Dealing with infertility issues can be emotionally draining. Men may experience sadness, frustration, and loss of hope, especially if they desire to have children.

Oligospermia(Low Sperm Count)

Oligospermia, is a medical disorder in which a man’s sperm count is abnormally low. It is a leading cause of male infertility, as the reduced number of sperm may hinder successful conception. Oligospermia refers specifically to the condition where the sperm count falls below the normal threshold (15 million sperm per milliliter or less than 39 million sperm total per ejaculate), impacting fertility and the chances of conception.

Stages

Oligospermia is usually grouped into stages based on the severity of the problem. The classification may vary depending on medical guidelines or sources, but commonly, the stages of oligospermia are as follows:
Mild Oligospermia: In this stage, the sperm count is slightly below the normal range, but there are still a significant number of sperm present in the semen.
Moderate Oligospermia: At this stage, the sperm count is further reduced, indicating a more pronounced decrease in sperm concentration.
Severe Oligospermia: This stage indicates a significant decline in sperm count, with only a small number of sperm present in the semen.
Cryptozoospermia: In this advanced stage of oligospermia, sperm are very scarce and may be challenging to detect even under a microscope. Sometimes it is referred to as near “azoospermia”.

Signs of Low Sperm Count

The main sign and symptom of oligospermia is a low sperm count in the semen. There might not be any noticeable physical symptoms. The primary indication is detected through a semen analysis conducted by a qualified healthcare professional. A diagnosis of oligospermia is made when the concentration of sperm in a man’s semen falls below the normal threshold.

Cause of Low Sperm Count

Oligospermia can result from a variety of different factors.

Varicocele: Swelling of the scrotal veins. This can cause the testicles to get hotter as well as toxins accumulate here and damaging the sperm and reducing sperm quantity.
Infections: Some infections, like sexually transmitted infections (STIs) or infections of the urinary tract, Mumps, and orchitis can affect the amount and quality of sperm.
Hormonal Imbalances: Imbalances in hormones like testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) can affect the production of sperm.
Testicular Injury: Accidents or sports injuries that hurt the testicles can cause them to make less sperm.
Genetic Factors: Some genetic diseases, such as Klinefelter syndrome, Y chromosome microdeletions, or chromosomal abnormalities, can cause oligospermia.
Lifestyle Factors: Habits bad for your health, like drinking too much, smoking, using drugs, and eating poorly, can hurt your sperm count.
Environmental Factors: Some toxins and chemicals in the environment, like herbicides, heavy metals, and radiation, can stop sperm from being made.
Health Problems: Some health problems, like diabetes, obesity, and thyroid problems, can affect the production of sperm.
Medications: Some antibiotics, antifungals, and cancer drugs can stop the body from making sperm.
Retrograde ejaculation: A situation when sperm is passed into the bladder instead of the penis. This lead to reduced sperm count in the ejaculate.

Low Sperm Count Treatment

Treatment for oligospermia depends on the cause and stage. Here are some treatments for low sperm count:

Treatment for Mild Oligospermia

For mild cases of oligospermia, lifestyle modifications can be beneficial. This includes maintaining a healthy diet, regular exercise, avoiding tobacco, alcohol, and recreational drugs, managing stress, and getting enough sleep.

Treatment for Moderate Oligospermia

The treatment for moderate oligospermia aims to improve sperm count and increase the chances of natural conception. Here are some common treatment options for moderate oligospermia:

Adapting a healthy lifestyle can have a positive effect on sperm production. Encourage the following alterations to your lifestyle:

Maintain a nutritious, vitamin- and antioxidant-rich, balanced diet.
Regular exercise to support overall health and hormonal balance.
Avoid smoking, alcohol, and drug use.
Manage stress effectively, as stress can affect fertility.

Medications: Hormone therapy may be prescribed to correct any hormonal imbalances contributing to oligospermia.
Antioxidant Supplements: Antioxidants such as vitamin E, vitamin C, and selenium may be advised to assist in minimizing oxidative stress and increase sperm health in the testicles.
Varicocele Repair: If a varicocele (swollen veins in the scrotum) is detected and suspected to be causing moderate oligospermia, varicocele repair surgery may be considered to improve sperm production.
Medical Treatment for Underlying Conditions: If there are any underlying medical conditions contributing to oligospermia, such as infections or hormonal imbalances, treating these conditions may help improve sperm count.
Intrauterine Insemination (IUI): In cases where the sperm count is moderately low, IUI may be considered as an assisted reproductive technique. In IUI, sperm is collected, washed, and directly placed into the woman’s uterus during ovulation, increasing the chances of conception.

Treatment for Severe Oligospermia

There are several treatment options available to improve the chances of achieving a pregnancy. Here are some of the treatment options for severe oligospermia:

Assisted Reproductive Techniques (ART):

In vitro fertilization (IVF): IVF is a popular ART in which sperm and eggs are fertilized in a laboratory after being removed from the woman’s ovaries. The embryos produced are subsequently put into the woman’s uterus. Since fertilization takes place outside of the body, IVF avoids the requirement for many sperm in the semen.
Intracytoplasmic Sperm Injection (ICSI): ICSI is a specialized form of IVF that is specifically designed for severe male factor infertility, including severe oligospermia. Within ICSI to make an egg fertile, a single sperm is put directly into it. This technique requires only a few sperm, making it an effective option for severe cases.

Sperm Retrieval Procedures:

Testicular Sperm Extraction (TESE): TESE A little amount of testicular tissue is surgically removed during TESE. Sperm is then extracted from this tissue and used for ICSI.
Percutaneous Epididymal Sperm Aspiration (PESA) or Testicular Sperm Aspiration (TESA): These minimally invasive techniques use a small needle to directly aspirate sperm from the epididymis or testicles, as appropriate. The ICSI procedure can utilize the recovered sperm.

Donor Sperm: In cases where severe oligospermia is untreatable or if ART is not a viable option, couples may consider using donor sperm for insemination or IVF.

Varicocele Repair: If a varicocele is identified as a contributing factor to severe oligospermia, varicocele repair surgery may be performed to improve sperm production. However, the success of this procedure may vary.

Risk Factors

Risk factors of low sperm count can be related to lifestyle, medical conditions, environmental exposures, and genetics. Some common risk factors of oligospermia include:

Aging
Hormonal Imbalances.
Testicular injury or infection.
Infection in the reproductive system
Diabetes
Obesity
Smoking, alcohol consumption, and drug use.
Radiation and chemotherapy.
Heat exposure.
Emotional stress.

Prevention

There are certain lifestyle changes and habits that can help promote better sperm health and potentially reduce the risk of developing oligospermia. Here are some preventive measures: