The ancient and modern areas 丨 Preparation for many years can not be pregnant. What examinations are essential for men?

Author:Guangdong Provincial Hospital Time:2022.07.26

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[Ancient and Men's and Men] It is a science popularization issue organized by the male department of the Traditional Chinese Medicine Hospital of Guangdong Province. Protection.

Mr. Zhang has been working hard for more than two years, and his wife's belly has not been seen. After evaluating the reproductive clinician, the woman believed that her fertility ability was not obviously abnormal. Caused infertility. Then he was diagnosed with Professor Yuan Shaoying, Master Yuan Shaoying, Zhuhai Hospital, Guangdong Province. After passing the physical examination and inquiring the medical history, Professor Yuan Shaoying allowed him to improve the semen -related examination and the scrotal color ultrasound. Weak sperm.

Then he arranged for his hospitalization to go through the microscopy lyric venous ligation, and based on the trial -based mode (dislike -dialectical -identifier -discrimination) at different periods of postoperative treatment: within January after surgery: based on "stasis and heat interoperability, consuming injury, consuming injuries, consuming injuries, consuming injuries, consuming injuries "Qi Yin" theory gives experience recipes and custody and orally; after January after surgery: Based on the theory of "lack of kidney essence", the experience recipe Yiyi Kidney is the main prescription. After April, his wife was pregnant and sent a flag for gratitude.

Evaluate male fertility, what are the must -check items? Evaluate male fertility, the most direct method is semen -related parameters. There are mainly the following points:

1. Multi -parameter analysis of semen

2. Sperm low osmosis swelling test

3. Special stain sperm morphology detection

4. Spermotase activity measurement

Today, I will give you the true face of the above projects.

Semen multi -parameter analysis

The main points of the multi -parameter analysis of semen are: semen volume, total sperm, sperm concentration, sperm vitality, sperm form. The latest sixth edition (promulgated in February 2022) The semen -related parameters of the World Health Organization semen inspection manual have changed from the fifth edition (2018 version), and the reference range has changed.

details as follows:

Life is like a marathon, and when millions or hundreds of sperm see a egg in front of them at the same time, there must be a speed of 100 meters to get priority to get the only chance to embrace (fertilization) with eggs. Although the sperm that can't be moved is only close to the egg, it can only be separated by the end of the world. So the vitality of sperm is especially important. However, if you want to approach the eggs, the speed of 100 meters sprint is not enough, because the eggs are still around the two city walls (the outermost layer is called radiation crown, and the inner layer is called transparent belt). Cell membrane. After experiencing layers of danger, you have the opportunity to enter the inner heart of the egg (combined with ejaculation). And most of the sperm have been exhausted in place before they pass through the two layers, so the total number and concentration of sperm will be too low, and it will be difficult to have the opportunity to combine sperm eggs.

Sperm hyponidity swelling test

Low -osmotic swelling test is a method used to detect sperm survival. Add the expansion solution to the semen specimen. After a series of treatment, the percentage of the sperm sperm is observed under the high -power microscope, which is the sperm survival rate. Only living sperm can approach the eggs and give birth to life. Therefore, it is also an important indicator of maternity inspection.

Special stain sperm morphology examination

After special dyeing, the deformed rate is calculated to observe the sperm head size, the proportion of sperm head and body. Deforming sperm is like a person's appearance, which is an external expression of internal abnormal genetic information (excessive sperm DNA fragment rate, chromosomal abnormalities, etc.). Therefore, sperm with high malformations usually means the overall quality deviation of the sperm and low fertilization rate.

Spermotase activity detection

Spermotase is a protease of the sperm head. The process of sperm through many obstacles (the outermost layer is called radiation crown, and the inner layer is called transparent belt) is called the top body reaction. It is necessary to rely on the continuous effect of topdocytes. Therefore, topdocytes play an important role in the process of fertilization. The clinical sedential veins and reproductive tract inflammation can affect the activity of sperm tidal enzymes.

