Oligospermia: What It Is and How It Affects Fertility

Oligospermia is a medical condition found in men, which is characterised by a low sperm count in their semen. To impregnate a woman, a healthy amount of sperm in a man's semen is usually necessary. As stated by WHO in the year 2009, if the sperm count is less than 15 million sperm per millilitre (mL), then the condition is called oligospermia.

Oligospermia can be classified into three categories:

• Mild oligospermia, when the sperm count is between, 10 to 15 million sperm/mL.
• Moderate oligospermia is diagnosed when sperm count lies between 5 to 10 million sperm/mL.
• Severe oligospermia when the sperm count is between 0 and 5 million sperm/mL.

Causes of Oligospermia:

The causes of the condition include:

• Hormonal imbalances: The hormones required for sperm production are produced by the hypothalamus and pituitary glands. The sperm production gets impaired if any alteration occurs in these hormones.
• Ejaculatory problems: When semen instead of flowing out of the penis, reverses back to the bladder, then it is known as retrograde ejaculation. This condition can reduce the sperm counts and cause infertility in men.
• Undescended testicles: Men born with this condition are unlikely to be fertile. If during fetal development, the testicles do not descend from the abdomen into the sac that forms the scrotum, then the fertility of that person gets hampered.
• Anti-sperm antibodies: Certain immune system cells known as anti-sperm antibodies tend to kill the sperm cells by mistakenly identifying them as harmful invaders causing low sperm count.
• Chromosomal abnormalities: Certain genetic disorders like Klinefelter's syndrome, Kallmann's syndrome and Kartagener' syndrome can cause abnormal development in the male reproductive organs.
• Obstructions: Obstruction is one of the major causes of oligospermia. The tubes that carry sperm, if blocked by some abnormal developments like cystic fibrosis or any injury due to prior surgeries and infections, can lead to a low flow of semen.
• Trauma or injury: Some surgeries like vasectomy, hernia repair surgery, scrotal surgeries, prostate surgeries, etc. can reduce the sperm count in your ejaculate.
• Certain medications: Certain medicines like antifungal, antibiotic, ulcer medicines, chemotherapy drugs, testosterone replacement therapy etc. can impair sperm production in one's body.
• Environmental factors: Exposure to chemicals, radiation, and heavy metals can reduce sperm production.

Symptoms of Oligospermia

For some men, there are no obvious signs and symptoms of oligospermia seen. Only when they find difficulty in conceiving a child, this medical condition gets diagnosed. But if a man has oligospermia due to other underlying issues like chromosomal abnormalities, hormonal imbalance or any obstruction, then certain signs and symptoms may occur. Let's take a look at the symptoms of oligospermia as given below:

• Swelling, pain, or lump in testis.
• Sexual functioning issues like the inability to maintain an erection during sexual intercourse or erectile dysfunction.
• Low facial and body hair growth and other signs of chromosomal abnormalities and hormonal imbalances.
• Thick discharge.
• Enlarged and swollen veins in the scrotum.
• If this problem happens due to transmission of a virus, then one can experience some burning sensation while urinating.

When to See a Doctor

If one finds any of the above-given symptoms, then seeking help from a fertility expert as early as possible is the best option here. He/She would further diagnose the condition and provide the treatment accordingly.

Risk Factors

There are a number of risk factors associated with low sperm count. Below listed are the risks of oligospermia:

• Unhealthy habits like smoking, consuming alcohol, and illicit use of drugs
• Being overweight
• Depression or stress in work and family life
• Being affected by certain infections in past
• Exposure to toxins and chemicals
• Testicles being exposed to extreme heat
• Trauma or injury to the testicles
• Use of certain medications
• Undescended testicles
• Having chronic illness or tumors and undergoing treatments like radiation and chemotherapy
• Genetic and chromosomal abnormalities can cause this fertility disorder

Oligospermia is caused by various medical, genetic, lifestyle and environmental factors. Certain aspects are unavoidable, but there are other such known factors that can be prevented to protect one's fertility.

Leading a healthy life, keeping stress at bay and avoiding chemical exposure are some of the effective measures to have healthy sperm production. If a person is affected by oligospermia due to any genetic and medical reason, then a proper treatment can improve their production in some cases.

Diagnosis of Oligospermia

Testing and diagnosis of the condition may involve the following:

• Semen analysis
• Scrotal ultrasound
• Hormone testing
• Post-ejaculation urine analysis
• Genetic tests
• Testicular biopsy
• Anti-sperm antibody tests
• Specialized sperm function tests
• Transrectal ultrasound

Treatment of Oligospermia

There are many ways to treat this medical condition, which includes the following:

• If varicocele or vasectomy is the reason for oligospermia, then it can be easily corrected or reversed through a surgery
• With proper medications and hormone treatments, the sperm count can be increased in some cases.
• Maintaining a good and healthy lifestyle through regular exercises and avoiding smoking and alcoholism can improve the sperm count to some extent.
• If nothing works, then consulting a fertility expert will be your next best option. The doctor would help you with assisted reproductive treatments.