What tests should male infertility patients do?

(1) Semen analysis: This is the most valuable examination to evaluate male fertility. In order to ensure the accuracy of the results, samples should be collected correctly. Patients should abstain from sex for 3~7 days, collect all semen from one ejaculation and submit it for inspection within half an hour. Because the semen parameters vary greatly, it is best for each subject to have two tests. The normal values of semen are: the semen volume is more than 2 ml, the liquefaction time is 60 minutes, the sperm density is more than 20 million /ml, and the survival rate is more than 60%; Vigor, after ejaculation within 60 minutes, more than 50% of the sperm moved forward, and more than 50% of the sperm with normal morphology.

(2) Determination of reproductive endocrine hormones: The central nervous system-hypothalamus-pituitary-testis constitutes the male reproductive shafting, which regulates the male reproductive function. They are regulated by endocrine hormones, so the level of endocrine hormones reflects the male reproductive state.

If the values of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PR 1) and testosterone (T) are normal, endocrine diseases of reproductive system can be basically ruled out. If FSH is increased, it suggests that the seminiferous epithelium of testicular seminiferous tubule is damaged; The increase of 1H and the decrease of serum testosterone suggest that leydig cells in testis are damaged. Blood testosterone (T), luteinizing hormone (1H) and follicle stimulating hormone (FSH) are all decreased, which means secondary testicular dysfunction, also known as hypogonadism, that is, the testis itself is normal, but due to pituitary or hypothalamic dysfunction, gonadotropin (FSH, LH) secretion is insufficient, leading to testicular dysfunction.

(3) Testicular biopsy: Testicular biopsy plays an important role in the diagnosis of male infertility. Through pathological examination of testis, we can evaluate the degree of spermatogenic function and spermatogenic disorder, and provide objective basis for the diagnosis, treatment and prognosis of male infertility. In the past, surgical incision was generally used to obtain testicular tissue, but in recent years it has been gradually replaced by puncture.

Testicular biopsy is mainly suitable for azoospermia and oligozoospermia with normal follicle stimulating hormone (FSH). For example, we can infer that azoospermia is caused by vas deferens obstruction according to normal testicular tissue, and infer the cause of the disease according to the pathological damage of testicular tissue, so as to evaluate the prognosis and formulate a reasonable treatment plan.

In addition, for male infertility patients, we can also carry out immunological examination, chromosome examination and spermatography to make a complete diagnosis of male infertility.