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. Besides, it is often associated with other conditions, some of which are described below:
Cryptorchidism: a condition associated with oligospermy
Cryptorchidism refers to the condition wherein one or both testicles fail to descend into the scrotum before birth. This can give rise to fertility difficulties because the undescended testicles are exposed to elevated temperatures, which can impact the production of sperm.
Cryptorchidism is most common in a single testicle (80%) and the left testicle is the most affected. Bilateral cryptorchidism is less common. To prevent fertility difficulties, boys with cryptorchidism need to have surgery to descend the testicles 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.
Furthermore, testicular varicocele can contribute to the development of oligoasthenoteratozoospermia, a condition characterized by low-quality spermatozoa in terms of their number, 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 refers to the condition in which the testicles do not produce an adequate amount of sex hormones, including testosterone. This hormonal imbalance significantly affects sperm production and can lead to infertility.
Male hypogonadism can be divided 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.
- Secondary hypogonadism: There is an issue in the hypothalamus or pituitary glands, which are the glands that produce the hormones that stimulate sperm production in the testes.
The treatment of hypogonadism is determined by the specific type of the condition. Hormonal therapy can be utilized in certain cases to restore testicular function and stimulate increased sperm production, ultimately improving the outlook for 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 refers to a condition where the concentration of spermatozoa in the semen is low, and the shape of the spermatozoa is abnormal. This term combines two observations from a spermogram: “oligo,” indicating a low sperm concentration (less than 15 million per milliliter), and “terato,” representing a low percentage of sperm with normal morphology (less than 4%). The presence of abnormal sperm morphology can hinder fertilization and potentially affect the development of embryos.
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.
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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 or someone you know is facing challenges in conceiving or experiencing complications related to the symptoms described above, it is crucial to seek assistance from specialized clinics that focus on oligospermy, male fertility, and assisted reproduction, such as Babynova Clinic by Novafem. Contacting such clinics will provide valuable guidance and enable prompt treatment for these concerns.
