Oligospermia - Low sperm count


It’s always disappointing but an expert can help you

Oligospermia denotes a sperm count below 15 million per millilitre of semen. Sperm count is only one of the important factor of semen in achieving pregnancy. Other factors are motility, morphology, vitality which are equally important in achieving pregnancy. If sperm count is in oligospermia range, still natural pregnancy is possible. The chances of natural conception can be further increased by expert advice. The treatment may vary from lifestyle changes to advanced microsurgical treatment.

Causes Of Oligospermia

Varicocele is commonly understood as dilated veins of scrotum. This is most common known cause of infertility in males. Varicocele is responsible for 35% to 75% cases of infertility in males. These dilated veins in scrotum leads to increase in testicular temperature which in turn leads to decrease in sperm production, motility and function. Varicocele is also responsible for increase in DNA fragmentation index (DFI). Even slight increase in testicular temperature can cause significant decrease in sperm count.

Multiple hormones plays crucial role in sperm production. FSH, LH, Prolactin, Estradiol and Testosterone are frequently tested in evaluation.

Infection of organs related to sperm production and transport is commonly associated with low sperm count. Symptoms include scrotal swelling, pain and fever.
Expert consultation including examination and lab test lead to correct diagnosis. These genital infections can affect sperm production for next few months. Prolonged infections can lead to blockage of sperm transport causing obstruction which can successfully treated with microscopic surgical technique leading to natural conception.

Klinefelter syndrome is a genetic abnormality which leads to azoospermia. This is the most common chromosomal genetic abnormality found in cases of azoospermia. This condition may go unnoticed till patient try to conceive or this may also present as signs and symptoms of delayed puberty, tall stature, reduced muscle mass, reduced facial or body hair, enlarged breast tissue, low bone mineral density, low energy, decreased libido, or behavioural and psychosocial problems. Though there is nil sperm count in ejaculate but it has been seen that many cases have occasional sperm production which can be retrieved microscopically.

Commonly seen urban lifestyle and diet habits are responsible for obesity in youth. According to a survey obesity is affecting nearly every third person. Obesity is also harmful for male fertility, as sperm production and maturation decreases with increase in weight.

FACTORS RESPONSIBLE FOR POOR SPERM COUNT IN OBESE CASES -
  • Increase in estradiol
  • Rise in testicular temperature
  • Increase in ROS load
  • Sexual dysfunction

Steroids, sex hormones and dietary supplements are commonly used as part of treatment or bodybuilders regimen. These directly or indirectly affect sperm production. These drugs should be avoided in males who are planning for a child. For normal production of sperms these drugs should be discontinued after proper consultation.

Due to chemical exposure, radiation and high temperature at working place certain occupations are considered as high risk for male infertility e.g: Agriculture, Herbicides, Construction, Machinists, Military, Plastic production, Printing industry, Service station Mechanics, Smiths, Taxi drivers, Tobacco Processing, Welding. Workers of these fields are at higher risk of low sperm count and should be considered responsible while managing an infertile couple.


Microscopic Sperm Retrieval

This is one of the procedures adopted for sperm retrieval in case the male is unable to produce and deliver healthy sperm through the natural process. The sperms are directly taken from the testicular tissues to complete the process.
Microscopic Sperm Retrieval or Micro TESE is a highly effective way of sperm retrieval in which under high magnification with the help of microscope good tissue in testis is searched for sperms.
In this procedure testis is cut opened and good tissue containing sperms are searched. Once the sperms are found in tissue removed from the testis the testis closed. Patient is discharged next day morning. Dressing is removed after 48 hours. Patient can return for daily activity after 2 days. Strenuous activity is avoided for 2 weeks.



Reconstructive surgery (VEA/ VVA):

Reconstructive surgeries like varicocelectomy are one of the most preferred treatment options to overcome the issues that are associated with male problems like varicoceles. The surgery is performed with a high powered surgical microscope.


Hoemonal therapy

The treatment based on hormone therapy emphasizes adding, removing and blocking a certain group of hormones that restricts the growth of cancerous cells. This may be used as an assisted treatment method for overcoming cancer.


Smoking ,Alcohol, Cocaine and Other Drugs Smoking

Worldwide smoking is a common addiction. In a survey with has been found that over one third of all men globally smoke some form of tobacco


Adverse effects Of smoking

  • Smoking affects all semen parameters including sperm count, motility and morphology. In a study it has been seen that smokers have a 19% reduction in sperm concentration compared with nonsmokers.
  • Women who directly smoked or exposed to second hand smoke have significantly lower implantation and pregnancy rates.
  • Paternal smoking has been seen to contribute to decreased IVF success rates.
  • Exposure to cigarettes to male child during pregnancy may lead to his ultimate fertility in future.

Ejaculatory problem

Males who are unable to produce semen sample usually have adequate number of sperm count but due to either partial blockage, complete blockage or retrograde ejaculation ejaculate does not have adequate amount of sperms. With relevant diagnosis of the cause and adequate treatment there are high likelihood of return of sperms in ejaculate leading to natural pregnancy.


Management

With relevant diagnosis of the cause and adequate treatment there are high likelihood of return of sperms in ejaculate leading to natural pregnancy. There are multiple medications and treatment protocol which are helpful after for achieving natural pregnancy after expert consultation and proper diagnosis.