Reproductive health examination, which items to check, estimation

Many couples who can't have children will blame the woman for "failing her stomach". In fact, pregnancy is a matter for both husband and wife! According to the World Health Organization (WHO), couples who have lived together for more than 1 year without any contraceptive measures are called male infertility. If there is no abnormality in the female examination, it is suggested that male friends should not ignore their own problems. Many male infertility patients generally need to do the following tests: 1. Physical examination of male reproductive system (testis, epididymis, vas deferens, spermatic vein, penis, foreskin, urethral orifice, etc.). ), as well as the second sexual characteristics (beard, Adam's apple, breast, pubic hair, etc. ). Suitable for every infertile patient who comes to see a doctor; Second, semen examination. Semen examination is the most important basis for evaluating male fertility. There are many semen examination items, including routine semen analysis, sperm morphological staining analysis, sperm acrosome reaction analysis, sperm nuclear DNA fragment analysis, anti-sperm antibody (AsAb) detection, seminal plasma biochemical analysis, semen infectivity index analysis and so on. 1. Routine semen analysis mainly includes semen volume, semen liquefaction time, semen PH value, sperm concentration and sperm motility rate (percentage of sperm moving forward or a+b grade). As the most basic fertility index for men, it is suitable for every male infertility patient. 2. Sperm morphological staining analysis is to observe the morphology of sperm after special staining. The results are often described as the proportion of normal sperm and abnormal sperm, which to some extent reflects the ability of sperm to fertilize and combine with eggs to form fertilized eggs. As the most basic fertility index for men, it is suitable for every male infertility patient. 3. The analysis of sperm acrosome reaction mainly includes the analysis of sperm acrosome integrity rate and sperm acrosome enzyme activity, which reflects the ability of sperm to fertilize eggs to some extent. It is suitable for patients with unexplained infertility and patients who are ready for artificial insemination or IVF. 4. Analysis of DNA fragment in sperm nucleus The proportion of sperm with DNA fragment in sperm nucleus was analyzed. The high rate of DNA fragment in sperm nucleus indicates that the proportion of sperm with DNA fragment in sperm nucleus is too high, which may affect sperm-egg combination and embryo quality. It is suitable for infertile patients with unexplained abortion and embryo abortion, as well as infertile patients who are preparing for IVF treatment. 5. The main method to detect anti-sperm antibody (AsAb) is semen mixed antiglobulin test (MAR test). It is suitable for infertile patients with poor sperm motility, excessive sperm agglutination or unknown reasons. 6. Semen pathogen examination mainly includes bacterial examination, mycoplasma examination and chlamydia examination. When leukocytosis is found, reproductive tract infection is suspected, and assisted reproductive technology is adopted, semen pathogens are examined in the first half of semen. 7. Biochemical analysis of seminal plasma mainly includes neutral α -glucosidase and fructose, which reflect the secretion function and patency of epididymis and seminal vesicle respectively, and is suitable for azoospermia or severe oligozoospermia patients suspected of vas deferens obstruction. 8. Enzyme staining analysis and seminal plasma elastase detection reflect whether there is infection and inflammation in semen. It is suitable for infertile patients with high proportion of round cells and suspected gonadal infection by routine semen analysis. Third, the detection of serum sex hormones mainly includes testosterone (T), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and estradiol (E2). It is suitable for patients with azoospermia, severe oligozoospermia and sexual dysfunction. Fourth, B-ultrasound examination 1. B-ultrasound of scrotum and contents: suitable for patients suspected of varicocele, testicular or epididymal diseases; 2. Transrectal ultrasound: check prostate, seminal vesicle and ejaculatory duct, which is suitable for patients with azoospermia, severe oligozoospermia, oligozoospermia or hemospermia. V. Genetic examination Chromosome karyotype analysis of peripheral blood is suitable for patients with azoospermia, severe oligozoospermia, primary testicular dysplasia, unexplained abortion and embryo abortion; Y chromosome microdeletion detection is suitable for azoospermia and severe oligozoospermia patients. Six, seminal vesicle and vas deferens are traumatic and risky, and are suitable for infertile patients who are suspected of having ejaculatory duct or vas deferens obstruction and are ready for surgery. Seven, the main surgical methods of testicular biopsy include needle puncture, biopsy gun or needle puncture and incision biopsy. To understand the spermatogenic function of testis.