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几种引起男子不育不孕的问题来源

发布日期：2024-07-05 10:18:15编辑：秩名


年龄会影响精子的质量

 
随着年龄的不断增长，男性的生育能力也逐渐下降。与女性卵子数量有限相比，男性产生精子的能力要强得多，但是，老年男性精子的“游动能力”越来越迟缓。人们一般都认为男人即使到了80岁也能生孩子，这是很片面的认识。精子游动每过一年都会减弱约0.7％，男性60岁时精子的异常比例上升到约85％。
 
 
 

温度影响精子活力

 
精子成长的过程需要低温，不然精子就会夭亡。阴囊是睾丸的“温度调节器”，当环境温度比体温低1～2℃时，才能顺利产生精子。当气温太高时，阴囊会扩大散热面积；而当温度降低时，它又会皱起来，以减少散热面积，从而使阴囊的温度保持比腹腔内低。因此，男性在洗澡时，水温不宜太高，常洗热水澡，可使精子数量减少，甚至导致不育。喜欢桑拿浴者更应慎行。

 

睾丸问题引起的不育

 
人的睾丸位于阴囊中，它的温度比腹腔温度低4～7℃，同时，多皱褶的阴囊皮肤分布大量的汗腺，可通过汗液分泌加速散热，以利于精子产生和生存。多数男孩在出生时，睾丸已从腹腔降入阴囊内，少数则在出生后逐渐下降，但最晚不应超过1年。睾丸未按期降入阴囊内称为隐睾症。隐睾症可以是一侧的，也可以是双侧的。
 
睾丸每日可产生上亿个精子。为什么它会有如此大的能力呢？因为睾丸具有一个庞大的“精子制造工厂”。睾丸内有数百条弯弯曲曲的小管，称作曲细精管。每条小管的直径还不到1毫米，但很长，所有小管的长度加起来约有250米。这些小管就是产生精子的场所。曲细精管的生精上皮含有生精细胞。这些生精细胞在不断发育的过程中，逐渐地向管腔方向移动，最终脱离曲细精管上皮，以成熟精子的形式向管腔内释放。
 
睾丸除了具有生精功能以外，另一个重要功能就是分泌雄性激素。从胎儿时期起睾丸就开始了内分泌的功能，以促使向男性分化。如因先天缺陷，雄激素分泌不足或缺乏接受雄激素作用的受体，胎儿会出现不同程度的假两性畸形。由于各种原因导致青春期时雄激素分泌不足，会使男性第二性征延迟出现、不出现或得而复失，且常常伴有不育症。此时需要外源补充雄激素，以促使内外生殖器官和第二性征的发育。
 

副性腺问题引起不育

 
副性腺是产生精浆的主要腺体，包括精囊、前列腺和尿道球腺。精浆是精液中的液体成分，精子仅仅在排出体外的一刹那与精浆接触几秒钟，但精浆对精子的转运和生理功能有重要影响，不少副性腺的疾病可造成不育。常见的是前列腺炎及精囊炎。
 
慢性前列腺炎是成年男子的常见病。引起慢性前列腺炎的主要原因是细菌感染。其次如性交过度、频繁手淫、酗酒或者受凉都可导致前列腺充血、腺小管阻塞及腺体功能低下。该病的临床表现多种多样，且经常变化。排尿异常，如尿急、尿频、尿痛或排尿不畅，尿痛可向会阴及肛门周围放射，甚至伴腰骶痛；可出现性功能障碍，如性欲减退、勃起功能障碍、早泄和遗精等。严重的慢性前列腺炎可导致男性不育。
 

阴囊问题引起不育

 
阴囊是腹壁的延续部分。它形成一个囊样结构，中间有一个中隔，将其分为左右两室。两个睾丸即分别位于两侧阴囊内。阴囊的主要功能是调节温度。阴囊皮肤多皱褶，松弛时，起到散热和降温的作用；收缩时则起升温和保温作用。因为阴囊皮肤富含汗腺，所以其调温能力很强，有利于睾丸生精上皮产生精子。由于阴囊的保护还使睾丸、附睾和精索免受外伤。但是，当阴囊异常时，也会影响睾丸的生精功能。
 
阴囊皮肤下面有一个两层腹膜形成的鞘膜，正常情况下，两层膜之间有少量液体，可以减少睾丸在阴囊内移动时的摩擦。因炎症、外伤、淋巴管阻塞等因素，可使鞘膜内液体量增加，形成囊性肿物样，称作鞘膜积液。有些小儿出生时就有先天性鞘膜积液。先天性鞘膜积液有时会不治自愈，有时需要手术治疗。
 
位于阴囊内，来自附睾和输精管的静脉汇合成精索静脉。当精索静脉曲张时，可影响睾丸的血液回流，从而影响睾丸的营养和氧气供应，以及代谢物排出，同时还会提高睾丸的局部温度。因此，对睾丸新陈代谢和生精作用产生不良影响。有部分患者可导致不育症。对明显的精索静脉曲张，实行高位结扎是主要的治疗方法，也可以进行精索静脉分流术或静脉栓塞。许多患者经治疗后精液质量得到改善，生育力恢复。当然，也有一些患者照样有良好的生育力，所以不要因患有此症而紧张。事实上，有相当一部分男性都患有程度不同的精索静脉曲张，至于是否应该治疗和如何治疗，可与医师讨论后决定。
 

阴茎、睾丸大小程度会引起的不育

 
只要阴茎发育正常，能正常勃起，就能过好性生活，不影响男性生育力。有人总是怀疑自己的阴茎小，其实勃起后的大小是正常的。还有人担心自己的阴茎粗，女性阴道的伸缩性很大，完全可以容纳。
 
需要重视的是睾丸的大小和质地。从出生到12岁青春期之前，睾丸处于相对静止期，一般体积为1～4毫升；之后睾丸体积迅速增大，成年男性的睾丸体积为16～25毫升，平均19.8毫升；60岁以后睾丸体积逐渐缩小。凡育龄男性睾丸体积小于15毫升，则显示睾丸的曲细精管生精上皮有损害。通常体积不超过3毫升的小睾丸多见于克氏综合征；睾丸大小在5～12毫升的患者可见于低促性腺激素型性腺功能低下症；睾丸不对称增大明显时，提示有睾丸肿瘤；睾丸对称性增大，可称为巨睾症，属于正常，但较少见。睾丸的质地亦应重视。正常睾丸轻压时有弹性，如轻压时感觉睾丸质软，则常伴有生精功能损害，可影响男性生育力，应及时就诊。
 

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