Other ways to evaluate fertility inspection

In addition to the above -mentioned basic items, there are some optional inspections. When the above -mentioned initial screening, the semen is abnormal, eliminating its own bad living habits, age, and environmental factors, it may also need to further improve other examinations and try to understand the causes, such as reproductive tract inflammation, varicocele, chromosomal abnormalities, and Y chromosome micro Lack, genetic mutations, etc.

(1) Chlamydia, chlamydia, bacterial culture, leukocyte peroxidase, etc. to understand the inflammation of the reproductive system;

(2) Cathery color Doppler ultrasound examination to understand whether there are exact varicose veins;

(3) For repeated abortion, infertility and other conditions after excluding the female infertility factors, it is necessary to further improve the sperm DNA fragment rate check;

(4) For spermatozoa, severe sperm disease, etc., the chromosome nucleus type, Y chromosome micro -lack examination, sex hormone examination, inhibitory B, zinc, fructose, neutral alpha glycosidase, etc.

There are many factors that affect or cause male infertility. In addition to the urogenital system, the lesions of other systems of the whole body may also affect fertility and require comprehensive analysis.

【Precautions for Semen Collection】

1. Before the specimen is collected, abstinence should be abstained for at least 2 days, but not more than 7 days. In order to avoid the fluctuations of the semen examination, the number of days of abstinence before each examination is as fixed as possible.

2. The collection of specimens is best to be carried out separately in the spermatic room near the laboratory. Pick up at home and send it to the laboratory within half an hour after the collection.

3. If it is difficult to get essence of masturbation, semen can be collected with a special condom. Daily latex condoms affect the survival rate of sperm and should not be used for semen collection. 4. The sexual intercourse interruption method should not be used to collect semen. Because the initial part of ejaculation may be lost, and this part of the sperm density is often the highest. Moreover, the specimen will be contaminated by bacteria and microorganisms; at the same time, acidic vaginal secretions will adversely affect sperm vitality.

5. Semen collection must be complete, and incomplete semen should not be analyzed.

【Men's Preparation Guide】

Although medicine is increasingly developed, 60%of patients with infertility are still found to be found. So daily maintenance is more important. The husband and wife are preparing for pregnancy, the precautions are as follows:

1. Do not smoke, drink, stay up late during pregnancy, avoid unclean diet.

2. Folic acid can increase the number of sperm and sperm. During pregnancy, you can strengthen foods rich in trace elements such as zinc, selenium, and folic acid, such as nuts.

3. During pregnancy, actively exercise physical exercise and enhance physical fitness.

Professor Yuan Shaoying

Vice Dean of Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, famous Chinese medicine medicine in Guangdong Province, doctoral supervisor, chief physician, instructor in Guangdong Province. Deputy Chairman of the Chinese Medicine Society of Chinese Medicine Society; vice president and secretary -general of therology branch of the Chinese National Medicine Society; chairman of the Chinese and Western Medicine Integrated Branch of the Chinese Medical Association; Deputy Chairman of the Chinese Medicine Association Organization Drug Research Committee; Chairman of the Men's Professional Committee of the Provincial Chinese Medicine Society. Create "Yu Jing", "Tong Jing" and "Clear Essence" series of male disease prescriptions. Inheriting and innovating ancient acupuncture techniques, the first orcstal disease acupuncture treatment is routine. He is good at combining modern andrology new technologies with traditional Chinese medicine therapy to push traditional Chinese medicine andrology to a new height.

Good at:

Traditional Chinese medicine, acupuncture, physiotherapy, and psychological therapy are combined with various male diseases, infertility, prostate diseases, sexual dysfunction, andr's miscellaneous diseases.

Disposal time:

All day, Thursday, and Friday, on Thursday morning, Saturday morning (Zhuhai Hospital)

King

Master of Medicine, residents of Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine

Good at:

Surgical treatment of excessive foreskin and phimosis, chronic prostatitis, sexual dysfunction, testicular-epididymitis, male infertility and other male diseases and treatment.

Disposal time:

Every Tuesday, Wednesday, Sunday (Zhuhai Hospital)

Executive editor: Wu Yuan Tuan