The need to understand the basic knowledge of patients with azoospermia

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azoospermiaThe concept must be confirmed: azoospermia semen 3 times or 3 times above the analysis, and the semen after centrifugation, the m



The concept must be confirmed: azoospermia semen 3 times or 3 times above the analysis, and the semen after centrifugation, the microscope has not yet found the sperm, semen collection provisions must be 2-7 days of abstinence. Inspection must ensure semen and the incidence of azoospermia for male infertility 19%-30%.

1 Classification

(1) the anterior aspect of the testis: refers to the normal function of the testis itself, but due to the hypothalamus and (or) pituitary endocrine dysfunction caused by secondary testicular development or not spermatogenic. (2) testis: the ability of the testes to produce sperm for various reasons.

(3): refers to the testes after testicular sperm and sperm normal, pipeline obstruction or congenital absence, for example: epididymal tuberculosis, bilateral epididymitis, seminal vesicle agenesis bilateral vas deferens and ejaculatory duct infarction.

2 etiology

(1) spermatogenesis disorder: testis is the only organ producing sperm. Testicular sperm production capacity disorder

(2): suffering from infection caused by mumps and other infections can cause this disease.

(3) congenital factors: some people are born without the ability to produce sperm, this abnormality is found in the study of chromosomes and genetic genes, or by biopsy and that.

(4) 6% male infertility patients have different degree of chromosomal abnormalities, including chromosomal abnormalities of patients with azoospermia rate even reached 10%-15%.

(5) ejaculatory dysfunction: ejaculation and retrograde ejaculation are not the same

(6) the vas deferens obstruction or absent

(7) the testicular sperm production decreased due to advanced age.

(8) other factors such as malnutrition, industrial hazards, radiation exposure, febrile diseases, allergy and bad habits such as smoking and drinking.

3 check

(1) clinical history and physical examination: pay special attention to the development of male secondary syndrome and reproductive organs, testicular volume, measure and test the epididymis, vas deferens etc..

(2) endocrine examination: the serum FSH, LH, T and PRL were observed

(3) testicular biopsy: the spermatogenic function and the development of interstitial cells of seminiferous tubules were examined

(4) determination of fructose: identification of whether there is obstruction of the vas deferens

(5): karyotype analysis for testicular dysplasia, external genital malformation and unexplained azoospermia

(6) ultrasound examination: mainly used for hydrocele, epididymal hematoma, varicocele, epididymis cyst, epididymitis disease etc.

4 treatment

For testicular anterior and hypothalamus and (or) pituitary dysfunction caused by testicular dysfunction, can use hormone replacement therapy, there are two ways: first, the use of HMG and HCG combined, the two is LHRH

(1) for testicular azoospermia, such as FSH increased significantly, or testicular biopsy confirmed severe and irreversible spermatogenic disorders should be chosen: for fine artificial insemination, the adoption of a child or not to have children.

(2) after testicular azoospermia: epididymis and vas deferens obstruction confirmed by partial upper obstruction, can perform surgery to remove the obstruction.

(3) assisted reproductive technology: mainly refers to intracytoplasmic sperm injection (ICSI), vas deferens and seminal vesicle like or obstruction, long segment obstruction, long ejaculatory duct aplasia or hypoplasia and obstruction, not by VAS reconstruction surgery, available epididymal sperm aspiration or testicular biopsy, to obtain sperm ICSI help pregnant.

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