male-fertility

Original source / Raw SKILL.md

---
name: male-fertility
description: Male fertility health tracking including semen analysis, hormone monitoring, and infertility assessment
argument-hint: <operation_type, e.g.: semen volume 2.5ml/hormone testosterone 15.5/status>
allowed-tools: Read, Write
schema: male-fertility/schema.json
---

# Male Fertility Health Skill

Male fertility health tracking and management, including semen analysis records, hormone level monitoring, and infertility factor assessment.

## Core Flow

```
User Input → Identify Operation Type → Parse Information → Check Completeness → Generate JSON → Save Data
                                     |
                              [Ask when information insufficient]
```

## Step 1: Parse User Input

### Operation Type Recognition

| Input Keywords | Operation |
|----------------|-----------|
| semen | Semen analysis |
| hormone | Hormone levels |
| varicocele | Varicocele |
| infection | Reproductive tract infection |
| status | View status |
| diagnosis | View diagnosis |

### Semen Parameter Recognition

| Parameter | Keywords | Extract |
|-----------|----------|--------|
| Volume | volume, ml | Number + mL |
| Concentration | concentration, 10^6/mL | Number |
| Progressive motility | pr, progressive | Percentage |
| Non-progressive motility | np | Percentage |
| Morphology | morphology, % | Percentage |
| pH | ph | 7.0-8.0 |

### Hormone Recognition

| Hormone | Keywords | Unit |
|---------|----------|------|
| Testosterone | testosterone, T | nmol/L |
| LH | LH | IU/L |
| FSH | FSH | IU/L |
| Prolactin | PRL | ng/mL |
| Estradiol | E2 | pg/mL |

## Step 2: Check Information Completeness

### Semen Analysis (semen)
- **Required**: At least one parameter value
- **Optional**: Abstinence period, test date

### Hormone Levels (hormone)
- **Required**: Hormone type and value
- **Optional**: Measurement time, test date

### Varicocele (varicocele)
- **Required**: Presence and location
- **Optional**: Grade, confirmation method

### Reproductive Tract Infection (infection)
- **Required**: Pathogen and result
- **Optional**: Test date

## Step 3: Interactive Prompts (If Needed)

Use consultation-style dialogue, friendly and natural questioning for missing information.

### Question Scenarios

#### Scenario A: Semen Analysis Missing Parameters
```
Please provide specific semen analysis parameters, such as:
- Volume (mL)
- Concentration (10^6/mL)
- Motility (PR/NP percentage)
- Morphology (normal形态%)
```

#### Scenario B: Hormone Test Missing Type
```
Which hormone test result is this?
Options: Testosterone, LH, FSH, Prolactin, Estradiol
```

## Step 4: Generate JSON

### Semen Analysis Data Structure

```json
{
  "record_type": "semen_analysis",
  "date": "2025-06-20",
  "abstinence_period": "3_days",
  "volume": {
    "value": 2.5,
    "unit": "mL",
    "reference": ">=1.5",
    "result": "normal"
  },
  "concentration": {
    "value": 45,
    "unit": "10^6/mL",
    "reference": ">=15",
    "result": "normal"
  },
  "total_count": {
    "value": 112.5,
    "unit": "10^6",
    "reference": ">=39",
    "result": "normal"
  },
  "motility": {
    "pr": {"value": 35, "reference": ">=32", "result": "normal"},
    "np": {"value": 20, "reference": ">=40", "result": "normal"}
  },
  "morphology": {
    "value": 4,
    "unit": "%",
    "reference": ">=4",
    "result": "normal"
  },
  "ph": {
    "value": 7.5,
    "reference": "7.2-8.0",
    "result": "normal"
  },
  "liquefaction": {
    "value": 30,
    "unit": "minutes",
    "reference": "<=60",
    "result": "normal"
  },
  "diagnosis": "normospermia"
}
```

