Under normal circumstances, male semen is in a liquefied state when it is just ejected from the body, but in a short time, it will solidify into a jelly or clot shape. After about 10 to 30 minutes, semen will liquefy into a water like liquid. This process is called semen liquefaction, which is a normal physiological phenomenon. "If semen is discharged from the body and remains gelatinous for more than 30 minutes, it is a pathological condition and is referred to as non liquefaction of semen.".
This process is very consistent with human reproductive requirements. The initial liquefied state of semen is very conducive to ejaculation, and the subsequent gelatinization is to allow the semen to stay in the female vagina without flowing out easily. Later, the liquefaction is to allow the sperm in the semen to fully move, so as to swim along the female reproductive tract towards the fallopian tube, facilitating sperm egg bonding and fertilization. If this is not a physiological process, it indicates that there is a problem with semen.
The reason why semen coagulates into a gelatinous state is due to the coagulation protein secreted by the seminal vesicle glands. The proteolytic enzymes and fibrinolytic enzymes secreted by the prostate gland in semen can decompose this coagulated protein and promote semen liquefaction. Therefore, non liquefaction of semen is caused by an increase in clotting protein or a decrease in proteolytic enzymes and fibrinolytic enzymes. During semen analysis, if the semen is in a non coagulable state, it may be caused by a defect in the ejaculatory duct or a congenital lack of seminal vesicles.
Non liquefaction of semen often affects the free movement of sperm. Non liquefied semen can be seen under a microscope as sperm clumps, unable to move or only slowly squirming. "The movement of sperm in this semen in the female reproductive tract is significantly hindered, making it impossible for sperm to ascend into the cervical canal, uterine cavity, and fallopian tubes, and cannot meet the egg, causing fertilization to be impaired.".
Common causes of non liquefaction of semen. Clinically, non liquefaction of semen is often due to insufficient fibrinolytic enzymes secreted by the prostate due to seminal vesiculitis and prostatitis, or a lack of trace elements (magnesium, zinc, etc.), as well as congenital prostate deficiency. We know that the secretions of the prostate and seminal vesicles participate in the process of semen coagulation and liquefaction. The coagulation factors produced by the seminal vesicles cause semen coagulation, while the proteolytic enzymes, fibrinolytic enzymes, and other semen liquefaction factors produced by the prostate gland cause semen liquefaction. Once inflammation occurs in the seminal vesicle or prostate gland, it can interfere with the secretion of the above factors, causing an increase in coagulation factors or a decrease in liquefaction factors, leading to the formation of semen non liquefaction syndrome. Therefore, when male semen does not liquefy, doctors often tell patients to check the prostate, etc.
According to the pathological phenomenon of non liquefaction of semen, the key to treating non liquefaction of semen is to treat diseases of the seminal vesicle and prostate. If there is an infection, it is necessary to examine the infected pathogens, such as Ureaplasma urealyticum, Chlamydia trachomatis, and Mycoplasma genitalium. If the above pathogens are found, a drug sensitivity test will be conducted at the same time, and evidence-based treatment will be obtained.
(Intern Editor: Cai Junyi)