azoospermia
Introduction
Introduction to azoospermia Azoospermia refers to those who have not found sperm after multiple semen examinations (usually more than 3 times). Azoospermia accounts for about 15%-20% of male infertility patients. There are many causes, and they are divided into two categories. One is the dysfunction of the testis itself, called primary azoospermia or non-obstructive azoospermia. Second, the testicular spermatogenesis is normal, but due to obstruction of the insemination pipeline, sperm can not be excreted, called obstructive azoospermia. TCM syndrome differentiation analysis of azoospermia: azoospermia is due to congenital deficiency, weak endowment, loss of kidney essence, and loss of life; or due to acquired disorders, excessive damage, spleen loss, lack of blood; , , ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;; Dialectical identification first identifies the truth. Deficiency syndrome has kidney deficiency, often accompanied by loss of libido, impotence, premature ejaculation, waist and knees and so on. There is a lot of enthusiasm, often accompanied by normal or hyperactive sexual desire, testicular swelling and pain, blood essence and so on. The general rule of law is to fill the kidney with kidney, clearing heat and removing phlegm. The former is mainly for tonifying kidney and filling the essence, while the latter is mainly for clearing away heat and removing silice. basic knowledge The proportion of illness: 0.003% Susceptible people: male Mode of infection: non-infectious Complications: male infertility
Cause
Cause of azoospermia
Sperm production barrier (25%):
Hereditary diseases, autosomal or sex chromosome abnormalities affect testicular sperm production, such as Klinefelter syndrome; congenital testicular abnormalities, abnormal testicular development or abnormal testicular position can cause spermatogenesis disorders; testicular lesions, such as testes Trauma, inflammation, torsion and testicular vascular disease.
Endocrine and drug damage (15%):
Hypertrophy or hypopituitarism, pituitary tumors, adrenal hyperfunction or hypothyroidism, hyperthyroidism or hypothyroidism can affect sperm production and cause azoospermia. Severe systemic diseases and malnutrition can cause azoospermia. Radiation damage and drugs, especially cytotoxic drugs, cause damage to testicular spermatogenic cells and, in severe cases, azoospermia.
Obstructive azoospermia (20%):
The patient's secondary sexual characteristics, sexual desire, normal sexual function, normal testicular development, sperm production, but no sperm discharge due to obstruction of the vas deferens, including: congenital malformations, common epididymal head ectopic, epididymal tube atresia, vas deferens If or not developed; infection, gonococcal bacteria, tuberculosis and other bacterial infections can cause obstruction of the epididymis and vas deferens; cysts in the epididymis compress the epididymis tube to cause obstruction; damage causes obstruction of the vas deferens.
Prevention
Azoospermia prevention
First, abandon cigarettes.
Second, take medicine carefully: drugs that treat depression, malaria and certain sores can affect sperm production. Therefore, when you need to use those drugs, you should consult your doctor beforehand.
Third, to avoid intense running Fourth, rest time is not too long: rest and physical labor should be moderate.
Fourth, not long-term abstinence: If the genitals are often congested, the temperature of the scrotum will increase, resulting in decreased sperm motility. Therefore, it should not be abstinent for a long time.
Fifth, urinating at night: it will be good for sperm production.
Complication
Azoospermia Complications, male infertility
This disease is easy to cause infertility.
Symptom
Symptoms of azoospermia common symptoms male infertility
Except for infertility, there are no clinical symptoms and signs.
Examine
Azoospermia
1. Endocrine examination, serum FSH (follicle stimulating hormone), LH (luteinizing hormone), PRL (prolactin), T (testosterone), DHT (dihydrotestosterone) help to distinguish whether it is primary testicular failure or succession Testicular failure.
2. Testicular B-ultrasound can be found in testicular gross lesions, testicular biopsy can provide a more accurate diagnosis and treatment basis.
3. Semen check.
Diagnosis
Diagnosis of azoospermia
diagnosis
After the semen was centrifuged, the sediment was taken for microscopic examination. No sperm was found for 3 times, and the diagnosis was azoospermia. It is necessary to further clarify the cause.
At the time of physical examination, pay attention to the development of secondary sexual characteristics and the development of external genitalia. If the testicular volume is less than 10 ml, the texture is abnormally soft, often indicating poor testicular function, palpation should pay attention to epididymis, vas deferens with or without deformity, nodules and so on.
Differential diagnosis
Identification with oligozoospermia and dead sperm disease:
1. oligozoospermia: oligozoospermia refers to a disease in which the number of sperm in semen is lower than that of a normal fertile man. The International Health Organization stipulates that male sperm should be no less than 20 million per ml, if less than 2 thousand. Wan is classified as oligozoospermia.
2. Dead sperm disease: The sperm survival rate in semen is reduced. In the semen examination, more than 40% of the dead sperm are found to be dead sperm, also known as dead sperm, but due to improper inspection methods or not collecting semen according to normal methods, The increase in dead sperm caused by man-made, called suspended sperm, must be identified.
