Why is a man in his 50s infertile?

Infertility in men in their 50s may be caused by vas deferens obstruction, testicular function decline, endocrine disorders, reproductive system infection or varicocele, etc. The diagnosis needs to be confirmed through semen analysis, hormone testing and imaging examinations. Azoospermia is divided into two categories: obstructive and non-obstructive. The former may be related to inflammation or surgical injury, while the latter often involves spermatogenic dysfunction.

1. Vas deferens obstruction

Vasectomy or congenital developmental abnormalities can lead to disruption of the semen transport pathway. Reproductive tract infections such as epididymitis and prostatitis may cause scar tissue to block the ducts. The diagnosis can be confirmed by vas deferens imaging, and microsurgical anastomosis can reconstruct the channel. Levofloxacin tablets must be used to prevent infection after surgery.

2. Testicular function decline

Aging leads to the degeneration of testicular spermatogenic epithelial cells, which is manifested by increased levels of follicle-stimulating hormone. Long-term exposure to radiation or high temperature environments will accelerate functional decline. It is recommended to avoid prolonged sitting and bathing in hot springs. If necessary, tamoxifen tablets can be tried to regulate hormones, but cardiovascular risks need to be assessed.

3. Endocrine disorders

Pituitary tumors or hypothalamic lesions can cause insufficient secretion of gonadotropins. Diabetes and thyroid dysfunction can also interfere with testosterone synthesis. Prolactin and thyroid hormones need to be detected. Bromocriptine tablets can treat hyperprolactinemia, and methimazole tablets are suitable for patients with hyperthyroidism.

4. Reproductive system infection

Chronic prostatitis or tuberculous epididymitis can disrupt the spermatogenic microenvironment. Chlamydial infection may lead to vas deferens fibrosis. Semen culture combined with PCR detection can identify the pathogen. Doxycycline capsules are effective against non-specific infections. Anti-tuberculosis treatment needs to be continued for more than 6 months.

5. Varicocele

Obstruction of scrotal venous return will increase testicular temperature and inhibit spermatogenesis. In patients with severe varicose veins, earthworm-like masses in the scrotum may be seen when standing. Spermatic vein ligation under a microscope can improve blood flow. After surgery, Maizhiling tablets can be used to reduce edema and avoid weight bearing for 3 months.

Men over 50 years old who have infertility should prioritize the diagnosis of organic diseases such as tumors. Maintaining moderate exercise can help improve pelvic blood circulation. It is recommended to do 150 minutes of brisk walking or swimming every week. It is necessary to increase the intake of zinc in the diet. Foods such as oysters and pumpkin seeds can help maintain spermatogenesis. Avoid tight pants and long rides, and get regular prostate-specific antigen screenings. If you need to have children, you can consider testicular puncture and sperm extraction combined with assisted reproductive technology, but the genetic risks need to be fully assessed.