While discussing male infertility, it is common to address the primary causes. Nevertheless, it is crucial to recognize that certain abnormalities may be associated with underlying conditions or diseases, which can lead to the development of further complications. Identifying these issues at an early stage allows for potential correction or consideration of alternative solutions that may yield better outcomes.
Oligospermy is one of the prevalent and consequential conditions that can impede conception in males. It is characterized by a reduced sperm count in the semen. According to data from the World Health Organization (WHO), a man is considered to have oligospermy if his sperm concentration is less than 15 million spermatozoa per milliliter.
Oligospermy can be attributed to various factors, including hormonal disorders, testicular issues, or infections. Moreover, it is often associated with other conditions, some of which are described below:
Cryptorchidism: a condition associated with oligospermy
Cryptorchidism is a condition characterized by the failure of one or both testicles to descend into the scrotum before birth. This condition can lead to fertility challenges since the undescended testicles are exposed to higher temperatures, which can adversely affect sperm production.
Cryptorchidism primarily occurs in a single testicle, accounting for approximately 80% of cases, and the left testicle is more commonly affected. Bilateral cryptorchidism, where both testicles are altered, is less common. To prevent fertility challenges, it is recommended that boys with cryptorchidism undergo surgery to descend the testicles into the scrotum before the age of 2 years.
Varicocele
Testicular varicocele is a condition that causes dilation of the veins supplying the testicles. This can cause an elevation of testicular temperature, which can impact sperm production. It is most common in one testicle, but can also influence both. If it influences both testicles, it is more likely to cause infertility.
It can also cause oligoasthenoteratozoospermia, which is a condition in which the spermatozoa are of low quality, both in number and in motility and morphology.
Adequate treatment can lead to notable improvement in cases of oligoasthenoteratozoospermia associated with testicular varicocele. Surgery is generally considered the most effective treatment, particularly in severe instances.
Hypogonadism and oligospermy: links in reproductive health
Male hypogonadism is a condition characterized by insufficient production of sex hormones, including testosterone, by the testicles. This condition has a direct impact on sperm production and can result in infertility.
Male hypogonadism can be classified into two main types:
- In cases of primary hypogonadism, the testes experience dysfunction caused by internal problems. Klinefelter’s syndrome, one of the most prevalent genetic disorders within this category, can lead to reduced testosterone levels, decreased muscle mass, inadequate development of facial and body hair, and diminished sperm production.
- In cases of secondary hypogonadism, the issue lies in the hypothalamus or pituitary glands, which are responsible for producing the hormones that stimulate the testes to produce sperm.
The treatment approach for hypogonadism varies depending on the type of the condition. In certain cases, hormonal treatment can be employed to restore testicular function and enhance sperm production, thereby increasing the chances of improved fertility.
Hydrocele
Testicular hydrocele is a condition where fluid builds up around one or both testicles. It can occur either from birth (congenital) or develop later in life (acquired), and it is more prevalent in men who are 40 years of age or older.
Hydrocele is not a direct cause of infertility, but may be associated in 10% of cases, in which it can cause a partial obstruction of the vas deferens, which can reduce the number of sperm in the semen.
Oligoasthenoteratozoospermia
Oligotherotherozoospermia is a condition in which the concentration of spermatozoa in the semen is low and the shape of the spermatozoa is abnormal. This term brings together two spermogram findings, “Oligo” which refers to a low sperm concentration (less than 15 million x ML), and “terato” refers to a low concentration of normal shaped sperm (less than 4%). Abnormalities in sperm shape hinder fertilization and may also affect embryo development.
For men with severe oligoteratozoospermia who desire to conceive, in vitro fertilization (IVF) treatment with intracytoplasmic sperm injection (ICSI) is typically recommended. This procedure involves the selection of sperm with good morphology under a microscope, which are then directly injected into the egg. This technique enhances the likelihood of developing a healthy embryo.
Are you from Australia? Get an accurate diagnosis for better results
While receiving any of these diagnoses may initially dishearten men in their pursuit of starting a family, it is crucial to acknowledge the positive aspect of identifying these conditions early for timely treatment. This recognition can serve as a pivotal moment in improving fertility and overall well-being.
It is advisable to keep up to date with general check-ups, not only to increase the chances of being able to start a family, but also to avoid these diagnoses that can lead to irreversible consequences. These diagnoses can compromise the health and well-being of patients.
If you are aspiring to start a family but are encountering difficulties in conception or are aware of someone facing infertility or related complications, it is essential to reach out to specialized clinics that specialize in oligospermy, male fertility, and assisted reproduction, such as Babynova Clinic by Novafem. Seeking advice and treatment from these clinics at the earliest opportunity can make a significant difference in addressing these issues.
