Post Date December, 03 2023
Therapeutic principles
1. Etiological treatment;
2. Endocrine therapy;
3. Non specific treatment;
4. Surgical treatment;
5. Artificial insemination.
Principles of medication
1. Sterility caused by genital tract infections is mainly treated with antibiotics and anti-inflammatory drugs, supplemented by drugs that enhance sperm motility.
2. Sexual hormone drugs should be used as the main endocrine therapy for azoospermia, oligospermia, and idiopathic infertility.
3. For those with low sperm motility, drug treatment to improve sperm motility is the main method.
4. Infertility caused by varicose veins, obstruction of the vas deferens, cryptorchidism, and hypospadias should be treated surgically, supplemented by endocrine and other adjuvant drugs.
5. Those who are absolutely infertile (such as azoospermia) should undergo artificial insemination.
Treatment includes two aspects: causal treatment and symptomatic treatment:
1. Promote spermatogenic function of testis
① Drug treatment: commonly used chorionic gonadotropin 1500 to 2000 U intramuscular injection, 3 times a week; Clomiphene 50mg orally, once daily, for 3 months.
② Surgical treatment: Patients with varicocele accompanied by abnormal semen routine should undergo high ligation of the spermatic vein. Patients with cryptorchidism or testicular insufficiency should undergo testicular descending fixation to promote testicular spermatogenesis.
2. Keep the vas deferens unobstructed
Actively treat sexual dysfunction and maintain a normal sexual life. Surgical treatment should be actively performed for congenital absence of the vas deferens, obstruction of the vas deferens, and vasectomy.
3. Improve sperm function
Patients with genital tract inflammation should be actively treated with antibiotics; Vitamin E, vitamin C, and zinc preparations such as complex protein zinc can all improve sperm function. For immune infertility, using condoms can eliminate and reduce the stimulation of sperm antigens to women. The short-term use of large doses of immunosuppressants and artificial insemination with sperm washing are helpful in the treatment of immune infertility. Artificial insemination (AI) includes two categories: donor sperm artificial insemination (AID) and husband sperm artificial insemination. In recent years, in vitro assisted reproductive technology has developed rapidly, especially intracytoplasmic sperm injection (ICSI), which has been used to treat oligospermia, asthenospermia, and azoospermia, and has achieved good results.
