertraline or citalopram) for premature ejaculation can cause a decrease in sperm count. 7. Can masturbation, too frequent sex or too little sex cause low sperm count? There is no direct connection between masturbation itself and weak spermatozoa, but too frequent masturbation can lead to prostate congestion, resulting in chronic prostatitis, and some patients can cause changes in sperm quality, and too frequent or too little sex and weak spermatozoa are not directly related, but the time frame for semen testing is 48 hours to 7 days after intercourse or ejaculation, and less than 48 hours after the test, the test results may be less weak spermatozoa. 8.What occupations are likely to cause oligozoospermia, and will they improve after I stop engaging in them? Exposure to high heat occupations (e.g. welding and ceramic industries), radiation (X-rays), heavy metals (lead), ethylene glycol, pesticides, etc. can cause oligozoospermia, and whether it will get better after stopping will depend on assessing the spermatogenic function of the testes, and if irreversible damage is caused, sperm quality will be difficult to recover. Sperm are afraid of heat, very fragile, just like tadpoles, need a suitable temperature, clinically encountered a patient, went to Africa, got malaria, repeated high fever, later found out severe oligozoospermia, so in order to protect your delicate sperm, avoid wearing thermal underwear, try to avoid sauna or hot tub. 9.Which drugs can cause oligozoospermia and whether sperm quality will recover quickly after stopping the drugs? (1) Immunosuppressive drugs: The effect on fertility is related to the type of drug, dose and duration of use. These drugs include cyclophosphamide, vincristine, adriamycin, scramblomycin, azulenimide, nitrogen mustard, procarbazine hydrochloride, cisplatin and etoposide, mainly for patients with malignant tumors, which are required for chemotherapy, so semen freezing can be performed before chemotherapy. (2) Antihypertensive drugs and drugs acting on sympathetic nerves: these are mainly patients with hypertension, most of them mainly impair sexual function. beta-blocker Tamsulosin can affect libido and erectile function; Ativan affects fertility by affecting erectile function and libido and potential impact on semen quality; calcium channel blockers can inhibit the normal fertilization process. alpha-adrenergic receptor blockers phenazopyridine, prazosin The alpha-adrenergic receptor blockers phenazopyridine, prazosin, tamsulosin, etc. can interfere with semen discharge, thus causing sperm retention in the caudal epididymis. (3) Sex hormones: Antiandrogenic drugs affect the normal physiological function of androgens in the body (decreased libido and spermatogenic disorders) and cause fertility problems. More and more athletes abuse anabolic steroids, such as large amounts of anabolic androgens can lead to low gonadal function with low gonadotropins, and in most cases normal gonadal function can be restored after stopping the drug. (4) Other drugs: some antibacterial agents such as neomycin, erythromycin, gentamicin, etc. may cause a decrease in semen quality. Colchicine and allopurinol for the treatment of gout also have an adverse effect on male fertility. Furacilin, cimetidine, salazosulfapyridine, cocaine, nicotine and cannabis can impair spermatogenesis, but spermatogenesis and/or sperm function can return to normal after cessation of the drug. Lyuzosulfapyridine can affect late sperm maturation. Generally, sperm quality can be restored and successful conception can be achieved after stopping the medication for 2-3 months. 10. How to confirm which of the many causes is responsible for oligozoospermia? To confirm which one is the cause of oligozoospermia, we have to make a comprehensive judgment based on the clinical aspects. 11. Is it necessary to identify which is the main cause of oligozoospermia in order to treat it? Sometimes it can be difficult to determine which is the main cause, and only one can be identified and removed.