Nowadays, there are many advertisements on TV for treating infertility. It is undeniable that procreation is a major issue, as it often involves a family issue. When a man has been cohabiting without taking defensive measures after marriage but has no children, what tests should he take?
1、 Laboratory examination: In addition to listing semen examination as a required item, other choices should be made based on the specific situation of the patient:
1. Semen analysis: This helps to understand male fertility and is a necessary check for infertility. The check includes color, volume, liquefaction time, pH, sperm count, motility, survival rate, and morphology.
2. In vitro xenofertilization experiment: Even if the routine semen analysis is completely normal, sometimes it still cannot fully represent the sperm's insemination ability. In vitro xenofertilization experiments can more accurately estimate the fertilization ability of sperm, which is of great value in determining male fertility. The commonly used method is the xenofertilization experiment in which human sperm penetrates hamster eggs, using the sperm of normal fertile individuals as a control.
3. Prostate fluid examination: The normal color is milky white and slightly alkaline. At high magnification, microscopic and refractive lecithin particles can be seen in the full field of vision, with a few epithelial cells, amyloids, and sperm. The number of white blood cells is greater than ten. When there is inflammation, the number of white blood cells increases, or even piles of pus cells are seen, with a significant decrease in lecithin particles.
2、 Endocrine examination. The function of the hypothalamus-pituitary-testis axis can be understood through gonadotropin releasing hormone (gonadotropin releasing hormone) or Kevifene stimulation tests. Measuring testosterone levels can directly reflect the function of plasma cells. If necessary, thyroid hormone, adrenocortical hormone, or prolactin can be measured.
3、 Doppler ultrasound examination. Helps identify varicoceles.
4、 X-ray examination. To determine the location of obstruction of the vas deferens duct, vasography, epididymography, vasography, seminal vesiculography, or urethrography can be used. Patients with hyperprolactinemia can take sphenoid saddle X-ray tomography (AP and lateral positions) to determine whether there is a pituitary adenoma.
5、 Immunological examination. Detection of sperm agglutination or immobilization antibodies in serum or seminal plasma by sperm agglutination or immobilization tests. Although there are various detection methods, they should be selected according to local conditions.
6、 Testicular biopsy. For azoospermia or oligospermia, it is used to directly examine the spermatogenic function of the seminiferous tubules of the testis and the development of interstitial cells. The synthesis and metabolism of local hormones can be reflected by immunohistochemical staining.
7、 Chromosome karyotype analysis. Used for external genital malformations, testicular dysplasia, and unexplained azoospermia.
Male infertile patients must be well examined and must not avoid medical treatment, because only when the cause is found correctly can we treat them with a targeted approach, and our chances of curing the disease will correspondingly increase.
(Intern Editor: Cai Junyi)