Low sperm count and male infertility.

Low sperm count and male infertility.

Low Sperm Count: “I can’t have a baby?” Of course, you can…
A low sperm count, or in scientific terms oligospermia/ azoospermia, refers to a condition where the concentration of sperm in ejaculated semen is below normal or not existing. That begs the question – What is normal sperm concentration supposed to be? World Health Organization (WHO), acclaims that concentration of <15 million sperm/ml is a low sperm count. If there appears to be no sperm in the sperm analysis it is called azoospermia.

So, what exactly causes a low sperm count?
A wide array of medical conditions are responsible for the cause of oligospermia or azoospermia i.e. only a few will be mentioned here.

Pre-testicular cause:

  • Smoking, Alcohol, and drugs (Substance abuse as well as medications such as androgens.)
  • Hypogonadism – Which simply means a reduction in functionality of the gonads. (The testes in males). The causes of this also being variable i.e. genetic, congenital, or acquired (such as opioid or anabolic steroid use)

Testicular:

  • Trauma.
  • Varicocele.
  • Age.
  • Neoplasm- Abnormal growth of cells.
  • Chromosomal abnormalities.

Post-testicular:
Mainly due to obstructive changes in the tubes of the internal genital system involved in ejaculation.

  • Vas Deferens obstruction. The Vas deferens are ducts that transport sperm to the ejaculatory ducts forms the epididymis of each testis.
  • Ejaculatory duct obstruction.
  • Infections e.g. prostatitis.

Treatment.
Management of oligospermia and male infertility is cause-based. Medical and surgical interventions are the main methods used.

Example of medical modalities are:

  1. Lifestyle changes. Smoking cessation, stress control & weight loss for those who are overweight or obese.
  2. Hormonal treatments
  3. Medications for ejaculation disorders’
  4. Vitamins and minerals. Vit E, C, B, Zinc, Selenium, Carnitine.

Surgical management in patients with oligospermia/ azoospermia include:

  1. Varicocelectomy
  2. Transurethral resection of the ejaculatory ducts.
  3. Reconstruction of the obstructed ejaculatory channels
  4. Sperm extraction techniques (PESE-percutaneous epidydimal sperm extraction, micro-TESE- microscopic testicular sperm extraction)

And of course, lastly, there are assisted reproduction techniques. The main being in vitro fertilization or IVF.

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