### Hormone Data Structure

```json
{
  "record_type": "hormone_test",
  "date": "2025-06-15",
  "testosterone": {
    "total": 15.5,
    "reference": "10-35",
    "unit": "nmol/L",
    "result": "normal"
  },
  "lh": {
    "value": 5.2,
    "reference": "1.7-8.6",
    "unit": "IU/L",
    "result": "normal"
  },
  "fsh": {
    "value": 8.1,
    "reference": "1.5-12.4",
    "unit": "IU/L",
    "result": "normal"
  },
  "prl": {
    "value": 12.5,
    "reference": "<15",
    "unit": "ng/mL",
    "result": "normal"
  },
  "e2": {
    "value": 35,
    "reference": "<70",
    "unit": "pg/mL",
    "result": "normal"
  }
}
```

Complete schema definition: see [schema.json](schema.json).

## Step 5: Save Data

1. Generate record ID: `fertility_YYYYMMDD_XXX`
2. Save to `data/生育记录/YYYY-MM/YYYY-MM-DD_精液分析.json`
3. Update `data/fertility-tracker.json`
4. Update `data/index.json`

## Semen Analysis Standards (WHO 2021)

| Parameter | Normal | Abnormal |
|-----------|--------|----------|
| Volume | >= 1.5 mL | < 1.5 mL (hypospermia) |
| Concentration | >= 15 x 10^6/mL | < 15 (oligozoospermia) |
| Total count | >= 39 x 10^6 | < 39 |
| PR (progressive) | >= 32% | < 32% (asthenozoospermia) |
| NP (total) | >= 40% | < 40% |
| Normal morphology | >= 4% | < 4% (teratozoospermia) |
| pH | 7.2-8.0 | < 7.2 or > 8.0 |
| Liquefaction time | <= 60 minutes | > 60 minutes |

## Diagnosis Classification

| Result | Diagnosis |
|--------|----------|
| All parameters normal | Normal semen (normospermia) |
| Concentration < 15 | Oligozoospermia |
| Concentration = 0 | Azoospermia |
| PR < 32% | Asthenozoospermia |
| Normal morphology < 4% | Teratozoospermia |
| Volume < 1.5mL | Hypospermia |
| Multiple abnormalities | Mixed abnormalities |

## Execution Instructions

```
1. Identify operation type (semen/hormone/varicocele/infection/status/diagnosis)
2. Parse input parameters, extract all available information
3. Check required fields, ask user if missing
4. Evaluate results against WHO standards
5. Generate JSON compliant with schema.json
6. Save to appropriate file path
7. Confirm save to user and display summary and recommendations
```

## Example Interactions

### Example 1: Record Semen Analysis
```
User: 精液分析 精液量2.5ml 密度45 前向35% 形态4%
AI: 解析中...
    Volume: 2.5 mL ✓ Normal
    Concentration: 45 x 10^6/mL ✓ Normal
    Progressive motility: 35% ✓ Normal
    Morphology: 4% ✓ Normal

    Diagnosis: Normospermia

    Saved to: data/生育记录/2025-06/2025-06-20_精液分析.json
```

### Example 2: Record Hormone Levels
```
User: 激素检测 睾酮15.5 LH5.2 FSH8.1
AI: Record hormone test results:

    Testosterone: 15.5 nmol/L ✓ Normal (reference: 10-35)
    LH: 5.2 IU/L ✓ Normal (reference: 1.7-8.6)
    FSH: 8.1 IU/L ✓ Normal (reference: 1.5-12.4)

    Assessment: Hormone levels normal, HPTA axis function normal

    Saved to: data/生育记录/2025-06/2025-06-15_激素检测.json
```

### Example 3: View Status
```
User: 生育状态
AI: Male fertility health status

    Semen analysis: Normal (last test: 2025-06-20)
    Hormone levels: Normal (last test: 2025-06-15)
    Varicocele: None
    Reproductive tract infection: Negative

    Comprehensive Assessment: Normal fertility function

    Recommendation: Continue trying natural conception, maintain healthy lifestyle
```

For more examples, see [examples.md](examples.md).

