What is the reason for oligospermia in a 45-year-old man?

Oligozoospermia in a 45-year-old man may be caused by decreased hormone levels, reproductive system infection, varicocele, bad living habits, and exposure to environmental toxins.

1. Decreased hormone levels:

Male testosterone secretion decreases year by year after the age of 40, directly affecting spermatogenic function. Hypothalamic-pituitary-gonadal axis dysfunction can lead to abnormalities in follicle-stimulating hormone and luteinizing hormone, further inhibiting spermatogenesis. Such patients are often accompanied by loss of sexual desire and erectile dysfunction, which need to be improved through hormone replacement therapy.

2. Reproductive system infection:

Inflammations such as chronic prostatitis and epididymitis will change the composition of seminal plasma, and inflammatory factors directly damage the seminiferous epithelium. Mycoplasma and chlamydia infections may cause obstruction of the vas deferens, and semen examination may show an increase in white blood cells. Anti-infective treatment requires the selection of sensitive antibiotics based on pathogenic test results.

3. Varicocele:

Abnormal expansion of the scrotal venous plexus will increase the local temperature of the testicles and affect the efficiency of spermatogenesis. The patient feels obvious swelling in the scrotum when standing, and in severe cases, vermiform veins can be seen. Microscopic spermatic vein ligation can effectively improve testicular microcirculation.

4. Bad living habits:

Long-term smoking will reduce the zinc content of semen, and alcohol will directly poison testicular interstitial cells. Disturbances in circadian rhythm caused by staying up late will inhibit melatonin secretion and affect the spermatogenic cycle. It is recommended to go to bed before 23:00 and exercise for more than 30 minutes every day.

5. Environmental toxin exposure:

Plasticizers such as bisphenol A have estrogen-like effects, and pesticide residues can damage the blood-testis barrier. Heavy metals lead and cadmium accumulate in testicular tissue and interfere with sperm DNA integrity. Those engaged in the chemical industry and printing industry should take good protection and conduct heavy metal screening every year.

It is recommended to increase the intake of zinc-rich foods such as oysters and pumpkin seeds, and avoid soaking in hot springs or wearing tight pants for a long time. Those with fertility needs can consider vitamin E combined with L-carnitine supplementation, but they need to be used under the guidance of a doctor. Semen analysis should be reviewed every 2-3 months. If there is no improvement for six months, genetic factors such as chromosomal abnormalities should be investigated. Properly perform squat exercises to promote pelvic blood circulation and maintain a ventilated and dry environment in the scrotum.