When discussing male infertility, the focus is often on the most common causes. However, it is important to consider that certain abnormalities may be linked to other underlying conditions or diseases, which can potentially give rise to additional complications. Early detection of these issues offers the opportunity for correction or exploration of more effective alternative solutions.
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 in which one or both testicles do not descend into the scrotum before birth. This can cause fertility difficulties, as the undescended testicles are exposed to higher temperatures, which affects sperm production.
Cryptorchidism predominantly affects a single testicle in about 80% of cases, with the left testicle being the most commonly affected. Bilateral cryptorchidism, where both testicles are undescended, is less frequent. To mitigate the risk of fertility difficulties, boys diagnosed with cryptorchidism should undergo surgical intervention to bring down the testicles into the scrotum before the age of 2 years.
Varicocele
Testicular varicocele refers to the condition in which the veins supplying blood to the testicles become dilated. This dilation can result in elevated testicular temperature, which can have a negative impact on sperm production. While it is more prevalent in one testicle, it can also affect both. If varicocele affects both testicles, it is more likely to be associated with 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 in which the testicles do not produce enough sex hormones, such as testosterone. This affects sperm production and can cause infertility as well.
There are two primary types of male hypogonadism that can be distinguished:
- 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.
- Secondary hypogonadism occurs when there is a problem in the hypothalamus or pituitary glands, which are responsible for producing the hormones that stimulate sperm production in the testes.
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 characterized by the accumulation of fluid around one or both testicles. It can be either congenital or acquired, and it is more frequently observed in men who are over 40 years old.
Hydrocele is generally not a direct cause of infertility, although it may be associated with infertility in around 10% of cases. In these instances, it can lead to a partial obstruction of the vas deferens, potentially resulting in a decreased sperm count in the semen.
Oligoasthenoteratozoospermia
Oligoteratozoospermia is a condition characterized by a low concentration of spermatozoa in the semen and abnormal sperm morphology. This term encompasses two findings from a spermogram: “oligo,” which indicates a low sperm concentration (less than 15 million per milliliter), and “terato,” which denotes a low percentage of normally shaped sperm (less than 4%). Abnormalities in sperm shape can impede fertilization and may also have an impact on embryo development.
Men with severe oligoteratozoospermia who want to have children will need to undergo in vitro fertilization (IVF) treatment with intracytoplasmic sperm injection (ICSI). In this treatment, sperm with good shape are selected under the microscope and injected directly into the egg, thus increasing the chances of a healthy embryo.
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Although any of these diagnoses may discourage men from pursuing their dream of conceiving a family, it is important to recognize the positive value of finding these conditions to treat them in time. That is what can represent a turning point in fertility and overall health.
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.