## Important Notice

- This system is for fertility health tracking only, cannot replace professional medical diagnosis
- Semen analysis requires 2-3 confirmations
- Abstinence 3-7 days before testing
- Infertility assessment requires both partners to be checked
- All data is stored locally only

## Seek Immediate Medical Care For

- Azoospermia
- Significantly abnormal hormones
- Grade III varicocele
- Positive reproductive tract infection


---

## Referenced Files

> The following files are referenced in this skill and included for context.

### schema.json

```json
{
  "$schema": "http://json-schema.org/draft-07/schema#",
  "$id": "https://wellallyhealth.com/schemas/male-fertility.json",
  "title": "Male Fertility Health Record",
  "description": "男性生育健康记录，包括精液分析、激素水平、精索静脉曲张等",
  "type": "object",
  "properties": {
    "record_id": {
      "type": "string",
      "description": "记录唯一标识符",
      "pattern": "^fertility_[0-9]{8}_[0-9]{3}$"
    },
    "record_type": {
      "type": "string",
      "enum": ["semen_analysis", "hormone_test", "varicocele_exam", "infection_test", "fertility_status", "diagnosis"],
      "description": "记录类型"
    },
    "date": {
      "type": "string",
      "format": "date",
      "description": "检测日期"
    },
    "semen_analysis": {
      "type": "object",
      "description": "精液分析结果",
      "properties": {
        "abstinence_period": {
          "type": "string",
          "description": "禁欲时间，如3_days"
        },
        "volume": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "unit": {"type": "string", "enum": ["mL"]},
            "reference": {"type": "string"},
            "result": {"type": "string", "enum": ["normal", "abnormal", "low", "high"]}
          }
        },
        "concentration": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "unit": {"type": "string", "enum": ["10^6/mL"]},
            "reference": {"type": "string"},
            "result": {"type": "string"}
          }
        },
        "total_count": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "unit": {"type": "string", "enum": ["10^6"]},
            "reference": {"type": "string"},
            "result": {"type": "string"}
          }
        },
        "motility": {
          "type": "object",
          "properties": {
            "pr": {
              "type": "object",
              "properties": {
                "value": {"type": "number"},
                "reference": {"type": "string"},
                "result": {"type": "string"}
              }
            },
            "np": {
              "type": "object",
              "properties": {
                "value": {"type": "number"},
                "reference": {"type": "string"},
                "result": {"type": "string"}
              }
            },
            "im": {
              "type": "object",
              "properties": {
                "value": {"type": "number"},
                "result": {"type": "string"}
              }
            }
          }
        },
        "morphology": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "unit": {"type": "string", "enum": ["%"]},
            "reference": {"type": "string"},
            "result": {"type": "string"}
          }
        },
        "ph": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "reference": {"type": "string"},
            "result": {"type": "string"}
          }
        },
        "liquefaction": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "unit": {"type": "string", "enum": ["minutes"]},
            "reference": {"type": "string"},
            "result": {"type": "string"}
          }
        },
        "diagnosis": {
          "type": "string",
          "enum": ["normospermia", "oligozoospermia", "azoospermia", "asthenozoospermia", "teratozoospermia", "hypospermia", "mixed_abnormalities"],
          "description": "诊断结果"
        }
      }
    },
    "hormones": {
      "type": "object",
      "description": "激素检测结果",
      "properties": {
        "testosterone": {
          "type": "object",
          "properties": {
            "total": {"type": "number"},
            "free": {"type": "number"},
            "reference": {"type": "string"},
            "unit": {"type": "string", "enum": ["nmol/L"]},
            "result": {"type": "string", "enum": ["normal", "low", "high"]}
          }
        },
        "lh": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "reference": {"type": "string"},
            "unit": {"type": "string", "enum": ["IU/L"]},
            "result": {"type": "string"}
          }
        },
        "fsh": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "reference": {"type": "string"},
            "unit": {"type": "string", "enum": ["IU/L"]},
            "result": {"type": "string"}
          }
        },
        "prl": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "reference": {"type": "string"},
            "unit": {"type": "string", "enum": ["ng/mL"]},
            "result": {"type": "string"}
          }
        },
        "e2": {
          "type": "object",
          "properties": {
            "value": {"type": "number"},
            "reference": {"type": "string"},
            "unit": {"type": "string", "enum": ["pg/mL"]},
            "result": {"type": "string"}
          }
        }
      }
    },
    "varicocele": {
      "type": "object",
      "description": "精索静脉曲张检查结果",
      "properties": {
        "present": {"type": "boolean"},
        "side": {"type": "string", "enum": ["none", "left", "right", "bilateral"]},
        "grade": {"type": "string", "enum": ["I", "II", "III", null]},
        "confirmed_by": {"type": "string", "enum": ["ultrasound", "physical_exam", null]},
        "surgery": {"type": "boolean"},
        "surgery_date": {"type": "string", "format": "date"},
        "notes": {"type": "string"}
      }
    },
    "infections": {
      "type": "object",
      "description": "生殖道感染检查结果",
      "properties": {
        "chlamydia": {"type": "string", "enum": ["positive", "negative", "not_tested", null]},
        "gonorrhea": {"type": "string", "enum": ["positive", "negative", "not_tested", null]},
        "mycoplasma": {"type": "string", "enum": ["positive", "negative", "not_tested", null]},
        "ureaplasma": {"type": "string", "enum": ["positive", "negative", "not_tested", null]},
        "date": {"type": "string", "format": "date"},
        "treated": {"type": "boolean"}
      }
    },
    "notes": {
      "type": "string",
      "description": "备注信息"
    },
    "metadata": {
      "type": "object",
      "properties": {
        "created_at": {"type": "string", "format": "date-time"},
        "updated_at": {"type": "string", "format": "date-time"}
      }
    }
  },
  "required": ["record_id", "record_type", "date"]
}

