Patient's question:
Sure, I can help with that. Please provide the content you want to be translated.Doctor's answer:
1. What is male infertility?Literally speaking, male infertility refers to a condition where a couple has been living together for more than one year after marriage without using contraception, and the wife is unable to conceive, with the cause or etiology occurring in the husband. In detail, it was once classified as male infertility and male impotence. Male infertility meant that the husband could impregnate the wife, but the fetus could not survive, such as in cases of miscarriage or stillbirth; while male impotence meant that the husband could not impregnate the wife. Currently, these two conditions are no longer distinguished in detail and are male infertility.
The World Health Organization (WHO) defines infertility as: at least 12 months of non-contraceptive sexual intercourse without pregnancy. Currently, the widely accepted definition in China is: at least two years of non-contraceptive sexual intercourse without the ability to impregnate the wife.
2. What is primary male infertility?
Primary male infertility refers to a man who has never been able to impregnate a woman, regardless of whether the woman is his wife, sexual partner, or others. This is essentially determined based on the patient's fertility history. It differs from the concept of idiopathic infertility and is not a diagnosis of unknown causes or etiology. Therefore, primary male infertility is not a diagnostic term for the cause. This is easily confused and should be distinguished.
3. What is secondary male infertility?
Secondary male infertility refers to a man who has previously been able to impregnate a woman, regardless of whether the woman is his current spouse or the outcome of the pregnancy, but has not been able to conceive in the past 12 months without using contraception. Overall, secondary male infertility in men has a higher likelihood of restoring fertility. Therefore, distinguishing between primary and secondary infertility has clinical significance.
4. What are the differences between relative infertility and absolute infertility?
Relative infertility and absolute infertility are general classification methods for male infertility patients. This classification method is important for assessing the treatment effectiveness and prognosis of male infertility patients.
Absolute infertility refers to a patient whose fertility has been completely lost and is difficult to treat with current methods. For such patients, psychological counseling should be provided to explain the situation clearly and encourage them to adopt or use donated sperm for artificial insemination to impregnate their wives, fulfilling their desire to raise children.
Relative infertility refers to a patient whose fertility has been partially damaged but has not yet completely lost the ability to reproduce. With reasonable adjustments and treatment, there is still hope for restoring fertility. For such patients, measures such as lifestyle guidance, medication, and artificial insemination can be adopted based on different conditions.
5. What are the main classification methods for male infertility?
There are various classification methods for male infertility. Some people classify it based on semen analysis results, such as oligospermia, asthenospermia, teratospermia, and azoospermia; others classify it as sexual dysfunction infertility, abnormal semen infertility, and azoospermia. These classification methods are either superficial or vague. Therefore, WHO proposed a classification method based on etiological diagnosis, which is currently the most authoritative diagnostic classification method for male infertility worldwide. It divides male infertility into 16 categories:
(1) Sexual dysfunction and/or ejaculation disorders; (2) Immunological etiology; (3) Unknown etiology; (4) Isolated seminal plasma abnormalities; (5) Iatrogenic etiology; (6) Systemic etiology; (7) Congenital abnormalities; (8) Acquired testicular damage; (9) Varicocele; (10) Male accessory gland infection; (11) Endocrine etiology; (12) Idiopathic oligospermia; (13) Idiopathic asthenospermia; (14) Idiopathic teratospermia; (15) Obstructive azoospermia; (16) Idiopathic azoospermia.
Idiopathic male infertility includes idiopathic oligospermia, idiopathic asthenospermia, idiopathic teratospermia, and idiopathic azoospermia. It refers to male infertility patients who have normal conditions except for abnormal sperm, but the cause or etiology of the abnormal sperm is unknown, hence the term idiopathic male infertility. For example, idiopathic oligospermia refers to a condition where semen analysis only shows a decrease in sperm count, while testicular volume, function, endocrine function, and other semen tests are normal. The cause or etiology of the reduced sperm count is unknown, and once the cause or etiology is identified, it can no longer be called idiopathic oligospermia.
In WHO's etiological diagnostic classification of male infertility, there is a category of male infertility with "unknown etiology." Some people often confuse it with idiopathic male infertility. As mentioned above, idiopathic male infertility refers to a condition where the fundamental cause or etiology of the disease is unclear, but the apparent cause or etiology is known, such as oligospermia or asthenospermia. In contrast, male infertility with unknown etiology means that all tests of the patient are normal, not only is the fundamental cause or etiology unknown, but even the apparent cause or etiology has not been found. Therefore, it is completely "unknown etiology."