Patient's question:
Married for three years without children, after a testicular biopsy, the microscopic description showed: the seminiferous tubules were relatively uniform in size and shape, tubular, with only a few Sertoli cells and occasional primordial germ cells observed in the lumen, but no sperm cells or sperm were seen. The diagnostic opinion was: consistent with testicular infertility (Johse score: 3 points).Doctor's answer:
Hello, infertility caused by testicular abnormalities requires identifying the root cause and treating it accordingly. Next, we will provide a detailed analysis from the following five aspects:1. Testicular Inflammation: Antibiotics should be used for treatment based on the type of inflammation, along with relevant symptomatic therapies.
2. Male Pseudohermaphroditism: Treatment should focus on gender selection and gonadal management. After appropriate treatment, fertility is generally difficult to maintain. Therefore, we recommend directing gender development as much as possible toward female.
3. Congenital Hypoplastic Testicular Syndrome: Treatment primarily involves supplementing insufficient androgens. Typically, injections of 200mg every 3–4 weeks can aid in masculinization but do not affect female breast development. In some cases, breast augmentation surgery may be performed for aesthetic or psychological reasons.
4. Testicular Agenesis: If diagnosed, treatment mainly involves reasonable and timely androgen supplementation to promote proper development of the external genitalia. However, early use of androgens may lead to premature epiphyseal closure, affecting physical growth. During medication, testosterone levels should be regularly monitored to adjust dosages. The implantation of an "artificial testicle" can, to some extent, alleviate patients' psychological inferiority and reduce emotional trauma.
5. Cryptorchidism: Treatment has a relatively complete protocol. The goal is to restore the reproductive cell count and function of the testicles as early as possible, thereby improving fertility.