```

### examples.md

```markdown
# 男性生育健康技能示例

## 示例 1: 正常精液分析

### 用户输入
```
精液分析 精液量2.5ml 密度45 前向35% 非前向20% 形态4% ph7.5
```

### 系统响应
```
✅ 精液分析已记录

精液分析报告:
━━━━━━━━━━━━━━━━━━━━━━━━━━
检测日期: 2025年6月20日
禁欲时间: 3天 ✓

精液参数:
━━━━━━━━━━━━━━━━━━━━━━━━━━
精液量: 2.5 mL ✓ (参考: >=1.5)
精子密度: 45 x 10^6/mL ✓ (参考: >=15)
精子总数: 112.5 x 10^6 ✓ (参考: >=39)

精子活力:
  PR(前向运动): 35% ✓ (参考: >=32)
  NP(非前向): 20% ✓ (参考: >=40)
  总活力: 55% ✓

精子形态: 4% ✓ (参考: >=4)
精液pH: 7.5 ✓ (参考: 7.2-8.0)

诊断结果:
━━━━━━━━━━━━━━━━━━━━━━━━━━
正常精液 (Normospermia) ✅

所有参数均在正常范围内。

建议:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 继续尝试自然受孕
✅ 保持健康生活方式
✅ 避免高温环境(桑拿、热水澡)
✅ 戒烟限酒
✅ 均衡饮食
✅ 规律运动

数据已保存至: data/生育记录/2025-06/2025-06-20_精液分析.json
```

## 示例 2: 异常精液分析

### 用户输入
```
精液检查 精液量1.2ml 密度12 前向25% 形态3%
```

### 系统响应
```
⚠️ 精液分析异常提示

精液分析报告:
━━━━━━━━━━━━━━━━━━━━━━━━━━
精液量: 1.2 mL ⚠️ (参考: >=1.5)
精子密度: 12 x 10^6/mL ⚠️ (参考: >=15)
前向运动: 25% ⚠️ (参考: >=32)
形态: 3% ⚠️ (参考: >=4)

