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Oligospermia - Causes, Diagnosis & treatment

Medically Reviewed by Dr Sravya, MBBS, MS 

Introduction

Oligospermia refers to a low sperm count in the semen. Throughout your life, your ejaculate’s sperm count can change. For fertility, a good sperm count is frequently required. Sperm counts at or above 15 million sperm per millilitre (mL) of semen are considered typical by the World Health Organization (WHO). Anything less than that is deemed low and is given the label of oligospermia.

Oligospermia

Oligospermia is also known as Oligozoospermia. Poor motility and morphology, which are frequently associated with lower sperm density, represent both qualitative and quantitative flaws in spermatogenesis. Many illnesses and therapies related to reproduction and non-reproduction could be to blame, although the majority of instances are still unexplained (idiopathic). Azoospermia is the medical term for the total lack of sperm.

  • 10 to 15 million sperm/mL is the threshold for mild oligospermia.
  • A milliliter containing 5 to 10 million sperm is considered to have moderate oligospermia.
  • Sperm counts of 0 to 5 million sperm per milliliter are considered severe oligospermia.

Table of Contents

    1. Signs and symptoms oligospermia
    2. Oligospermia Causes
      1. Medical Causes  of oligospermia
      2. Environmental causes of oligospermia
    3. Risk factors of oligospermia
    4. Diagnosis of oligospermia
    5. Severe oligospermia treatment
Oligospermia causes

Sign and Symptoms of Oligospermia

The inability to conceive a child is the primary indicator of low sperm count. There may be no other visible symptoms or indicators. Signs and symptoms may be brought on by an underlying issue in certain men, such as an inherited chromosomal abnormality, a hormonal imbalance, dilated testicular veins, or a disorder that prevents sperm from passing.

A low sperm count may cause the following symptoms:

  • difficulties with sexual function, such as a lack of sex desire or trouble keeping an erection (erectile dysfunction).
  • A testicle-area lump, swell, or both.
  • reduced body or facial hair, and other chromosomal or hormonal problems.

Oligospermia Causes

The complex process of producing sperm depends on the normal functioning of the testicles (testes), as well as the hypothalamus and pituitary glands, two brain structures that provide hormones that stimulate sperm production. Once sperm is created in the testicles, it is transported through delicate tubes until it combines with semen and is expelled from the penis. Any of these systems can experience issues that impact sperm production.

Additionally, aberrant sperm morphology, motility, or function issues may arise.

However, the cause of low sperm count is frequently not found.

Several medical conditions and therapies can result in low sperm counts. A few of these are:

Medical Causes of Oligospermia

  • Varicocele : A varicocele is an enlargement of the veins that drain the testicles. It is the most frequent treatable reason for male infertility. Even though the exact cause of varicoceles that lead to infertility is unknown, poor testicular temperature regulation may play a role. Varicoceles result in a decline in the sperm's quality.
  • Infections: Some infections can harm sperm quality or quantity, or they can leave scar tissue that prevents sperm from passing through. These include some sexually transmitted infections, such as gonorrhoea or HIV, as well as inflammation of the testicles or epididymis (orchitis). Despite the fact that some diseases might permanently destroy the testicles, sperm is often still retrievable.
  • Ejaculation problems:When semen during orgasm enters the bladder rather than coming out of the tip of the penis, this is known as retrograde ejaculation. Retrograde ejaculation or the absence of ejaculation can be brought on by a number of medical disorders, including diabetes, spinal injuries, and bladder, prostate, or urethral surgery.
  • Alpha-blockers:which are used to treat high blood pressure, are one kind of medicine that may cause ejaculatory issues. While some ejaculatory issues can be resolved, others are irreversible. Sperm can still be taken straight from the testicles in the majority of situations where there are persistent ejaculation issues.
  • Antibodies that attack sperm:Immune system cells called anti-sperm antibodies wrongly view sperm as dangerous invaders and make an effort to eliminate them.
  • Tumors :Cancers and benign tumours may directly impact the male reproductive organs, via the pituitary gland or other reproductive hormone-releasing glands, or by unidentified causes. Radiation, chemotherapy, and surgeries associated with tumours may potentially have an effect on male fertility.
    One or both testicles may occasionally fail to descend from the abdomen into the scrotum, the sac in which the testicles ordinarily reside, during fetal development. Men with this illness are more prone to experience decreased fertility.
  • Hormone imbalances:Hormones required for the production of sperm are produced by the hypothalamus, pituitary, and testicles. Changes to these hormones, as well as those from other organs including the thyroid and adrenal gland, may hinder sperm production.
  • Sperm defects :Transporting tubules Different tubes are used by sperm to travel.
    They may become blocked for a variety of causes, including unintended damage from surgery, previous infections, trauma, or abnormal growth, such as in cystic fibrosis or other hereditary illnesses.
    Any level of obstruction is possible, including in the urethra, epididymis, vas deferens, the testicle itself, the tubes that drain it, the epididymis near to the ejaculatory ducts, and the tubes that drain it.
  • Chromosome defects: Male reproductive organs grow abnormally as a result of inherited conditions like Klinefelter's syndrome when males are born with two X chromosomes and one Y chromosome instead of one X and one Y. Kartagener's syndrome, Kallmann's syndrome, and cystic fibrosis are a few further genetic syndromes linked to infertility.
    Male infertility can result from the intestinal ailment celiac disease, which is brought on by a sensitivity to gluten. Fertility may increase once a gluten-free diet is adopted.
    Testosterone replacement therapy, prolonged anabolic steroid usage, chemotherapy, specific antifungal and antibiotic drugs, specific ulcer medications, and other medications can reduce male fertility and impede sperm production.
  • Prior surgeries:Vasectomy, inguinal hernia repairs, scrotal or testicular surgery, prostate surgery, big abdominal surgery for testicular or rectal cancer, among other procedures, may all prohibit you from having sperm in your ejaculate. In the majority of cases, surgery can be used to remove these obstructions or to remove sperm straight from the testicles and epididymis.

