What is semen non-liquefaction?

In normal adult males, semen initially appears as a thick gel-like substance after ejaculation, which helps it remain in the female reproductive tract. Within 5 to 20 minutes, the semen gradually liquefies into a thinner liquid, allowing sperm to move freely and fertilize the female egg. If the semen fails to liquefy within 60 minutes after ejaculation, it is diagnosed as semen non-liquefaction^[1]. This condition affects sperm motility and vitality, accounting for approximately 1.2% to 11.8% of male infertility cases^[2,3].

Which department should be consulted for semen non-liquefaction?

Reproductive Medicine, Andrology, or Urology.

What are the causes of semen non-liquefaction?

The exact cause is not fully understood, but it may be related to the following factors:

• Chronic prostatitis: Research indicates that 43.2% of semen non-liquefaction cases are caused by chronic prostatitis. Inflammation disrupts normal semen formation, leading to impaired sperm production and non-liquefaction^[4].
• Reproductive tract infections: Infections (e.g., mycoplasma, bacterial) can damage enzymes related to sperm motility, resulting in non-liquefaction and reduced semen quality.
• Varicocele: Varicocele causes blood stagnation in the testicles, increasing levels of catecholamines, serotonin, prostaglandins, and other metabolites, which may lead to semen non-liquefaction and reduced sperm quality^[4].
• Unhealthy lifestyle: Habits such as chronic sleep deprivation, smoking, excessive alcohol consumption, spicy diets, and high stress levels can negatively affect sperm quality.

Who is more likely to experience semen non-liquefaction?

• Men with chronic prostatitis;
• Men with reproductive tract infections;
• Men with varicocele;
• Men with poor lifestyle habits, such as chronic sleep deprivation or excessive alcohol consumption.

What are the main symptoms of semen non-liquefaction?

Semen fails to transition from a thick gel-like state to a thin liquid within 60 minutes after ejaculation^[1]. Non-liquefaction can be complete (no change in consistency) or partial (partial liquefaction but not fully), with the latter being more common.

How is semen non-liquefaction diagnosed? What tests are needed?

Diagnosis is based on medical history and laboratory tests.

• Medical history: Conditions such as chronic prostatitis, spermatocystitis, epididymitis, or other reproductive infections may impair semen quality and cause non-liquefaction.
• Laboratory tests: Semen analysis, seminal plasma biochemistry, funnel testing, and filament length observation help evaluate sperm composition, morphology, and quality to guide treatment.

How is semen non-liquefaction treated?

There is no specific cure, but treatment focuses on lifestyle adjustments and addressing underlying causes.

• Antibiotics: Used for patients with reproductive infections (e.g., chronic prostatitis). Macrolides and quinolones are common choices. Long-term use may affect sperm quality, so strict medical supervision is required^[4].
• Hormone therapy: Patients with low testosterone may benefit from testosterone supplements (e.g., testosterone undecanoate) or human chorionic gonadotropin (hCG) injections to regulate gonadal secretion^[4].
• Micronutrient supplementation: For idiopathic cases, zinc, vitamin C, and vitamin E may be recommended. Pancreatic kininogenase can improve sperm motility, while vitamin E has antioxidant and fertility-enhancing effects^[5].

How does semen non-liquefaction affect life?

It typically reduces sperm motility and vitality. Higher non-liquefaction rates correlate with poorer sperm quality, potentially leading to subfertility or infertility.

How to prevent semen non-liquefaction?

• Adopt healthy habits: balanced diet, regular sleep, avoid smoking/alcohol/spicy foods.
• Limit sauna use, as scrotal overheating harms sperm.
• Stay hydrated, urinate frequently, avoid prolonged sitting.
• Avoid excessive masturbation or sexual activity; maintain genital hygiene to prevent infections.
• Exercise regularly to boost immunity.