诊断结果:
━━━━━━━━━━━━━━━━━━━━━━━━━━
少精症 + 弱精症 + 畸形精子症
⚠️ 精液质量异常

🏥 建议就医:
━━━━━━━━━━━━━━━━━━━━━━━━━━
建议咨询泌尿外科或男性科医生进一步评估:

进一步检查:
• 精索静脉超声
• 激素水平检测
• 生殖道感染筛查
• 遗传学检测(如需要)

生活方式调整:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 戒烟(非常重要)
✅ 限制酒精
✅ 避免高温环境
✅ 减少紧身裤
✅ 均衡营养
✅ 规律运动
✅ 充足睡眠
✅ 减轻压力

⚠️ 重要提示:
━━━━━━━━━━━━━━━━━━━━━━━━━━
精液质量异常不等于绝对不育。
轻度异常可通过生活方式改善和医学治疗得到纠正。

建议2-3个月后复查，同时咨询男性科医生。

数据已保存
```

## 示例 3: 激素检测

### 用户输入
```
激素检测 睾酮15.5 LH5.2 FSH8.1 泌乳素12.5 雌二醇35
```

### 系统响应
```
✅ 激素检测已记录

激素检测报告:
━━━━━━━━━━━━━━━━━━━━━━━━━━
检测日期: 2025年6月15日

激素水平:
━━━━━━━━━━━━━━━━━━━━━━━━━━
睾酮(T): 15.5 nmol/L ✓ (参考: 10-35)
LH: 5.2 IU/L ✓ (参考: 1.7-8.6)
FSH: 8.1 IU/L ✓ (参考: 1.5-12.4)
泌乳素(PRL): 12.5 ng/mL ✓ (参考: <15)
雌二醇(E2): 35 pg/mL ✓ (参考: <70)

评估:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 所有激素水平在正常范围
✅ 下丘脑-垂体-睾丸轴功能正常
✅ 无明显内分泌异常

激素-精子关系:
━━━━━━━━━━━━━━━━━━━━━━━━━━
正常激素水平提示:
• 睾丸产生精子功能正常
• 内分泌调节正常
• 精子质量问题可能与睾丸局部因素有关

建议:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 激素水平正常
✅ 重点关注精子质量
✅ 考虑精索静脉曲张检查
✅ 生殖道感染筛查

数据已保存
```

## 示例 4: 精索静脉曲张

### 用户输入
```
精索静脉曲张 左侧 II级
```

### 系统响应
```
✅ 精索静脉曲张已记录

检查结果:
━━━━━━━━━━━━━━━━━━━━━━━━━━
部位: 左侧
分级: II级
确诊方式: 超声

评估:
━━━━━━━━━━━━━━━━━━━━━━━━━━
左侧精索静脉曲张 II级

精索静脉曲张影响:
━━━━━━━━━━━━━━━━━━━━━━━━━━
• 可能导致精子质量下降
• 常见不育原因之一
• 可手术治疗

🏥 建议就医:
━━━━━━━━━━━━━━━━━━━━━━━━━━
建议咨询泌尿外科评估:

治疗选择:
• 观察(轻度)
• 手术治疗(中重度)
• 显微外科精索静脉结扎术
• 介入栓塞术

手术适应症:
━━━━━━━━━━━━━━━━━━━━━━━━━━
• 精液质量异常
• 睾丸体积缩小
• 睾丸疼痛
• 不孕2年以上

⚠️ 重要提示:
━━━━━━━━━━━━━━━━━━━━━━━━━━
精索静脉曲张是可治疗的不育原因。
手术可改善精液质量，提高自然受孕率。

数据已保存
```

## 示例 5: 查看状态

### 用户输入
```
生育状态
```

### 系统响应
```
📍 男性生育健康状态

基本信息:
━━━━━━━━━━━━━━━━━━━━━━━━━━
年龄: 35岁
不育类型: 原发性不育
伴侣年龄: 32岁
尝试受孕时间: 18个月

精液分析:
━━━━━━━━━━━━━━━━━━━━━━━━━━
最近检测: 2025年6月20日
精液量: 2.5 mL ✓
精子密度: 45 x 10^6/mL ✓
精子活力: PR 35% ✓
精子形态: 4% ✓
诊断: 正常精液

