Pathological analysis of abnormal semen volume, causes of global sperm quality decline, and systematic assisted reproductive strategies.

143. Abnormal semen volume can lead to infertility. A normal, healthy man ejaculates 1.5 to 6 ml of semen during each sexual intercourse. However, some men experience abnormal semen volumes: either too low (less than 1 ml) or too high (more than 8 ml), both of which can cause infertility. Why is this? This is because seminal plasma is the source of neurotransmitters and nutrients for sperm. It contains buffering substances that stabilize the pH of semen, protecting sperm survival in the acidic vaginal secretions. Since sperm only accounts for 1% of semen volume, abnormal semen volume undoubtedly indicates a significant change in the composition of seminal plasma. If the semen volume is too low, the seminal plasma cannot dilute the sperm in the epididymis, causing them to lose motility and function due to insufficient energy and neurotransmitters. This prevents sperm from passing through the cervix into the fallopian tubes for fertilization, resulting in infertility. Conversely, when semen volume is too high, sperm density decreases, and the diluted semen easily leaks out of the vagina, rapidly reducing the sperm count, which is also unfavorable for conception. The main causes of low semen volume include: infection or other lesions of the accessory glands, ejaculatory duct obstruction, bladder sphincter dysfunction, and retrograde ejaculation. Excessive semen volume is commonly seen in seminal vesiculitis.

The decline in male sperm quality has been a persistent problem for nearly half a century. Simultaneously, the incidence of testicular abnormalities has increased significantly, posing unpredictable risks to human survival. Male fertility is related to sperm count to some extent, and a decline in sperm count may reflect a general decline in male fertility. The average sperm density in human semen has decreased from 113 million/ml in 1940 to 66 million/ml in 1990, and the average semen volume per ejaculation has decreased from 3.40 ml to 2.75 ml. What causes this overall decline in human semen quality? Increased pollution and deteriorating environmental conditions play a significant role. In addition, diseases, malnutrition, socioeconomic status, chronic stress, emotional repression, smoking, alcoholism, drug addiction, and occupational exposure to toxic substances such as heavy metals, pesticides, anesthetics, cell growth inhibitors, antimetabolites, and radiation-a wide variety of environmental factors-can negatively impact various reproductive health parameters. These factors can also affect health issues during puberty and menopause.

Nine strategies to prevent infertility (1) Find the cause of infertility: American male infertility expert Hughie Stolberg says that a quick self-test can help determine if you have varicocele, the primary cause of male infertility. Varicocele is an enlarged blood vessel in the seminal vesicle that obstructs blood flow and raises the temperature of the testicles to a level that kills sperm. To find varicocele, stand up, preferably after a bath, when the testicles are warm and relaxed. Due to the distribution of veins in the testicles, varicocele occurs more often on the left side than on the right. If you find varicocele, don't panic; a minor surgery at a hospital or clinic can solve the problem. (2) Keep the testicles relaxed and lower their temperature: One reason for the testicles to hang freely on the male body surface is that they must be kept at a temperature 4°C below body temperature in order to produce sperm. Medical expert Dr. Goldstein's methods to avoid excessively high testicular temperature include: avoiding prolonged hot baths, wearing loose underwear and trousers, and losing weight if obese so that the testicles are not covered by fat. (3) Pay attention to diet: Although there is no conclusive research to support this, many doctors believe that men can improve sperm quality by consuming certain vitamins. Emphasizing the important role of sufficient vitamin C, vitamin E, and beta-carotene. Medical experts also recommend adequate intake of inorganic zinc, which is beneficial to the prostate gland that produces semen. The best way to ingest the above nutrients that help protect sperm is to eat at least two kinds of fruits and three kinds of vegetables every day, and it is recommended to take a multivitamin/inorganic salt supplement containing at least 20 vitamins. (4) Relax your mind and body: Many doctors offer patients a common-sense suggestion to effectively cope with stress, including engaging in moderate-intensity exercise. Stress can affect the whole body and is also one of the pathogenic factors of infertility. (5) Quit smoking immediately: Medical experts warn that nicotine can reduce sperm count, damage sperm morphology, and reduce its motility. Studies have shown that the sperm of male smokers has a lower ability to penetrate the egg than the sperm of non-smokers; women who have sex with male smokers are more likely to miscarry. Furthermore, the damage that smoking causes to sperm chromosomes can lead to birth defects or cancer in children. (6) Take Vitamin C: If you are trying to quit smoking but have not yet succeeded, you can consider taking some Vitamin C. A study compared the sperm of smokers who took Vitamin C with those who did not, and found that the former not only had 34% more sperm, but also had better sperm health and motility. (7) Drink less alcohol: Alcohol can not only reduce sperm production, but also aggravate the consequences of varicocele. Experts recommend that alcohol consumption should be reduced to only 2 drinks per week. (8) Pay attention to the environment you are exposed to: Lead and radiation have been proven to cause male infertility, at least temporarily. Although it is unlikely that you will ingest large amounts of substances that cause infertility simply by drinking water, you should still check the water you drink to make sure it is lead-free. In addition, when undergoing X-ray examination, be sure to cover the testicles with a protective apron. (9) Use medication with caution: It has been proven that infertility is related to some medications used to treat hypertension, infectious intestinal diseases, ulcers, and gout. Therefore, medication should be taken with caution, and antibiotics should be taken appropriately according to the doctor's prescription. Pay attention to taking some safe medications.