Oligospermia

　　1. Infection factors (25%)

　　Acute and chronic inflammations of the reproductive tract or reproductive glands such as epididymis, vas deferens, seminal vesicle, and prostate can reduce the motility of sperm. The impact of infection on sperm vitality can be multifaceted. The direct action of microorganisms, such as mycoplasma, can adhere to the head, middle, and tail of sperm, increasing fluid dynamic resistance and slowing down the speed of sperm movement during forward movement, affecting sperm vitality and the ability to penetrate the egg cell. In addition, mycoplasma can cause partial sperm membrane defects or even membrane structure damage, affecting the sperm's fertilization ability. Escherichia coli can bind to sperm through its own receptors to reduce sperm vitality; the indirect action of microorganisms on sperm can be through the production or release of toxic substances, such as mycoplasma producing NH3, which has a direct toxic effect on sperm. Escherichia coli can produce sperm制动因子. The decrease in sperm vitality caused by infection can also be achieved by changing the pH value of seminal plasma; when the pH value is below 7 or above 9, the sperm vitality decreases significantly. Patients with acute accessory gland inflammation or epididymitis have a pH that is often alkaline, while chronic accessory gland inflammation can reduce the pH value below 7. In addition, an increase in leukocytes in seminal fluid caused by inflammation can lead to a decrease in sperm motility through direct and indirect causes. The insufficient sperm vitality caused by prostatitis may be the result of a combination of various factors, in addition to microorganisms, leukocytes, pH value, and other factors, it may also be related to zinc disorders.

　　Two, Abnormal seminal fluid liquefaction (20%)

　　The failure of seminal fluid to liquefy or high viscosity is one of the causes of male infertility, and an important factor may be through affecting sperm motility leading to infertility. In the seminal fluid that does not liquefy, it is possible to see long fibrous fibrin and a network between them, reducing the space for sperm activity, and the sperm being constrained. At the same time, it is also seen that coarse fibers are connected by many fine fibers to form a network, which may be the cause of mechanical restriction of sperm forward movement. The authors of this article found that when using urokinase-type plasminogen activator (uPA) alone on non-liquefied seminal fluid samples in vitro, the sperm viability and forward motility increased significantly when the seminal fluid changed from non-liquefied to liquefied state, and the same effect was obtained with chymotrypsin.

　　Three, Autoimmune factors (15%)

　　Antisperm antibodies (AsAb) can affect sperm fertilization function through several different pathways. The impact on sperm vitality may be due to the binding of AsAb to the tail of sperm, hindering sperm vitality, reducing motility, and poor penetration ability, which has been confirmed by the significant decrease in the ability to penetrate cervical mucus when antisperm antibodies are present in the sperm tail. Some scholars have observed a so-called 'shaking phenomenon' in sperm when contacting AsAb-positive serum with human sperm, mainly due to the binding of antisperm antibodies to the head and the entire tail of sperm, inhibiting the forward movement of sperm but without significant changes in survival rate.

　　Four, Endocrine factors (10%)

　　Endocrine hormones not only affect sperm development and maturation but also influence sperm motility. Gonzales and others found a linear relationship between prolactin in seminal plasma and sperm activity, which increases sperm oxygen uptake or affects sperm vitality through the cAMP system. When the level of E2 in serum increases, it reduces sperm vitality. Excessive testosterone in seminal plasma may inhibit sperm motility.

　　Five, Kartagener's syndrome (5%)

　　In the early 1930s, Carter first discovered a disease, which was later confirmed by other scholars as a congenital cilium structural deficiency, manifested as the inability of the cilia of various cilium cells in the body to move, mainly due to the absence of the peripheral microtubule cilium motor protein arm (dyneinalms). Patients with this syndrome, in addition to the inability of sperm to move, may also have chronic respiratory tract infections traced from their medical history.

　　Six, Chromosomal abnormalities (5%)

　　Autosomal and sex chromosome anomalies not only affect the number of sperm but also influence the viability and forward motility of sperm. It is known that ultrastructural devices related to sperm motility can appear abnormally due to genetic factors, such as the lack of an inner arm or an outer arm, or both arms are absent. It can also be due to the lack of central connection and central complex structure, because the interaction between the central microtubules and the radiating spines can adjust the sliding of the outer microtubules. When this structure is abnormal, sperm may experience motility disorders.

