In biological sense, a new life is born at the moment when sperm and egg combine, and semen plays a decisive role in the success of this moment.
The semen referred to in modern reproductive physiology consists of two parts: the fluid secreted by seminal vesicle gland, prostate gland and urethral gland, and the sperm produced by testis and stored in epididymis. A normal male ejaculates about 1-6 ml, including 200-500 million sperm. As the carrier and guardian of sperm, the primary task of semen is to transport a certain amount of sperm safely to the female reproductive organs in order to get the chance of pregnancy. Semen is weakly alkaline, which can neutralize acidic substances in vagina and is beneficial to sperm activity. Semen has the function of providing active energy and nutrients for sperm to ensure normal reproductive activities. Therefore, it is no exaggeration to call semen a messenger of life from men.
However, in daily clinical practice, many people often know nothing about common sense problems such as the quantity, thickness and color of semen, which causes a lot of unnecessary panic.
Query on "more or less"
A college student wrote that he often had spring dreams in recent days. At first, he had a lot of semen, and then the amount of semen became less and less. He is worried that semen will be lost. Some young couples in the new wedding banquet have frequent sexual life during their honeymoon. At first, they injected more semen, but later they got less and less, so they have similar concerns. There are also some young men who masturbate and find that semen is significantly less than before, but it can be as little as only a few drops. They are also worried that this will affect their future sex life and fertility.
In fact, these worries are unnecessary. A man, from the first spermatorrhea to the end of his life, always has semen in his body, and the amount of semen in a person is immeasurable. Wet dream, masturbation and sexual intercourse are frequent, so the amount of semen is high. But seminal vesicle, prostate, urethral gland and other glands in the body, as long as the function is normal, will continue to secrete, so semen will not be exhausted. Some young men masturbate frequently, once a few days or even several times a day, which will obviously reduce the amount of semen. There is a simple reason. Although the ability of human body to produce sperm and semen is very strong, after ejaculation 1-2 days can supplement it, but if ejaculation is too frequent, there will still be a situation of "demand exceeds supply". The oligospermia caused by this situation is certainly not a disease, so don't worry at all. Prolonging the interval of semen discharge will cure the disease. But if the amount of semen discharged each time is too small, it will be morbid. In male infertility cases, infertility caused by too little semen (less than 1 ml) accounts for about 2% of the total cases. The cause of oligozoospermia may be abnormal testicular function, endocrine disorder, seminal vesicle, prostate disease or urethral stricture. This kind of oligozoospermia is easy to distinguish, just need to abstain from sex or masturbate for 5-7 days, and then discharge semen. There is more semen than before without disease, otherwise it is pathological oligozoospermia.
So, too much semen, okay? Similar to the situation of too little semen, too much semen, such as more than 7 ml, is also a pathological state, which is mostly caused by seminal vesicle inflammation. The essence of excessive semen is excessive secretion or exudation of seminal plasma, while the total number of sperm has not changed. This will obviously reduce the density of sperm in semen and affect the chances of pregnancy. Excessive secretion of seminal plasma will interfere with sperm activity and function due to pathological factors such as inflammation. In addition, excessive semen after sexual intercourse will bring a large number of sperm out of the vagina, reducing the chance of pregnancy. Therefore, the more semen, the better.
Query on "Thin and Thick"
A young man told the doctor that after masturbation, he found that the ejaculated semen was as thin as water. He said that semen used to be sticky, but now it is like water. He asked: Is it caused by frequent masturbation? Will it cause infertility? There is also a couple who have been married for three years and have been living together since marriage. They have normal sex 2-3 times a week. Neither side took contraceptive measures, but the woman was not pregnant. After examination, the female's reproductive organs, menstruation and ovulation functions are normal, and the male's sperm quantity, shape and activity are also normal, but the ejaculated semen will become thinner from gelatinous when it exceeds 1 hour. They want to know if this jelly-like semen has any effect on pregnancy.
