Oligospermia: Symptoms, Causes And Treatment Options

Key Takeaways

• Oligospermia, or low sperm count, is a male fertility issue diagnosed when sperm concentration falls below 15 million sperm/mL.
• Depending on the sperm count levels, it can be categorised into mild, moderate, and severe oligospermia.
• Caused by varicocele, infections, ejaculation problems, medications, lifestyle factors, hormonal imbalances, and genetic or traumatic causes.
• Diagnosis involves semen analysis, and treatment options include surgery, hormonal treatments, medications, lifestyle changes, and assisted reproductive techniques.

When you and your partner are trying to conceive, it can be disheartening to face challenges along the way. One such challenge that many men encounter is oligospermia, also known as low sperm count. If you’ve recently been diagnosed with this condition, you might be feeling overwhelmed and unsure of what to expect. Rest assured, you’re not alone in this journey.

Oligospermia is a common indicator of male infertility, affecting a significant number of men worldwide. However, with the right information and support, you can navigate this condition and explore various treatment options to improve your chances of starting a family. In this article, we’ll delve into the details of oligospermia, including its causes, symptoms, and the various approaches to managing and treating this condition.

What is Oligospermia?

Oligospermia is a condition characterised by a low concentration of sperm in the semen. According to the World Health Organization (WHO), oligospermia is defined as having fewer than 15 million sperm per millilitre of semen. This reduced sperm count can significantly impact one’s ability to fertilise an egg, leading to difficulties in achieving pregnancy.

Types of Oligospermia

There are three main types of oligospermia, based on the severity of the condition:

1. Mild Oligospermia: Sperm count is slightly below the normal range.
2. Moderate Oligospermia: Sperm count is moderately below the normal range.
3. Severe Oligospermia: Sperm count is significantly below the normal range, often fewer than 5 million sperm per millilitre of semen.

Symptoms of Oligospermia

In many cases, oligospermia does not present with obvious symptoms. However, some potential signs may include:

• Difficulty in achieving pregnancy: The primary indicator of oligospermia is the inability to conceive after one year of regular, unprotected sexual intercourse.
• Sexual function problems: Decreased libido, difficulty maintaining an erection, or premature ejaculation can sometimes be associated with underlying causes of oligospermia.
• Pain or swelling in the testicular area: This could indicate conditions such as epididymitis or orchitis.
• Decreased facial or body hair: This can be a sign of hormonal imbalances that may affect sperm production.

Potential Causes of Oligospermia

Several factors can contribute to the development of oligospermia, including:

1. Environmental toxins: Exposure to heavy metals like arsenic, cadmium, lead, and mercury can negatively impact sperm production.
2. Heat-related factors: High temperatures, such as those from tight clothing, hot tubs, or laptops placed on the lap, can impair sperm production as testicles function best at a slightly lower temperature than the rest of the body.
3. Hormonal imbalances: Abnormalities in hormone production, particularly in the hypothalamus, pituitary gland, or testicles, can disrupt sperm production.
4. Medications and substances: Certain medications, including those for depression, high blood pressure, and cancer, as well as non-prescription substances like steroids and marijuana, can lower sperm count.
5. Genetic factors: Certain genetic conditions, such as Klinefelter syndrome or Y-chromosome microdeletions, can impact sperm production and lead to oligospermia.
6. Varicocele: This condition, characterised by enlarged veins in the scrotum, can impair sperm production and quality.
7. Infections: Infections of the reproductive tract, such as epididymitis or orchitis, can cause inflammation and damage to the sperm-producing tissues.
8. Lifestyle factors: Poor diet, lack of exercise, stress, and habits like smoking and excessive alcohol consumption can contribute to low sperm count.

How is Oligospermia Diagnosed?

If you suspect that you or your partner may have oligospermia, the first step is to consult with a doctor. They will typically conduct a comprehensive evaluation, which may include:

1. Medical history: Your doctor will ask about your medical history to identify potential causes of low sperm count.
2. Physical examination: A physical exam can help detect any abnormalities that may be affecting sperm production.
3. Semen analysis: The primary method for diagnosing oligospermia is through a Advanced semen analysis, which involves the following steps:

• Providing a semen sample: You’ll be asked to provide a semen sample, which will then be sent to a laboratory for analysis.
• Examining the sample: The laboratory will examine your semen sample under a microscope to assess the concentration, sperm motility (movement), and morphology (shape) of your sperm.
• Additional tests: Depending on the results of your semen analysis, your doctor may recommend additional tests, such as a physical examination, hormone testing, or genetic screening, to identify any underlying causes of your low sperm count.

How Does Oligospermia Affect Fertility?

With fewer sperm available, the chances of successful fertilisation and conception are reduced. It’s estimated that male factor infertility, which includes low sperm count, contributes to about half of all infertility cases.

Managing Low Sperm Count: Treatment Approaches

The treatment approach for oligospermia depends on the underlying cause and the severity of the condition. Options may include:

Lifestyle Changes:

• Eating a balanced diet rich in antioxidants and essential nutrients
• Engaging in regular exercise
• Practising stress reduction techniques
• Avoiding harmful habits like smoking and excessive alcohol consumption

Medical Interventions:

• Hormonal treatments for cases caused by hormonal imbalances
• Antibiotics to treat infections that may be impacting sperm production
• Surgical procedures like varicocele repair or correction of vas deferens obstruction

Assisted Reproductive Techniques (ART):

• Intrauterine Insemination (IUI): Placing sperm directly into the uterus to increase the chances of fertilisation
• In Vitro Fertilisation (IVF) with Intracytoplasmic Sperm Injection (ICSI): Often recommended for severe cases of oligospermia, ICSI involves injecting a single sperm directly into an egg

Managing Hormonal Oligospermia

For cases of oligospermia caused by hormonal imbalances, medications may be prescribed to stimulate the pituitary gland to produce more follicle-stimulating hormone (FSH) and luteinising hormone (LH), which are essential for sperm production. However, these medications are typically used under strict medical supervision due to potential side effects and the need for careful monitoring.

How to Conceive With Severe Oligospermia?

While oligospermia can make it more challenging to conceive naturally, there are still options available to help you achieve pregnancy. Procedures like IVF and ICSI can significantly increase the chances of successful fertilisation, even with a low sperm count. These procedures bypass many of the natural barriers to fertilisation, allowing even a single sperm to fertilise an egg. While success rates vary depending on individual circumstances, IVF with ICSI has helped many couples with severe oligospermia achieve their dream of starting a family.