The so-called no sperm disease is refers to 3 consecutive semen centrifugal microscopic not seen sperm, also need to eliminate not ejaculation and retrograde ejaculation rear can diagnose. No sperm disease is a kind of extreme male infertility, its incidence of infertile men of 8% ~ 10%. Clinical admiral, its divided into obstructive and the obstructive no sperm disease two kinds big.
Obstruction sex no sperm disease is genital tract obstruction to happen, sperm production can not arrive after the in vitro, but in the distal obstruction but have a lot of sperm exist. Clinical common obstruction parts have the epididymis vasectomy, groin period and ejaculation pipe, etc. These patients often has a good life pure function, is often the result of previous reproductive tract infection, such as the epididymitis and epididymis n/med tuberculosis, gonorrhea, etc and groin surgery or causes damage epididymis suggesting the lumen jams, of course also includes are the result of the vas ligation obstruction. The above already bear a male testing found no sperm, is because after birth for reproductive tract infection and cause obstruction, form secondary no sperm disease.
The obstruction sex no sperm disease is ruled out the obstruction factors of low birth of pure function sex disease. This kind of patients can't produce sperm or produced only very few sperm and semen to can not find sperm. Usually congenital or acquired by factors, common innate factors including congenital testicular dysplasia (g syndrome), and only support cells cryptorchidism was syndrome. And the day after tomorrow is the main factor is that pollution of the environment, long-term exposure to chemicals (such as lead, benzene, etc), adolescence in mumps orchitis, and long-term use lead to life essence oil bred cell damage, etc.
Diagnose needs overall check
In the diagnosis of no sperm disease, first to distinguish between obstruction or not. This can be through the history in question, physical examination, semen parameters and seminal plasma biochemical, hemorrhagic hormone detection, B ultrasonic and chromosome detection etc make the initial diagnosis. If patients have clear reproductive tract infection history, physical examination in the scrotum or the tail section vasectomy epididymis touch nodules, and seminal plasma neutral glycosidase enzymes can reduce a primary diagnosis of obstructive no sperm disease. If patients semen quantity is little, semen solidify, pH value less than 7.0, the combination can be diagnosed as basic negative fructose ejaculation tube obstruction. The reproductive system and by transrectal ultrasound can be clear and seminal vesicle have perfect vasectomy such as. Sperm cells exfoliated inspection found sperm cells was born, the basic rule out obstruction factors.
Obstruction after type effect is good
If epididymis puncture find great sperm, can be diagnosed with obstructive no sperm disease. In the exclusion of the bilateral congenital vasectomy after absent, can consider further surgery to remove obstruction. Epididymis obstruction feasible vasectomy epididymis-anastomosis. The scrotum vasectomy for obstruction (including vas ligation postoperative) feasible-suggesting vasectomy anastomosis. Ejaculation open tube obstruction, can transurethral will cut the ejaculation mouth.
If puncture not found sperm, need to be further cut take testicular tissue biopsies. As in biopsy tissue found in the smaller number sperm, microscope every 10 at high magnification only find article 1 ~ 2 sperm, is that of low birth preliminary function. Who can find the biopsy sperm, but through the second generation test-tube baby to get birth, namely single sperm injection (ICSI) in follicle treatment.
In theory the man has only ICSI technology article 1 form the normal sperm can live completed fertilization, this makes those less serious weak sperm and bilateral congenital lack such as, can't do vasectomy of surgical treatment of obstructive no sperm disease, and the art of failure to vasectomy patients have the possibility of fertility. Before the operation, the study need super promote ovulation, B ultrasonic guided in in oviposit period achieved after eggs, the man take fine, finally by experienced technician artificial choose the best article 1 sperm for puncture fertilization. Because be artificial selection sperm, not the sperm of the survival of the fittest between natural selection, the choice of sperm there may be some defects. Those who have a genetic defect patients, such as g syndrome patients, testicular biopsy take fine for ICSI, will bring the next generation genetic defect, it needs to be conducted before the embryo transfer genetic diagnosis. At the same time, another defect is ICSI expensive and limited success rate, the current domestic some technical leading reproductive center success rate keep in 35% ~ 40%.
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