　　Seven, varicocele (5%)

　　Varicocele can lead to male infertility through various pathways, not only affecting spermatogenesis but also causing a decrease in sperm vitality. The mechanism may be due to the retention of blood in varicose veins, microcirculatory disorders, lack of nutrition supply and decreased oxygen partial pressure, insufficient energy generation, and endocrine dysfunction. In addition, it may also be because varicocele leads to autoimmune reactions such as the production of antisperm antibodies and the indirect induction of a decrease in sperm vitality by mycoplasma infection.

　　Eight, other factors (5%)

　　1, Trace elements such as zinc, copper, and magnesium in seminal plasma are related to seminal fluid quality. The content of seminal zinc is more than 100 times that of plasma. The content of zinc, iron, and magnesium in seminal plasma of patients with low sperm vitality is significantly lower than that of healthy men with normal sperm vitality. Zinc can delay the oxidation of cell membrane lipids, maintain the stability and permeability of cell structure, thereby ensuring good sperm activity. When the content of trace element cadmium (Cd) is high, it can lead to a decrease in sperm motility. Cadmium can directly inhibit the oxidative enzymes of sperm and directly inhibit the motility organs of sperm. The content of cadmium in seminal fluid of infertile men is significantly higher than that of fertile men.

　　2, Deficiency or decreased activity of enzymes related to sperm motility, vitamin deficiency, working in high-temperature, radioactive professions, and contacting chemical toxins can all cause a decrease in sperm vitality.

　　3, Smoking, drinking, and drug factors such as nicotine in tobacco can affect sperm vitality through direct and indirect damage to sperm, long-term alcoholics can directly and indirectly affect sperm motility, and there are many drugs that affect sperm vitality.

　　There are some cases of low sperm vitality whose etiology cannot be found, called idiopathic oligospermia.

　　1, Affect the combination of sperm and egg, leading to infertility.

　　2, Poor sperm quality,不利于optimal breeding, the rate of embryonic malformation is high.

　　3, It is easy to have premature delivery or abortion.

　　4, Lead to male acquired factor disorder.

　　5, Affect the spermatogenic function of the testis.

　　6, Lead to obstructive azoospermia.

　　1, Deficiency of both Qi and blood type

　　Symptoms: Low sperm vitality, or sperm mortality rate of 40%; apathy of sexual desire, not firm erection; thin and weak physique, pale complexion, fatigue, poor appetite, abdominal distension, shortness of breath, loose stools; palpitations, forgetfulness, dizziness, spontaneous sweating. The tongue is pale with white fur, or the tongue is pale and fat, with tooth marks on the edges, and the pulse is deep and weak.

　　2, Kidney Yang deficiency, seminal fluid cold coagulation type

　　Symptoms: Semen does not liquefy, or it does not fully liquefy, with clots or gelatinous lumps inside; the scrotum and testicles feel cool or cold, with soreness in the lower back and knees, and aversion to cold and cold limbs. The tongue is pale with thin white fur, and the pulse is deep, slow, or thin and weak.

　　3, Blood stasis and turbidity, thick and not liquefied type

　　Symptoms: Semen does not liquefy, there is a fixed or hidden pain in the lower abdomen and perineum; liver or spleen enlargement. The tongue is purple and dark, with ecchymosis or purpura, and the pulse is涩.

　　4. Kidney Qi deficiency type

　　Symptoms: low sperm vitality or 40% mortality rate of dead sperm; poor rigidity during erection, weak ejaculation; premature ejaculation, spermatorrhea, lack of sexual desire; weak lower back and knees, fatigue and weakness; dizziness, tinnitus, aversion to cold, limb weakness; copious sweating, clear and long urine. The tongue is pale with white fur, the pulse is deep and weak.

　　5. Damp-heat downward type

　　Symptoms: warm and relaxed penis, poor rigidity during erection; scrotal dampness and heat, bitter and sticky taste, not thirsty; hot and painful urination. The tongue is red with yellow greasy fur, the pulse is slippery and rapid.

　　6. Liver depression and blood stasis type

　　Symptoms: high sperm mortality or low sperm vitality; pain in the perineum or lower abdomen; ashen complexion, purple lips; chest and胁胀痛, melancholic and easily angry; tinnitus and ear closure. The tongue is purple and dark, the pulse is wiry, or sticky and not smooth.

