Generally speaking, those who have lived together without taking defensive measures after marriage, and have not had children for more than two years . If there is no problem with the wife after examination, the man should go to the hospital for examination in time, so as to find out the cause and treat it early .
1. Laboratory examination
In addition to semen examination as a mandatory item, the rest should be selected according to the specific situation of the patient:
1. Semen analysis: This is helpful to understand male fertility and is a must-check item for infertility. The inspection content includes color, volume, liquefaction time, pH, sperm count, motility, survival rate and shape.
2. In vitro heterogeneous fertilization experiment: Even if the routine semen analysis is completely normal, sometimes it still cannot fully represent the fertilization ability of the sperm. The in vitro heterogeneous insemination experiment can more accurately estimate the fertilization ability of sperm, and is of great value in judging male fertility. The most commonly used method is the heterogeneous insemination experiment in which human sperm penetrates hamster eggs, and the sperm of normal fertile people is used as a control.
3. Examination of prostatic fluid: normally it is milky white and slightly alkaline. Under a high-power microscope, you can see tiny, refracted lecithin granules, a few epithelial cells, amyloids, and sperm, and the number of white blood cells is greater than ten. When there is inflammation, the number of white blood cells increases. , or even see piles of pus cells, lecithin particles significantly reduced.
Second, endocrine examination. The function of the hypothalamus-pituitary-testis axis can be understood by gonadotropin-releasing hormone or clomiphene stimulation test. Determination of testosterone levels can directly reflect the function of plasma cells. Thyroid hormone, adrenal sebum hormone or prolactin can be measured if necessary.
Third, Doppler ultrasonography. Helps identify varicocele.
Fourth, X-ray examination. In order to determine the obstruction site of the vas deferens, vas deferens, epididymis, vas deferens, seminal vesicles, or urethrography can be used. For hyperprolactinemia, X-ray of sella sella (frontal and lateral views) can be used to determine whether there is a pituitary adenoma .
5. Immunological examination. Sperm agglutination or brake antibodies were detected in serum or seminal plasma by sperm agglutination test or brake test. Although there are many detection methods, they should be selected according to local conditions.
6. Testicular biopsy. For azoospermia or oligospermia, directly check the spermatogenic function of the seminiferous tubules of the testis and the development of interstitial cells. The synthesis and metabolism of local hormones can be reflected by immunohistochemical staining.
7. Karyotype analysis. For abnormalities of external genital organs, testicular dysplasia, and unexplained azoospermia.