Oligospermia: male infertility, its causes, and treatments – Dr. Himali Maniar

Oligospermia, the male infertility condition, is the inability of a man to produce sperm. It doesn’t mean that a man has no fertility. A consultation with Dr. Himali Maniar, a gynecologist and an infertility specialist in Ahmedabad, will improve your knowledge about your conditions, causes, and treatment options. Please don’t hesitate to meet with her to sort out the couple’s goal of becoming parents.

She is a highly experienced doctor and has helped many couples to increase their marital bliss with the addition of an infant into their lives.

She specializes in IVF and ICSI treatment and is considered the best IVF doctor in Ahmedabad.

At Nisha IVF Centre, you will be able to get advice and guided treatment from start to finish for all your gynecological and fertility treatments.

Oligospermia means that your testicles don’t produce enough semen to produce adequate amounts of sperm needed to fertilize an egg. There are several possible causes for oligospermia, a broad range of which are listed below. If you’re reading this, you’re most likely one of the many men that suffer from oligospermia. Don’t let this limitation in your life keep you from having children. Read on to learn more.

Diagnosis of oligospermia or low sperm count:

Semen analysis is carried out to determine if you are suffering from low sperm count. The criteria set by WHO for low reference point is classified into 3:

sperm to semen concentration

Mild oligospermia is 10 – 15 million sperm/ml of semen

Moderate is 5 – 10 million sperm/ml of semen

Severe is less than 5 million sperm/ml of semen.

The result of the semen analysis will tell you which category your condition falls into.

What are the causes of oligospermia?

Oligospermia can be attributed to the following causes:

1. Pre-testicular causes:

Pre-testicular causes indicate the factors that do not provide adequate support to the testes, which include poor hormones and poor general health, including

Hypogonadism – diminished functional activity of the gonads(testes)

It is also commonly referred to as low testosterone or Low T

Lifestyle factors including smoking, drinking, drug abuse

Strenuous riding (motorcycle, horseback)

Medications that include androgens.

2. Testicular causes:

Although the body is providing adequate hormonal support to the testis, it cannot produce quality semen. The factors that may cause this are

• age,
• a genetic defect in the y chromosome
• Abnormal chromosomal set. Men are mostly XY chromosomal set, but in Klinefelter syndrome, its XXY chromosomal set, which means that the female gender characteristics are more prominent in the man.
• Cryptorchidism means the testes have not receded from the abdomen
• Neoplasm: tissue overgrowth – benign or malignant.
• Varicocele means an enlarged vein that pushes the blood back to the heart, and it does not reach the testes.
• Trauma to testes
• Hydrocele testes are where serous fluid accumulates around the testicle; if there is no herniation, it heals itself.
• Mumps is a viral infection that involves complications like inflammation of the testes, breasts, ovaries, pancreas, brain, and meninges. It may result in reduced fertility and sterility in some rare cases.
• Malaria – recurrence of malaria may result in many complications, including sterility in some cases.

3. Post-testicular:

• Obstruction in vas deferens.
• Absence of vas deference due to genes
• Infection of the reproductive organs
• Obstruction of the ejaculatory duct.

4. Idiopathic oligospermia:

Unexplained factors are responsible for low sperm count and quality of sperm.

5. DNA Damage:

Single nucleotide polymorphism of BRCA2 causes severe oligospermia.

Age obesity and occupational stress are highly factorial in men suffering from mild oligospermia.

Treatment:

Treatment is done in the context of infertility treatment, and the female partner’s fecundity must also be taken into account. As a result, making decisions can be difficult.

Direct medicinal or surgical intervention can improve sperm concentration in various scenarios, such as the use of FSH in males with pituitary hypogonadism, antibiotics in the case of infections, and operational corrections of a hydrocele, varicocele, or occlusion of the vas deferens.

There is no direct medicinal or surgical intervention that has been proven to be beneficial in most cases of oligospermia, including its idiopathic form. Tamoxifen, HMG, Clomiphene citrate, HCG, FSH, testosterone, Vitamin C, anti-oxidants, Vitamin E, carnitine, acetyl-L-carnitine, zinc, and high-protein diets have all been explored in clinical trials. Some promising findings have been reported in several pilot trials. With limited success, clomiphene citrate has been utilized. Tamoxifen and testosterone, in combination, have been shown to improve sperm quality.

Carnitine improved sperm quality in men with infertility in a controlled trial, but more research is needed.

Intrauterine inseminations are successful in a large number of cases.

IVF, or IVF with ICSI, is used in more severe cases and is often the best option, especially if time is an issue or if the female side has fertility issues. Low-dose estrogen-testosterone combination therapy may enhance sperm count and motility in some men, especially those with severe oligospermia.