少精子症诊疗中国专家共识

Chinese experts'consensus on the diagnosis and treatment of oligozoospermia

少精子症作为男性不育最常见的类型之一,是指射出体外的精液中精子总数(或精子浓度)低于正常生育力男性精液检查参考值下限。本共识由中国医师协会生殖医学专委会生殖男科学组组织专家编写,从少精子症的病因、诊断流程以及个体化治疗方案等多个方面进行了深入的探讨,提出基于2次及以上精液检测结果的分级标准;推荐进行生殖内分泌激素检查、影像学检查、遗传学检测(疑似遗传因素)等明确少精子症的病因;推荐针对少精子症病因的治疗(激素治疗、精索静脉曲张结扎术、精道内镜手术等)、抗氧化治疗、中西医结合治疗等,以及辅助生殖技术助孕(经上述常规治疗手段无效时,合理选择宫腔内人工授精、体外受精、卵胞质内单精子显微注射、植入前遗传学检测等方案)。本共识可为从事生殖医学、男科学的专业医务人员提供专家咨询和建议。

As one of the most common types of male infertility,oligozoospermia is defined as that the total number of sperm(or sperm concentration)in the ejaculated semen is lower than the lower limit of the reference value of normal fertility male semen examination.This consensus was drafted by experts organized by Reproductive Andrology Group,Reproductive Medicine Professional Committee of Chinese Medical Doctor Association,and conducted in-depth discussions on the epidemiology,etiology,diagnosis process,and individualized management of oligozoospermia.It was proposed that oligozoospermia was graded based on the twice or more results of semen analysis.And reproductive endocrine hormone examination,imaging examination,genetic testing(suspected genetic factors),etc.are recommended to determine the cause of oligozoospermia.Furthermore,we recommend treatments according to the causes of oligozoospermia(hormonal therapy,varicocelectomy,endoscopic surgery of the seminal tract,etc.),antioxidant therapy,integrated Traditional Chinese and Western Medicine,etc.Additionally,when the above-mentioned conventional treatments are invalid,assisted reproduction,including intrauterine insemination,in vitro fertilization,intracytoplasmic sperm injection,preimplantation genetic testing,was recommended reasonablly.This consensus can provide expert consultation and advice for medical professionals engaged in reproductive medicine and andrology.