A male patient, 34 years old.First time (date): October 5, 2015The second half of nonparous complained.History: with 27 years of marriage, s
A male patient, 34 years old.
First time (date): October 5, 2015
The second half of nonparous complained.
History: with 27 years of marriage, spouse health, marriage without contraception for 2 years without a child, poor semen quality check (specific and unspecified), oral medicine 1 months pregnant wife, 1 sub fertility health, now 5 years old, for half a second child failed, then to the hospital. Carved disease: sexual desire is lower than before when the waist sour weak, pale tongue, thin white fur, pulse shen.
Past history: physical health, denial of other medical history and history of testicular trauma.
Personal history: no smoking and drinking history, no exposure to radiation and toxic and harmful substances.
Family history: parent body health, no family history.
Physical examination: normal secondary sex characteristics, bilateral testes of about 7ml, the texture is soft, without tenderness, without palpable varicocele.
Auxiliary examination: Scrotal color Doppler ultrasound: bilateral testicular volume is small, the left epididymis cyst. Semen routine: the amount of 2ml, a density of 1 million 730 thousand /ml, 0% B, level 0%, survival rate 5.33%.
Thinking: Patients with small testes, sperm density and vitality of the poor, for the severe and less weak sperm disease, sex hormones should be checked to understand the situation of the gonadal axis, a week after the review of sperm, temporarily not be treated with drugs.
Referral date: October 12th: sex hormone in return: Six: FSH 30.42mIU/ml (1.27-19.26), LH 9.81mIU/ml (1.24-8.62), E2 4.00pg/ml (20-47), T
2.17ng/ml (1.75-7.81). Semen examination is still severe and weak sperm. Considering that the patients had high gonadotropin hypogonadism and reduced spermatogenesis, it was suggested that the patient should investigate the karyotype and Y chromosome microdeletion.
Case analysis: severe oligozoospermia sperm density is less than 5 * 106/ml, severe asthenospermia refers to a sperm is zero, B grade and C grade sperm number < 30%. Physicochemical factors and chromosome, infection, endocrine, immune injury, cryptorchidism, varicocele, obstruction, drugs, various kinds of interference of spermatogenic abnormality and many other reasons can cause oligospermatism. The patients with severe oligoasthenospermia, if there exists a chromosome may also make young, his wife pregnant, but with age, the semen quality is getting worse, so although a son should also check the chromosome and Y chromosome microdeletion.
Conclusion: patients in one take January Yu Decoction, pregnant woman, because a spermatogenic cycle for 3 months, was not considered traditional Chinese medicine plays a major role. With this visit for the purpose of "second child", want to use traditional Chinese medicine treatment, solve the male fertility problems, the testicular spermatogenic function is small, low, unknown etiology, application of Chinese medicine in the treatment process, the quality of sperm may be reduced or even become azoospermia. There was a close relationship between the size of AZF deletion in Y chromosome and the degree of spermatogenesis disorder. The results showed that the more wide the range of AZF factor was, the worse the testicular spermatogenic function was. AZFc deletion of oligozoospermia, progressive decline with the number of sperm, some patients developed azoospermia. The harvest of this case: the treatment of male infertility, physical examination and improve the examination is very important, can not be blindly treatment. The patients with severe oligoasthenospermia of unknown cause, not found chromosome karyotype and Y chromosome microdeletion, in case of unknown etiology, blind treatment, not only a waste of money and time of the patients in the treatment process, the quality of sperm may be reduced or even become azoospermia. If there is a problem with the loss of the Y chromosome in a patient, it will lead to a daughter chromosome abnormality.