For married couples of childbearing age in their prime who desire children and use no contraception, the probability of conceiving within one year is 90%. Among the remaining 10% of couples, at least one partner likely has infertility issues. The likelihood of the female partner being the cause is 50%, the male partner 30%, and both partners having issues 20%.
When conducting infertility examinations, doctors typically recommend starting with the husband. Male infertility screening is more straightforward and economical, requiring only a few hundred yuan for simple tests like semen analysis. This approach yields relatively accurate conclusions. If male factors are ruled out, treatment can then focus entirely on the female partner.Focusing solely on the female partner from the outset may waste significant time, effort, and resources.
Understanding Causes of Male Infertility
1. Chromosomal abnormalities: Common examples include male pseudohermaphroditism, Klinefelter syndrome, and XYY syndrome.
2. Endocrine disorders stem from gonadotropin deficiency.
3. Common conditions include selective hypogonadotropic hypogonadism (Kallmann syndrome); selective LH deficiency and FSH deficiency; adrenal cortical hyperplasia; and hyperprolactinemia.
4. Genitourinary infections are relatively common. In recent years, with the rising incidence of sexually transmitted diseases, the prevalence and severity of genitourinary inflammations such as prostatitis, epididymitis, orchitis, and urethritis have increased, significantly impacting male fertility.
5. Obstruction of the spermatic ducts impairs sperm transport. Testicular spermatogenic dysfunction is commonly seen in cryptorchidism. Physicochemical factors such as varicocele, toxins, magnetic fields, high fever, and trauma can all cause testicular spermatogenesis disorders.
6. Abnormal sperm structure and seminal plasma abnormalities affect sperm motility, capacitation, and acrosome reaction.
7. Immune infertility: Both male-produced anti-sperm antibodies and female-produced anti-sperm alloantibodies can cause male infertility.
8. Male sexual dysfunction: Erectile dysfunction, premature ejaculation, anejaculation, and retrograde ejaculation can all lead to male infertility.
How to Detect Early Signs of Male Infertility
Diagnostic approaches for male infertility typically include detailed medical history review, physical examination, laboratory tests, imaging studies, and other assessments.
First, physicians conduct comprehensive medical history gathering—a critical foundation for establishing diagnostic pathways. Inquiries generally cover marital/reproductive history, sexual history, past medical conditions, and family medical history.
Second, physical examinations assess height, weight, body composition, and degree of obesity. This includes evaluating congenital testicular abnormalities, trauma, and hypoplasia for differential diagnosis. Prostate massage may also be performed to collect prostate fluid for testing.Second, physical examination includes assessing height, weight, body composition, and degree of obesity. This helps rule out congenital testicular abnormalities, trauma, or hypoplasia. A prostate massage may be performed to collect prostatic fluid for laboratory analysis. Laboratory tests follow to exclude bacterial infections such as epididymitis, seminal vesiculitis, urogenital tract inflammation, or prostatitis.Additionally, semen analysis is a crucial diagnostic tool for male infertility, reflecting sperm quality produced by the testes, patency of the sperm ducts, and secretory function of the epididymis. Reminder: Self-examination can detect warning signs Men can conduct effective self-checks by learning basic fertility knowledge and self-assessment methods.
If you gently palpate along the spermatic cord from top to bottom and detect large, worm-like, soft, and tortuous masses within the scrotum, be alert—this may indicate varicocele. It elevates testicular temperature, and venous blood stasis impairs testicular metabolism, thereby disrupting spermatogenesis and reducing semen quality.
Swelling and pain in the testicle that gradually subsides followed by testicular shrinkage may indicate testicular torsion or atrophic testicular damage after inflammation.This often involves irreversible damage to sperm-producing cells. If the testicle fails to descend into the scrotum and remains in the abdominal cavity, it is called cryptorchidism. The elevated temperature in the abdominal cavity is unfavorable for sperm production and significantly increases the risk of testicular malignancy.
Observing semen can also partially indicate fertility. Normal semen appears grayish-white or slightly yellowish. Pink or red semen indicates hematospermia. Normal semen volume ranges from 2 to 6 milliliters; volumes exceeding 7 milliliters are considered excessive. This not only lowers sperm density but also increases the likelihood of semen leakage from the female body, reducing the total sperm count.A volume below 2 milliliters indicates low semen volume, while less than 1 milliliter is considered extremely low and highly likely to cause infertility. Typically, semen liquefies within 15-30 minutes after ejaculation. If it fails to change consistency after 30 minutes, this clinical condition is called semen non-liquefaction, another cause of infertility.