Patient's question:
Married for a year but still not pregnant. Upon examination, it was found that the male's sperm count is too low and there are many abnormal sperm. The test results show that the sperm density is 13.32 million/ml, the sperm motility rate is 27.42%, the sperm vitality is 18.28%, and the abnormal sperm rate is 40%. I would like to ask the experts, is there a high chance of curing this condition? Other: The patient has bad habits such as smoking and drinking, and has now abstained from smoking and drinking for half a month.Doctor's answer:
The causes of male infertility can be divided into two major categories: normospermic infertility and sexual dysfunction-related infertility.Normospermic infertility includes: azoospermia, severe oligozoospermia, normozoospermic infertility, polyzoospermia, and asthenozoospermia, collectively known as semen abnormality-related infertility.
Sexual dysfunction-related infertility includes: congenital developmental abnormalities, psychological, neurological, vascular, endocrine, and drug-induced factors (encompassing eight aspects in total: developmental abnormalities of reproductive organs, genetic diseases, endocrine dysfunction, immune system abnormalities, infections of reproductive organs, obstruction of the vas deferens, sexual dysfunction, and physical/chemical factors).
Currently, male infertility accounts for approximately 30% to 40% of infertility cases among fertile couples, with the number increasing by 5% annually. Among these, semen abnormality-related male infertility constitutes about 70% to 80%. Therefore, infertility is not solely a female issue; males also account for a significant proportion. Semen abnormality-related infertility includes six symptoms: azoospermia, oligozoospermia, necrozoospermia, low sperm motility, and incomplete liquefaction of semen, as well as sperm malformation. For azoospermia, a testicular biopsy is necessary to confirm whether there is spermatogenic function. If the testes lack spermatogenic function, it indicates true azoospermia, caused by dysfunction of the hypothalamic-pituitary-gonadal axis (testes), such as congenital developmental abnormalities, cryptorchidism, or sequelae of orchitis and epididymitis caused by mumps. If testicular biopsy reveals spermatogenic cells, it indicates pseudo-azoospermia, and the underlying cause can be investigated, including potential vas deferens obstruction. Through targeted treatment, it may be cured.
According to British reports, cryptorchidism is associated with environmental pollution and the misuse of contraceptives by mothers before conception. However, oligozoospermia and low sperm motility, as well as incomplete liquefaction of semen, are related to daily habits such as smoking, excessive alcohol consumption, consumption of cottonseed oil, masturbation, and infections of the reproductive tract, varicocele, endocrine diseases, and various physical/chemical factors that interfere with spermatogenesis.
Why is this the case?
Nicotine in cigarettes and alcohol in beverages can kill testosterone, leading to a decline in testosterone levels, reduced male hormone levels, testicular atrophy, and consequently oligozoospermia, low viability, or even azoospermia. Masturbation can induce reproductive tract infections, such as prostatitis or seminal vesiculitis, and common clinical symptoms like frequent urination, urgency, urinary splitting, incomplete voiding, hesitancy, white discharge, lower back pain, testicular heaviness, and dampness can all affect sperm vitality, leading to incomplete liquefaction and the formation of jelly-like crystallization. Even if sperm viability is 98%, achieving pregnancy may still be difficult, or it may lead to atrophy of the penis and testes, affecting sexual function, among other issues. Additionally, physical/chemical factors can damage spermatogenic epithelial cells. Common clinical examples include radiation and toxic chemicals such as insecticides, fertilizers, herbicides, rust removers, and food additives, which can cause the shedding of spermatogenic epithelial cells, impair interstitial cell function, and even lead to teratogenesis, such as empty cysts or embryonic arrest.
In addition to the aforementioned causes, male infertility is also influenced by some factors that are often overlooked in daily life:
(1) Both excessive and insufficient sexual intercourse can cause infertility. For males, sperm generally do not return to normal levels within 24 hours of ejaculation. Younger men typically require at least 48 or 72 hours for normal sperm counts to be restored in the semen.
(2) The temperature around the scrotum plays a crucial role in testicular spermatogenesis. Wearing thick, tight jeans or tight pants is the scrotum's ability to dissipate heat. If a man wears tight pants continuously for ten weeks, it can lead to a decline in sperm quality.
Traditional Chinese Medicine (TCM) holds that the primary factors or causes of male infertility are attributed to the kidneys, followed by spleen deficiency, liver stagnation, phlegm-dampness, blood deficiency, and blood stasis. "The kidneys are the root of congenital health and the foundation of life." Therefore, the kidneys store essence and govern reproduction, and the quantity and quality of reproductive essence are directly linked to the strength of kidney qi and the balance of yin and yang. Generally, sperm quantity is more closely related to kidney yin, while sperm quality (morphology, motility, and viability) is more closely related to kidney yang. Thus, the imbalance of kidney yin and yang, especially insufficient kidney qi, is the main pathological mechanism of male infertility. If there is congenital deficiency or early marriage, irregular sexual habits, excessive sexual exertion, masturbation, or emotional disturbances after severe illness, symptoms such as dead sperm, azoospermia, oligozoospermia, or clear, cold semen may occur. Sperm reduction is attributed to the kidneys and is classified as a deficiency condition.