Post Date December, 03 2023
Ejaculatory disorders
Typical ejaculation disorders lead to male infertility, including non ejaculation and retrograde ejaculation. At the same time, clinical findings show that low sexual function can also cause male infertility, such as premature ejaculation. Suffering from external genital diseases, such as congenital penile enlargement or hypospadias; Trauma of reproductive organs causes patients to be unable to ejaculate or even ejaculate in retrograde ejaculation, and semen cannot enter the female genital tract, leading to male infertility.
Obstruction of vas deferens
Obstruction of the vas deferens, which prevents sperm from combining with the egg, naturally leads to infertility. In clinical practice, diseases such as epididymitis, vasculitis, ejaculatory duct, and urethritis can all lead to dysfunction of semen delivery, resulting in obstruction of the vas deferens, affecting sperm excretion, and leading to male infertility.
Spermatogenic disorder
Sperm is the key to male reproduction, and if spermatogenesis is impaired, it can lead to male infertility. For example, male testicles are poorly developed, which may lead to difficulty in producing sperm in the testicles, leading to azoospermia; Local warmth in the testicles can also affect sperm quality. Men who wear tight pants for a long time, sit for work and drive for a long time, are also prone to male infertility.
Inflammation of the reproductive system
Inflammation of the reproductive system is also a cause of male infertility, specifically inflammation and damage to the reproductive system, which may lead to male reproductive disorders, non liquefaction of semen, or obstruction of the vas deferens, leading to infertility.
Hormonal abnormalities
Hormone abnormalities can cause male infertility. High prolactin, follicle estrogen or luteinizing hormone can cause testicular dysplasia, affect sperm activity and cause impotence. In addition, some patients may develop pituitary tumors, which can also lead to male infertility.
Abnormal structure of spermatic cord blood vessels
Abnormal vascular structure of the spermatic cord is one of the factors causing male infertility. The spermatic cord is usually located in the scrotum and the venous plexus in the groin of men, and it is usually connected with the large blood vessels in the epigastrium, which will cause the blood supply to the testes to return to the spermatic cord. When varicocele occurs, the blood flow velocity in the spermatic veins slows down, as congestion of the venous plexus can easily cause a local temperature increase in the testicles, which can easily hinder sperm production.
There are many factors that can lead to male infertility, and it is necessary to do a good job in examinations. So, what are the commonly used tests for male infertility?
1. Check for gonadotropins:
The determination of gonadotropins has important value in determining the functional status of the male hypothalamic pituitary gonadal axis. By observing the levels of follicle stimulating hormone, the degree of testicular development or damage can be understood. Under normal circumstances, the spermatogenic effect of the male seminiferous tubules is mainly promoted by the secretion of pituitary follicle stimulating hormone. Of course, this needs to be achieved when the androgen testosterone is normal, as there is insufficient testosterone in the blood, and even if the pituitary gland secretes normal follicle-generating hormone, there may be problems with its semen. In terms of simple testicular underdevelopment, the poorer the testicular development, the more obvious the obstacle to spermatogenesis, and the higher the follicle forming hormone value in the serum. In addition, the detection of luteinizing hormone and prolactin also has very important clinical value.
When the testicular spermatogenic function is impaired, the response of luteinizing hormone is significantly lower than that of follicle forming hormone. When chromosomal abnormalities and testicular atrophy occur, luteinizing hormone levels are also significantly higher in individuals with normal chromosomes. For male infertility patients with high levels of luteinizing hormone, it is suggested to consider whether the chromosomes are normal. The increase of prolactin will also lead to male infertility. Testis atrophy, decrease of sperm number and decrease of sperm motility are common.
2. Conduct special project inspection:
Anti sperm antibody test. People who are positive for anti sperm antibodies often have other problems at the same time, and some are also closely related to this positivity. For patients with extremely poor sperm quality, low sperm count, and a large number of abnormal sperm, although the possibility of chromosomal abnormalities is ruled out, anti-sperm antibody testing must be carried out, because positive anti-sperm antibody itself can completely lead to this, and positive anti-sperm antibody may also be accompanied by other problems. For example, about 70% of people with positive anti sperm antibodies are also infected with ureaplasma urealyticum, which is one of the important reasons for infertility. In some cases where pathogenic microorganisms, including ureaplasma urealyticum, are positive in semen, there is a significant increase in the content of anti sperm antibodies in semen.
Whether it is anti sperm antibodies or ureaplasma urealyticum, they are the "enemies" of sperm quality. In patients infected with Ureaplasma urealyticum, the positive rate of anti sperm antibodies is much higher than in normal non infected individuals, indicating that male Ureaplasma urealyticum infection is a trigger for the production of anti sperm antibodies. If a patient is positive for anti sperm antibodies, further examination for Ureaplasma urealyticum should be conducted. If a positive result is found, treatment should be given simultaneously.
