Oligospermia – definition, causes, diagnosis, treatment of reduced sperm count in semen

Oligospermia is a reduced sperm count (less than 20 million / ml) in semen. The causes of this ailment are, among others, varicose veins of the spermatic cord, obstructed sperm ducts or endocrine disorders. According to research, oligospermia is one of the most common causes of male infertility.

Oligospermia – the definition of the disease

Oligospermia is a condition associated with a low sperm count and the most common cause of male infertility. The condition may be temporary, but it may also be permanent.

Infertility occurs when the couple has had unprotected intercourse with each other and is still not pregnant. There are several degrees of reduced sperm count in sperm in oligospermia:

  1. mild oligospermia – 10-15 million sperm / ml,
  2. moderate oligospermia – 5-10 million sperm / ml,
  3. severe oligospermia – 0,5 million sperm / ml,
  4. azoospermia – complete absence of sperm in semen,
  5. cryptozoospermia – a very small amount of sperm in the semen.

Oligospermia – causes

Sometimes the causes of oligospermia are unknown, but it is usually the result of an obstruction in the sperm tube or poor sperm production.

Abnormal sperm production can be caused by:

  1. endocrine problems, e.g. hypergonadropic hypogonadism,
  2. varicose veins,
  3. cryptic,
  4. overheating of the testicles,
  5. mumps orchitis,
  6. smoking cigarettes,
  7. taking certain medications, e.g. tetracycline, chemotherapeutic agents, anabolic steroids.

As for the causes of the obstruction of the sperm tubes, we distinguish among them:

  1. removal of the vas deferens,
  2. epididymal obstruction,
  3. injection tube obstruction,
  4. bilateral lack of congenital vas,
  5. cysts on the vas deferens,
  6. hypertrophy of seminal vesicles,
  7. changes after inflammation in the epididymis (e.g. gonorrhea),
  8. complications after surgery for a hernia located in the groin.

Diagnosis of oligospermia

The assessment of sperm count is of key importance in the diagnosis of male infertility. A 50 µl semen sample mixed with distilled water is analyzed. Twenty-fold dilution and immobilization of sperm in distilled water facilitates the counting of sperm in the hemocytometer. Semen material is obtained by masturbation leading to ejaculation. It is important that it comes from the first and the first ejaculation, and its entire volume should be placed in a container. The obtained semen should be delivered to the laboratory within 30 minutes, during transport it should be at a temperature similar to the natural temperature of the human body. Otherwise, the sperm may die and the test will be unreliable. Therefore, it is best that the semen should be donated on the spot. In addition, in the laboratory, each man is given a questionnaire with questions about:

  1. past injuries in the area of ​​the testicles,
  2. the time the semen was donated,
  3. the use of stimulants,
  4. taking medications,
  5. the period of abstinence before the test,
  6. previous diseases, e.g. venereal diseases,
  7. addictions,
  8. exposing the testes to harmful factors, e.g. high temperature.

The presence of germ cells is evidence of the permeability of the sperm transport routes.

In this test (semogram), apart from the concentration of sperm, the following are also assessed:

  1. semen acidity,
  2. ejaculate volume,
  3. presence of white blood cells in semen,
  4. proper sperm structure,
  5. sperm motility,
  6. sperm viability.

In diagnostics, it may be necessary to carry out an endocrine examination, e.g. the determination of hormones – testosterone, prolactin, as well as FSH and LH. In some patients, there is an additional need to visit a urologist and perform an ultrasound or testicular biopsy. Some people do genetic testing. If the results of the semen tests are bad, they should be repeated after about three weeks at the earliest.

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Oligospermia – treatment

In order to implement the appropriate treatment, the doctor must find the cause of the disease. Patients can get rid of some disorders by taking vitamins, hormones or micronutrients. It is also important to change your lifestyle and certain habits. Gentlemen should wear looser underwear, avoid high temperatures around the testicles, and use the sauna is also inadvisable. In addition, the daily diet should include healthy products, while physical activity plays an important role.

Surgical methods are used in the case of varicocele or cryptorchidism. If the patient cannot undergo surgery or oligospermia has a different cause than obstruction of the spermatic ducts – having children may be possible thanks to supporting techniques, e.g. sperm collection directly from the testes or epididymides and their intracytoplasmic injection into the egg for fertilization.

Note: Prevention is important. Men with fertility problems should immediately limit alcohol and smoking. Stress is also inadvisable.

Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House

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