Patient's question:
Hello doctor, I would like to consult about the reasons that cause low sperm vitality. My sperm vitality is particularly low, and I don't know what caused it to be so low. If anyone knows, could you tell me what the reasons are and how to treat it? What are the main reasons that lead to low sperm vitality?Doctor's answer:
1. Reproductive System Infections: Reproductive system infections can cause inflammation in the reproductive system, such as prostatitis, seminal vesiculitis, epididymitis, and urethritis. These inflammations can lead to variations in semen, making the pH level, oxygen supply, nutrition, and metabolism in semen unfavorable for sperm activity and survival. A reduction in magnesium, zinc, citrate, and fructose in semen, as well as an increase in pH levels, can all affect sperm viability.2. Varicocele: Varicocele causes hypoxia in the testicular area due to impaired venous blood (return flow). Additionally, elevated levels of prostaglandins and 5-hydroxytryptamine in venous blood can also reduce sperm viability. Varicocele increases scrotal temperature, which can also lower sperm viability.
3. Production of Anti-Sperm Antibodies: Anti-sperm antibodies refer to the male body producing "self-defense," leading the immune system to generate antibodies that cause sperm agglutination or immobilization, making it difficult for sperm to survive and thus resulting in low sperm viability.
4. Impaired Testicular Development: Insufficient secretion of gonadotropins by the pituitary gland before puberty can lead to testicular biopsy showing that the seminiferous tubules are composed of undifferentiated primitive Sertoli cells and primitive germ cells, lacking Leydig cells. This manifests as incomplete maturation or damage and thinning of the testicular germinal epithelium, poor sperm quality, and weakened sperm vitality. After puberty, pituitary lesions or excessive treatment with androgens or estrogens can cause testicular atrophy. Early changes in testicular biopsy include thickening of the tunica albuginea and degeneration of spermatogenesis, while late-stage changes involve (hardening) of the seminiferous tubules and atrophy of Leydig cells. This results in small, soft testicles and a reduced volume of semen with no sperm. All of these factors contribute to low sperm viability.