1, abstinence is required before semen examination.
Liu Yafeng, deputy director of the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University, suggested abstinence 2-7 days before sperm collection.
Semen examination is a very routine examination item in andrology examination and an important basis for the diagnosis of male reproductive system diseases. It is best to abstain from sex for 2~7 days before semen examination, including no masturbation and no nocturnal emission.
Sperm is produced in the testis and then swims to the epididymal pool, waiting for ejaculation. The distance from testis to epididymal pool is tens of centimeters, and it takes 2~3 days for sperm to arrive. If the male ejaculates just once before the semen examination, the sperm in the epididymal pool can not be replenished in time, which may lead to the low sperm density in the examination results.
Some men will feel puzzled-"I ejaculate twice in a row, and the second time I have a lot of semen." ! "In fact, prostatic fluid accounts for about 40%, seminal vesicle fluid accounts for about 60%, and urethral fluid accounts for about 1%. There are many sperm, but the volume is almost negligible. If the time interval between two ejaculations is short, the semen of the second ejaculation is mainly prostatic fluid and seminal vesicle fluid, and the number of sperm will be greatly reduced compared with that of the first ejaculation.
One week before sperm collection, it is necessary to avoid sauna and bathing at a temperature 2℃~4℃ lower than normal body temperature, that is, generally speaking, the most suitable temperature for male testis is between 34℃ and 35.5℃, in order to produce a large number of healthy sperm. If the testicular temperature reaches above 36℃, the sperm "Mr." will suffer from heatstroke, which will affect the quality of sperm and even cause male infertility.
Sauna, steam room, hot water sitz bath and recently reported automobile electric heating device will increase the temperature of male scrotum, resulting in long-term high temperature of testis. When the temperature of testis is higher than 40℃ for a long time, the spermatogenic ability of testis will be greatly reduced. In addition, many men like to wear jeans, giving people the feeling of being unrestrained, and some men like to wear tight underwear. However, if you are a long-term office worker or driver, you should pay more attention. Jeans and tight underwear will hinder the blood circulation of testicles and raise the temperature around testicles by 2.5℃.
Quitting smoking and drinking 2~3 months before sperm collection will increase the abnormal rate of sperm, and drinking alcohol will increase the risk of gonadal infection such as prostatitis, which will lead to the decrease of sperm quantity and vitality. What is the proportion of normal sperm (normal sperm morphology, normal sperm motility and normal chromosomes) that meet the fertility requirements? This ratio has been changing with the times. At the earliest, the proportion of normal sperm was required to reach at least 80%. Later, the requirement of this ratio was reduced to 30%, and then it was 15%. The current requirement is that as long as the proportion of normal sperm reaches 4%, the fertility requirements can be met. The requirement of normal sperm ratio on fertility is decreasing, which is related to the decrease of sperm number of the whole population and the continuous improvement of detection level.
Normal men of childbearing age have about 60 million to 200 million sperm at a time, of which more than 70% belong to normal sperm. Such sperm can reach the fallopian tube through their own efforts and external help, and finally only one sperm can complete the task of combining with the egg. There are many obstacles in the way of sperm and egg fusion. If the number of sperm is not enough, it is difficult to achieve the purpose of pregnancy.
It was only after the inflammation was cured that gonadal infection was found to be the primary cause of male infertility. Take the infection of prostate as an example, which will lead to poor liquefaction of semen. Normal semen will liquefy into water in an hour or so, which is beneficial for sperm to swim bravely forward to the egg. If semen is not liquefied, it will always be sticky and lumpy, and it is difficult for sperm to break through the tight encirclement. Prostate infection can also lead to asthenospermia, and then develop into oligozoospermia. In addition, when the prostate is infected, the reactive oxygen species of white blood cells in the prostatic fluid will reduce the PH value of semen and the vitality of sperm. He suggested that if men suspect that they have gonadal inflammation, especially those who have had unclean sex, they must be thoroughly treated as soon as possible.
The semen condition of men is greatly influenced by other factors, which is closely related to the interval between sperm collection and the last ejaculation, whether to take drugs that affect sperm motility, and the personnel and instruments for examination. Therefore, a semen examination sometimes does not fully reflect the real situation of semen. To this end, the World Health Organization specifically requires more than two routine semen examinations within two weeks before a diagnosis can be made based on the results.
2. Precautions for men before examination
1, three days before the physical examination, don't eat too greasy and indigestible food, and don't drink alcohol, strong tea, coffee and other irritating foods;
2. Pay attention to rest the day before the physical examination, ensure adequate sleep and avoid strenuous exercise;
3. Don't have sex the day before the male physical examination, so as not to affect the test results of prostatic fluid;
4. Blood drawing, B-ultrasound and oral examination are needed on the day of physical examination, so it is necessary to fast and ban water in the morning;
5. Pay attention to keep blood pressure stable during physical examination. Walking into the physical examination station with a normal heart will have less influence on blood pressure, electrocardiogram and other items. Physical examination found no abnormalities, does not mean that there is no basic disease. If you have symptoms of the disease, you should seek medical advice in time.
Specifically, the male fertility examination items are as follows:
1. Routine semen examination: This is the most basic and important clinical index to determine male fertility. The parameters related to semen are the first thing doctors need to know. Patients should pay attention to: 3 ~ 5 days for room examination; It is best to masturbate and sample; All semen must be obtained; Review twice in two weeks.
Biochemical examination of seminal plasma: the analysis of chemical components of seminal plasma is helpful to understand the functions of epididymis, prostate and seminal vesicle. When the patient has oligozoospermia, azoospermia, oligozoospermia, unexplained sperm motility decline, accessory gonad congenital defect and accessory gonad disease, biochemical examination of seminal plasma can be done, such as sugar, carnitine and acid phosphatase.
3. Microbiological examination related to male infertility: Male urinary and reproductive system infections often lead to male infertility. Pathogenic microorganisms related to male genitourinary system infection include bacteria, viruses, spirochetes, mycoplasma, chlamydia and so on. Neisseria gonorrhoeae, papillomavirus, adenoids and chlamydia trachomatis are common.
Four. Endocrine examination related to men: Reproductive endocrine dysfunction affects male sexual function and reproductive function, which is an important cause of male infertility. Endocrine examination is mainly the determination of sex hormones T, FSH, LH, PRL, E2 and various stimulation tests, such as HCG stimulation test.
The above is the introduction of matters needing attention in male fertility physical examination, and I hope it will help everyone.
Male physical examination is very important, especially under the dual effects of life and work pressure, regular physical examination must be beneficial. In addition, introduce several inspection packages to male friends:
Prostate cancer detection: the project includes andrology, prostate tumor marker combination and prostate color ultrasound.
Entertainment group (male): Conduct health screening for common tumors, cardiovascular and cerebrovascular diseases, liver diseases, kidney diseases, some infectious diseases and chronic lifestyle diseases, and provide accurate early warning, so that you can better understand your current physical condition.