Semen originally exists in the reproductive tract as a liquid. After the semen is ejected from the penis mouth, it will immediately become milky white or yellowish translucent colloid under the action of a substance similar to protein secreted by seminal vesicle, which is the semen character that people usually see. At this point, the sperm is "frozen" in the semen and cannot swim freely. After 5-30 minutes, with the participation of hydrolase secreted by prostate, semen liquefies and automatically changes from jelly to dilute water sample. This change of sperm has very important physiological significance: at first it is liquid, which is convenient for sperm injection; The subsequent formation of gel is beneficial to the sperm to stay in the vagina for a long time, so that the sperm can be fully rested and empowered; Once liquefied, the sperm has enough energy to swim quickly, looking for an egg "blind date". If there are diseases such as inflammation of prostate or seminal vesicle, the semen of these patients may not liquefy or liquefy incompletely for a long time due to insufficient secretion or destruction of hydrolase. The phenomenon that ejaculated semen liquefies after half an hour or even 1 hour is a pathological phenomenon, which is medically called semen non-liquefaction.
Because semen is too thick, sperm can't swim normally, which will naturally cause infertility. Therefore, the morphological changes of semen coagulation and liquefaction can protect sperm function and normal fertility. Therefore, patients with abnormal semen liquefaction should be actively treated.
In addition, during sexual intercourse during ovulation, infertile patients with high semen viscosity can inject several strands of semen that begin to contract and ejaculate into the vagina, then pull out the penis, and the second half of semen is discharged from the body, that is, ejaculate step by step, which reduces the viscosity of semen, is beneficial to sperm swimming and increases the chances of conception.
Query on "Color"
In the sexual medicine consultation clinic, many men told doctors that their semen was sometimes milky white, sometimes pale yellow, and some said it was red or reddish. They want to know what color normal semen should be and whether yellow or red is pathological.
Generally speaking, normal semen should be translucent egg white. For people who don't ejaculate for a long time, the semen can be yellowish and sticky.
When there is inflammation in the male reproductive tract, semen can be yellow, and a large number of pus balls can be seen under the microscope. Some men may find that semen turns pink or mixed with bloodshot in after ejaculation for the first time, which often surprises them and makes them think that they are terminally ill. In fact, this situation is mostly caused by inflammation of seminal vesicle, which is a disease with mild symptoms and good prognosis. When the seminal vesicle suffers from congestion and edema caused by inflammation, it is easy to bleed. Secretions and semen from seminal vesicles will mix with blood when they pass through the seminal vesicles, resulting in blood essence. In addition, prostatitis often involves seminal vesicles and can also produce blood sperm. In this regard, as long as sexual intercourse is suspended and antibiotics and hemostatic drugs are taken under the guidance of a doctor, the condition can be controlled.
Of course, seminal vesicles and prostate tumors can also have hemospermia, but generally speaking, the characteristics of cancerous hemospermia are persistent and gradually aggravated, which is different from inflammatory transient hemospermia. In addition, tuberculosis, schistosomiasis or systemic blood system diseases occasionally cause hemospermia, and these situations should be treated accordingly. Clinically, when the reproductive tract bleeds, the semen is red or reddish, and a large number of red blood cells can be seen under the microscope, and some of them look brownish red or soy sauce color to the naked eye because the semen contains a large number of red blood cells. These pathological hemospermia should be diagnosed and treated in time.
There are three reasons for the emergence of hemospermia: first, the seminal vesicle contracts strongly during ejaculation, which changes the permeability of capillaries in the seminal vesicle wall and makes red blood cells in the blood vessels penetrate into semen; Second, when the frequency of sexual life is low, the secretion in seminal vesicle increases, which increases the pressure, and the pressure in after ejaculation seminal vesicle suddenly decreases, which causes capillary rupture and bleeding; Third, the enzyme activity of dissolving tissue fibrinogen in semen of men with allergic constitution increases, which damages the capillaries of seminal vesicle wall and causes exudation. Most of this physiological hemospermia can be cured without treatment, so don't worry.
Test results of "ups and downs"
Sperm testing is one of the ways to understand male fertility, but many people don't know much about this knowledge. Semen examination involves many links, which are related to abstinence time, method, container, transportation mode, examiner's sense of responsibility, examinee's own physiological fluctuation and many other factors. If the doctor's explanation is unclear, or the patient does not follow the doctor's requirements, there will be a phenomenon of "ups and downs" in semen indicators, which will affect his diagnosis and medication.
In order to accurately detect semen, we should first pay attention to the correct collection of semen, and should do the following: ① abstinence for 3-5 days; (2) masturbate with a clean container given by the hospital, and immediately submit all semen for inspection (within half an hour), paying special attention to keeping warm in winter; (3) If it is the first sampling, it can be repeated 1-2 times every other week. This kind of test can reflect the actual situation more accurately.