　　1. Do not eat overly greasy food, quit smoking and drinking. The reproductive cells in the testicles are affected by harmful substances in tobacco, leading to poor sperm count and quality, and often causing infertility or malformed infants. Excessive drinking can lead to chronic alcoholism, poor sperm development, or loss of sperm motility.

　　2. Avoid excessive noise. According to data, males living in an environment with noise levels of 70 to 80 decibels for a long time tend to have weakened sexual function, and sexual function can become disordered in a high-noise environment of 90 decibels or more.

　　3. Try to avoid or use as few chemicals as possible. The clothes taken from the dry cleaning store should be left for a few days before wearing them, because dry cleaning agents can affect male sexual function; go to bed before 11 o'clock every day, sweat all over the body every day, and try to eat unprocessed natural food.

　　4. Prevent various infectious diseases that harm male fertility, such as mumps and sexually transmitted diseases.

　　5. Men should learn some physiological knowledge, and if they find that the testicles have changes different from usual, such as swelling, hardness, unevenness, pain, etc., they must seek timely treatment.

　　6. Avoid long-term masturbation. It can cause chronic congestion of the prostate, leading to asymptomatic prostatitis, affecting the nutritional content, quantity, viscosity, and acidity of seminal fluid, and causing infertility.

　　7. Supplementing zinc and selenium to prevent asthenozoospermia. Zinc, especially protein zinc, can affect the immunoreactivity of the body and can also directly affect the ability of the prostate to inhibit and kill bacteria. Therefore, zinc supplementation plays an important role in increasing sperm vitality and can also improve the body's immune function, helping to prevent chronic prostatitis. Selenium, on the other hand, has the effect of enhancing sperm vitality and sexual function. Therefore, selenium is known as the 'gold within men'. Diabetics, patients with heart disease, liver disease, and those with urinary system disorders have varying degrees of decline in sexual function. Selenium supplementation can regulate immune function and antioxidant function, improve and enhance sexual function, and help people with impotence, premature ejaculation, and low sexual function gradually return to normal.

　　1. Immunological examination

　　It should be noted that in addition to the sperm agglutination test of males, there are many detection methods, which should be selected according to local conditions.

　　2. Testicular biopsy

　　Experts remind patients with azoospermia or oligozoospermia how to inspect asthenozoospermia directly by examining the spermatogenic function of the seminiferous tubules and the development of stromal cells in male patients, and the synthesis and metabolism of local hormones in male patients can be reflected by immunohistochemical staining.

　　3. Routine semen examination

　　Through the characteristics of semen, the number and vitality of sperm, a preliminary assessment is made of male reproductive capacity and reproductive system diseases. Routine semen examination items include general physical examination and microscopic examination.

　　4. Sperm function test

　　The main examination items are semen analysis, cervical mucus penetration test, and biochemical examination of sperm, through sperm function examination, can scientifically and accurately detect the vitality of men's sperm and predict the potential fertilization ability of sperm.

　　1. Salmon, which is rich in protein and can increase the hormone content in the human body.

　　2. Nuts, which contain an ingredient that helps enhance sexual function.

　　3. Angelica sinensis, which contains natural plant hormones and also has the effect of nourishing the blood, can smooth the Qi and blood, and increase sexual interest.

　　5. Chives, which have the effect of warming the kidneys and helping Yang, are even better when soaked in wine.

　　6. Caviar, which contains a high amount of protein and hormone components, has a good aphrodisiac effect.

　　7. Chocolate, which has an exciting effect, can reduce stress and effectively enhance sexual desire.

　　8. Ginseng, which has always been praised as a good medicine for body tonifying, has powerful effects on increasing the quantity and frequency of sperm production.

　　9. Other strong sperm foods such as onions, garlic, and scallions.

　　Treatment Principles:

　　1. Targeted treatment

　　Only by understanding the cause of the disease can targeted treatment be carried out, making the treatment effective. Many patients have been treated in many ways but have not achieved satisfactory results, so the key to whether it is possible to cure severe oligospermia lies in not finding the cause correctly.

　　2. Continuous treatment required

　　Continuous treatment is required because it takes about 75 days for sperm to develop from spermatogonia to mature sperm, so immediate effects cannot be expected. Therefore, once patients choose a treatment method for oligospermia, they need to persist with the treatment.

　　3. Pay attention to daily life

　　In daily life, do not smoke, drink, stay up late, or take hot baths. Follow the doctor's instructions.