激素水平:
━━━━━━━━━━━━━━━━━━━━━━━━━━
睾酮: 15.5 nmol/L ✓
LH: 5.2 IU/L ✓
FSH: 8.1 IU/L ✓
泌乳素: 12.5 ng/mL ✓
评估: 激素水平正常

其他检查:
━━━━━━━━━━━━━━━━━━━━━━━━━━
精索静脉曲张: 无 ✓
衣原体: 阴性 ✓
淋球菌: 阴性 ✓

综合评估:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 精液分析正常
✅ 激素水平正常
✅ 无明显不育原因

可能因素:
━━━━━━━━━━━━━━━━━━━━━━━━━━
• 特发性不育
• 伴侣因素(需检查)
• 免疫因素
• 遗传因素

建议行动:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 继续尝试自然受孕
✅ 伴侣妇科检查(如未做)
✅ 2-3个月后复查精液
✅ 考虑染色体检测(如需要)

💡 本周关注:
━━━━━━━━━━━━━━━━━━━━━━━━━━
• 健康生活方式
• 避免高温环境
• 戒烟限酒
• 规律作息
```

## 示例 6: 查看诊断

### 用户输入
```
不育诊断
```

### 系统响应
```
📋 男性不育诊断报告

评估日期: 2025年12月31日

不育类型:
━━━━━━━━━━━━━━━━━━━━━━━━━━
类型: 原发性不育
尝试受孕时间: 18个月

精液分析评估:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 精液量正常
✅ 精子密度正常
✅ 精子活力正常
✅ 精子形态正常
结论: 精子分析正常

激素评估:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 睾酮正常
✅ LH正常
✅ FSH正常
✅ 泌乳素正常
结论: 内分泌功能正常

其他检查:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 无精索静脉曲张
✅ 无生殖道感染

综合诊断:
━━━━━━━━━━━━━━━━━━━━━━━━━━
特发性不育 (Idiopathic Infertility)

诊断说明:
━━━━━━━━━━━━━━━━━━━━━━━━━━
精液分析和激素水平均正常，
未发现明显不育原因。

特发性不育约占男性不育的30-40%。

可能因素(未证实):
━━━━━━━━━━━━━━━━━━━━━━━━━━
• 精子DNA碎片率增加
• 氧化应激
• 线粒体功能异常
• 隐匿精子质量缺陷
• 免疫因素

建议进一步检查:
━━━━━━━━━━━━━━━━━━━━━━━━━━
📋 精子DNA碎片率检测
📋 抗精子抗体检测
📋 Y染色体微缺失检测
📋 染色体核型分析
📋 伴侣妇科检查

治疗建议:
━━━━━━━━━━━━━━━━━━━━━━━━━━
✅ 继续尝试自然受孕
✅ 改善生活方式
✅ 抗氧化剂治疗(如需要)
✅ 辅助生殖技术(如需要)

辅助生殖技术选择:
━━━━━━━━━━━━━━━━━━━━━━━━━━
• 人工授精(IUI)
• 体外受精(IVF)
• 卵胞浆内单精子注射(ICSI)

预后:
━━━━━━━━━━━━━━━━━━━━━━━━━━
特发性不育预后:
• 仍有自然受孕可能
• 辅助生殖成功率良好
• 不影响后代健康

⚠️ 重要提示:
━━━━━━━━━━━━━━━━━━━━━━━━━━
不育不等于绝对不能生育。
现代生殖医学技术可帮助大多数不育夫妇实现生育。

建议咨询生殖医学中心制定个体化治疗方案。

数据已保存
```

```