Post Date December, 03 2023
Azospermia is simply defined as the absence of sperm in the semen. So, what are the characteristics of semen in patients with azoospermia?
Semen volume can reflect the secretion of male hormones by the testis and the functional status of the accessory gonads. Congenital abnormalities or dysfunction of the seminal vesicle and prostate can lead to a decrease in semen volume. In our study, it was found that the endocrine hormone levels of semen with lower than normal semen volume were mostly characterized by high levels of prolactin (PRL), follicle stimulating hormone (FSH), and luteinizing hormone (LH). During color Doppler examination, abnormalities such as seminal vesicles, small seminal vesicles, testicular sheath effusion, varicose veins, and epididymal cysts were mostly found. The attending physician at the Infertility Diagnosis and Treatment Center of Jiashi Hengxin Andrology Hospital said that the semen volume of azoospermia can also explain hyperprolactinemia and hypergonadotropin secretion and hypogonadism to a certain extent.
In addition, congenital absence of seminal vesicles, epididymis lesions, and obstruction of the vas deferens lead to a decrease in semen pH; In acute epididymitis, prostatitis, and seminal vesiculitis, PH>8.0. In our study, it was found that the detection of elastase content in semen with pH>810 indicates infection; At the same time, the Doppler examination of patients with azoospermia whose semen is characterized by pH<710 shows whether there are seminal vesicles! Abnormalities such as cysts or varicose veins in the epididymis. Therefore, the volume and pH value of semen in patients with azoospermia can reflect the development and function of male gonads and accessory gonads, which is of great significance in analyzing the etiology of azoospermia and should be highly valued.
The biochemical examination of semen in azoospermia is an analysis of the secretory function of the prostate, seminal vesicle, and epididymis. "Semen fructose is mainly produced by the secretion of seminal vesicles. In patients with congenital azoospermia, or azoospermia caused by the development of vas deferens or seminal vesicles, fructose is zero or trace, and the volume of semen is also low.". In patients with simple vas deferens obstructive azoospermia, the fructose content is normal. In our study, we found that in azoospermia patients with fructose lower than normal, color Doppler routine physical examination was mostly characterized by abnormal or absent seminal vesicles. At the same time, we also found that the fructose content of azoospermic patients with high serum levels is significantly higher than the reference value. Buckett et al. believed that this may be related to the reduction of fructose metabolism in azoospermic patients, and it is more likely that azoospermic patients increase the fructose product of the seminal vesicle.
Obstructive azoospermia is mainly caused by obstruction of the vas deferens due to the absence or abnormality of the accessory gonads and infection. In male genital tract infections, the elastase secreted by lobulated granulocytes in the extracellular seminal plasma during anti-inflammatory reactions such as phagocytosis of pathogens has been recognized for its reliability as a diagnostic and prognostic indicator for static genital tract infections. Our experiment found that elastase content was reflected in infected cases, and color Doppler examination showed that most cases were orchitis, testicular sheath effusion, and epididymal cysts.