Environmental Causes of Oligospermia

When overexposed, the following environmental elements may affect sperm function or production:

  • Industrial chemicals :Prolonged exposure to benzenes, toluene, xylene, herbicides, pesticides, organic solvents, painting materials, and lead might result in low sperm counts.
  • Exposure to heavy metals:Lead exposure, among other heavy metals, can also result in infertility.
  • Radiation or X-rays:Sperm production may be hampered by exposure to radiation. It may take several years to normalize sperm production. The generation of sperm may be irreversibly decreased by high radiation doses.
  • Overheating the testicles: Sperm production and function are hampered by high temperatures. Frequent use of saunas or hot tubs may temporarily lower sperm count, while research is scarce and inconsistent.
    Your scrotum's temperature can increase and somewhat reduce sperm production if you spend a lot of time sitting, wearing restrictive clothing, or using a laptop computer for extended periods of time.

Risk Factors of Oligospermia

Numerous risk factors are connected to low sperm count and other conditions that can cause low sperm count. They consist of:

  • smoking cigarettes
  • consuming alcohol
  • using certain illegal drugs
  • having a lot of stress or melancholy while being obese
  • having certain illnesses from the past or present
  • Having toxic exposure
  • a testicle overheating
  • having undergone testicular injury
  • having a reproductive condition that you were not able to control as a child or having a sibling or father who has one as a blood relative
  • possessing certain medical issues, such as malignancies and persistent illnesses
  • undergoing radiation therapy for cancer
  • Using particular drugs
  • having previously experienced undescended testicles.
  • substantial abdominal surgery, a previous vasectomy, or pelvic surgery

Diagnosis of Oligospermia

  • Semen analysis and sperm function testing are two further tests.
  • A urine test can identify retrograde ejaculation (sperm moving backward inside you).
  • Imaging exams for your reproductive organs include transrectal and scrotal ultrasounds.
  • assays to measure the endocrine system's hormone levels.
  • investigation of genetic illnesses.

Severe Oligospermia Treatment

The recommended course of treatment will depend on what caused the oligospermia. By eliminating any drugs or habits that are causing low sperm counts, you may boost your sperm count.

Other causes could require other therapies. For instance,

  • a varicocele or sperm duct blockage may be treated surgically.
  • Supplements for hormones.
  • For infections, antibiotics.
  • Encourage people to seek counseling to address problems like erectile dysfunction or early ejaculation.
  • treatment options for issues with sex
  • medicines and hormone therapies
  • Assisted reproductive technology (ART): ART treatments may involve acquiring sperm by routine ejaculation, surgical extraction, or from donors. The sperm are then either used for IVF or intracytoplasmic sperm injection, or they are injected into the female vaginal canal.
Frequently Asked Questions

Yes, males can acquire fungal infections, particularly in the genital area. Although it is less frequent in men than in women, men must recognize the signs and seek proper treatment. 

No, fungal infections are not classified as sexually transmitted infections. However, sexual activity can sometimes upset the natural balance, increasing the risk of infection.

While vaginal yeast infections are more frequent in women, they can occur in men as well, mainly through sexual transfer.

For minor yeast infections, over-the-counter antifungal treatments can be beneficial. However, if symptoms persist or worsen, it is essential to seek medical attention.

Stress can impair the immune system, making it more difficult to battle illnesses such as yeast infections.