How to solve the problem of infertility in a 60-year-old man

Azoospermia in 60-year-old men requires targeted treatment based on the cause, mainly including hormone replacement therapy, surgical dredging, assisted reproductive technology, etc. Azoospermia is usually caused by testicular dysfunction, vas deferens obstruction, endocrine abnormalities and other factors. It is recommended to seek medical advice as soon as possible for a clear diagnosis.

1. Hormone replacement therapy

For testicular hypofunction caused by hypogonadotropin, chorionic gonadotropin injection, urinary gonadotropin injection and other drugs can be used according to the doctor's advice to stimulate spermatogenesis. This type of treatment requires continuous monitoring of semen changes for 3-6 months. Side effects such as breast swelling and pain may occur during this period, and hormone levels need to be reviewed regularly.

2. Vas deferens anastomosis

If obstructive azoospermia is caused by vasectomy or inflammation, microsurgical vasovasostomy can be used. The probability of sperm appearing in semen within 3 months after surgery is high, but it should be noted that restenosis may occur after surgery. This operation has a better effect on iatrogenic obstruction, but the success rate of infectious obstruction is relatively low.

3. Testicular puncture and sperm extraction

Patients with non-obstructive azoospermia can achieve fertility by extracting viable sperm through testicular fine-needle aspiration, combined with intracytoplasmic sperm injection technology. It is suitable for patients with chromosomal abnormalities such as Klinefelter syndrome, but the probability of obtaining viable sperm is positively correlated with testicular volume, and testicular spermatogenic function needs to be evaluated in advance.

4. Artificial insemination with sperm

For irreversible spermatogenic disorders, human sperm banks can be used to donate sperm with the consent of both parties. It is necessary to complete infectious disease screening, genetic disease testing and other procedures, and use intrauterine insemination or in vitro fertilization technology. The law requires that informed consent forms be signed and medical records kept for more than 20 years.

5. Traditional Chinese Medicine conditioning

For kidney essence deficiency type, you can try Wuzi Yanzong Pills combined with acupuncture at Guanyuan, Shenshu and other acupoints. For liver stagnation and qi stagnation, add or subtract Bupleurum Shugan Powder. It is necessary to regulate the menstrual cycle for 3 consecutive times, and avoid eating cold, spicy food during this period. Traditional therapy may have some improvement effect on functional spermatogenic disorders.

Elderly men with azoospermia should prioritize the investigation of secondary factors such as tumors and metabolic diseases. It is necessary to avoid factors that inhibit spermatogenesis such as high temperature environments and ionizing radiation on a daily basis, and to supplement trace elements such as zinc and selenium in appropriate amounts. It is recommended that spouses check their fertility function simultaneously and choose an appropriate plan according to their family plan. All treatments must be carried out under the professional guidance of the Reproductive Medicine Center.