Post Date April, 15 2023
Inspection method 1: Perform a special item test: 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. Clinical studies have found that 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.
Inspection method 2: Analyze chromosomal factors: When the number of sperm is too low, the motility is too low, there are a large number of abnormal sperm, or there are no sperm at all, chromosomal issues should be considered. If a male has underdeveloped secondary sexual characteristics or sexual dysfunction with feminization, an average volume of less than 10 milliliters on both sides of the testicles, higher levels of follicle growth hormone, or if the testicles are developing normally and the secondary sexual characteristics are developing normally with very little or no sperm, further examination of the autosomes should be conducted. The common chromosomal abnormality is 47, XXY type. Once confirmed by examination, there is no need for treatment because treatment cannot be effective. Inspection method 3: Check for gonadotropins: Measurement of gonadotropins is of great 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.
(Intern Editor: Huang Jiazhen)