Because there are many factors that affect the test results, such as incorrect collection methods and diseases of genitourinary system, the test results may be abnormal, so it is necessary to analyze the test results correctly. For example, the normal range of sperm count is generally set at 60 million to1200,000 per milliliter, and below or above this range can be regarded as abnormal. But clinically, some people with sperm count below 60 million per milliliter can have children. Therefore, abnormal test results do not confirm male infertility.
The latest research on semen
According to the latest research report, semen contains more than ten kinds of prostaglandins, and the types and contents of prostaglandins in these semen have been proved to be closely related to pregnancy. For example, prostaglandin E 1 can promote fertility. The semen deposited in vagina and cervix during sexual intercourse, absorbed by vaginal mucosa, acts on uterus and fallopian tube, making cervix and uterus relax, which is beneficial to sperm swimming. At the same time, semen is also a "panacea" to relieve premenstrual syndrome and dysmenorrhea in women. Women with normal sexual life after marriage will naturally reduce or even completely disappear PMS, which may be related to prostaglandin contained in semen.
In addition, there is a natural antibacterial substance comparable to penicillin in normal semen-physostigmine, which can inhibit the growth of staphylococcus and streptococcus. Clinical practice has proved that women who have a long interval of sexual life or have no sexual life all the year round often suffer from vaginitis, cervicitis, endometritis and salpingitis. So it can be said that when human beings are living a normal and harmonious sexual life, nature has created a cleaner for them.
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According to the standard of normal semen stipulated by the World Health Organization, judging whether semen is normal can be analyzed from the following aspects:
(1) Semen volume: normal ≥2ml. Too much when it is more than 7ml not only reduces the sperm density, but also easily flows out of the vagina, resulting in a decrease in the total number of sperm, which is common in seminal vesiculitis; Less than 2ml means too little semen, but usually less than 1ml. At this time, the contact area between semen and female reproductive tract is small, or because of its viscosity, it is not conducive to sperm entering the woman's cervix, leading to infertility, which is common in severe accessory gland inflammation, low testosterone level, ejaculatory duct obstruction, retrograde ejaculation and so on.
(2) Color: usually grayish white or light yellow. Milky white or yellow-green suggests inflammation of reproductive tract or accessory gonad; Microscopically, pink, red and red blood cells are bloody semen, which is common in inflammation of accessory gonads and posterior urethra, and occasionally seen in tuberculosis or tumors.
(3) pH value: The normal pH value of semen is 7.2 ~ 7.8. Less than 7 2 is seen in ejaculatory duct obstruction or urine pollution; More than 7.8 is found in seminal vesicle inflammation or old specimens.
(4) Liquefaction time: After normal semen is injected, it becomes gelatinous under the action of seminal vesicle coagulase and liquid 15 ~ 30 minutes under the action of prostatic liquefaction enzyme, which is semen liquefaction. It is abnormal that semen is not liquefied after 30 minutes of ejaculation.
(5) Stickiness: The glass rod comes into contact with the liquefied semen and is gently lifted to form semen filaments, the length of which is generally less than 2 cm.
(6) Sperm count: generally expressed by the number of sperm per milliliter of semen. Normal count ≥20× 10? 6/ ml. Below this value, there are too few sperm, which can be seen in the dysfunction of spermatogenesis caused by various reasons, which can lead to low fertility or infertility due to the decrease of the chance of sperm entering the uterine cavity and fallopian tube. If the sperm count is greater than 250× 10? 6/ml means that there are too many sperm, which will also lead to infertility because the motility of sperm is affected.
(7) Sperm morphology: Sperm with normal morphology ≥50%, otherwise it may lead to infertility.
(8) Viability: Sperm moving in a straight line is ≥50%.
(9) Survival rate: Generally, it means that the live sperm is ≥50% when examined within after ejaculation 1 hour. The common reasons leading to the decline of sperm motility and survival rate are hypogonadism, varicocele, ciliary stagnation syndrome caused by chronic respiratory infection, the existence of anti-sperm antibodies in semen or improper preservation of specimens.
(10) white blood cells: white blood cells in normal semen < 1× 10? 6/ ml. Leukocytosis indicates that there is infection in reproductive tract or accessory gonad.