The journey to conceive can be fraught with challenges. In approximately half of all infertility cases, a male factor is involved, and one of the most common causes is oligospermia. This article delves into everything you need to know about oligospermia, from its definition, types, causes, and treatments to its future prospects.
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What is oligospermia?
Oligospermia, also known as oligozoospermia, is an andrological condition characterized by a low sperm concentration in the ejaculate. According to established WHO criteria, a sperm count is considered normal when it is equal to or greater than 15 million sperm per milliliter (ml) of semen. A count below this threshold is diagnosed as oligospermia.
Oligospermia should not be confused with absolute infertility, but rather indicates reduced fertility.
Types or degrees
Oligospermia is classified into different grades according to the severity of the low sperm concentration.
Mild oligospermia
Sperm concentration ranges from 14 to 5 million per ml. The chances of natural fertilization exist, although they are low. Often, lifestyle changes can be enough to improve these parameters.
Moderate oligospermia
The sperm count is between 5 and 1 million sperm per ml. In these cases, the probability of natural pregnancy is low, and assisted reproductive techniques are usually recommended.
Severe or serious oligospermia
The concentration is less than 1 million sperm per ml. This is the most critical stage, where the chances of natural conception are extremely remote. It is usually associated with other semen abnormalities and requires highly complex assisted reproductive technologies.
Cryptozoospermia
In cryptozoospermia, sperm are not detected in conventional semen analysis, but they can be identified after centrifugation and careful examination of the sediment. The quantity is minimal, but it allows for techniques such as IVF/ICSI.
Main causes and risk factors
Sperm production is a process that can be affected by a multitude of factors.
Pre-testicular (hormonal) causes
Problems in the endocrine system that affect the hormonal signaling necessary for sperm production, such as hypothalamic or pituitary disorders, thyroid disorders, deficiency of testosterone or genetic syndromes such as Kallman syndrome.
Testicular (primary) causes
They directly affect the testicles, where sperm is produced, such as varicocele (dilated veins in the spermatic cord), which is the most common reversible cause of male infertility, cryptorchidism, infections such as mumps, which affect the testicles, trauma or testicular torsion, cancer treatments such as chemotherapy or radiotherapy, or genetic factors.
Post-testicular (obstructive) causes
They prevent sperm from being ejaculated, even if they are produced normally, such as obstruction of the vas deferens, congenital absence of the vas deferens, or retrograde ejaculation (the semen goes into the bladder instead of coming out through the urethra).
Risk and environmental factors
Smoking, excessive alcohol consumption, drugs, obesity, exposure to toxins such as pesticides, heavy metals, industrial solvents and radiation, oxidative stress that damages the sperm membrane and DNA, testicular heat from frequent use of saunas, hot baths or very tight underwear, or drugs such as anabolic steroids, some antibiotics and blood pressure medications.
What if I have oligospermia: Symptoms and warning signs
Oligospermia itself does not usually present obvious physical symptoms. The main, and often only, warning sign is the inability to achieve pregnancy after one year of regular, unprotected intercourse.
In some cases, there may be signs associated with the underlying cause such as pain, swelling or the presence of a lump in the testicles (possible varicocele), decreased facial or body hair, or problems with erectile dysfunction (associated with low testosterone), or recurrent respiratory infections (which could indicate a genetic condition such as Kartagener syndrome).
How is it diagnosed?
Medical history and physical examination
The doctor will conduct a detailed interview about your medical history, lifestyle habits, any previous infections, and how long you have been trying to conceive. The physical examination will focus on your genitals to detect abnormalities such as varicoceles or small testicles.
Seminogram or spermatobioscopy
Through the seminogram A semen sample obtained by masturbation after 3 to 5 days of sexual abstinence is analyzed. The test evaluates ejaculate volume, concentration, motility, and morphology.
hormone analysis
Blood levels of hormones such as testosterone, FSH (follicle-stimulating hormone), LH (luteinizing hormone), and prolactin are measured to assess testicular and pituitary function.
Testicular Doppler Ultrasound
It allows visualization of the testicles and surrounding structures, confirming the presence of a varicocele or other abnormalities.
Genetic studies
Tests such as karyotyping or Y chromosome microdeletion screening can be requested to rule out inherited genetic causes.
Complications and associated risks
The most direct and significant complication of oligospermia is the difficulty in achieving pregnancy naturally.
In addition, it is important to consider that oligospermia can be a marker of other, more serious underlying health conditions.
Some studies suggest that men with infertility have a slightly higher risk of developing certain types of cancer, such as testicular or prostate cancer, so a thorough diagnosis is essential, and if the cause is genetic, there is a risk of passing on the same condition or infertility factor to offspring.
What are the treatments for oligospermia?
Medical and surgical treatments (for specific causes)
Varicocele surgery can significantly improve sperm count and quality in many cases.
If a hormonal imbalance is detected, medication can be prescribed to correct it. Antibiotics are effective for treating infections, and there are drugs used to help with retrograde ejaculation.
It may interest you: How to speed up male ejaculation naturally.
Assisted Reproductive Technologies (ART)
Artificial insemination in cases of mild oligospermia, where the sperm are selected sperm more mobile and are deposited directly in the uterus.
In in vitro fertilization (IVF) eggs are extracted from the woman and fertilized with sperm in the laboratory, suitable for moderate oligospermia.
ICSI (Intracytoplasmic Sperm Injection) is suitable for severe oligospermia and cryptozoospermia. A single sperm, even if immotile, is selected and injected directly into an egg.
Lifestyle changes and supplementation
Adopting a Mediterranean diet rich in antioxidants, quitting smoking and reducing alcohol consumption, maintaining a healthy body weight, avoiding exposure to excessive heat sources in the testicular area, and taking antioxidant supplements can help reduce oxidative stress and improve semen parameters.
Prognosis: Is there a cure for oligospermia?
In many cases, oligospermia is manageable and treatable, allowing the couple to achieve pregnancy.
When oligospermia is caused by factors such as varicocele, hormonal imbalances, or poor lifestyle habits, correcting these problems can "cure" the condition and restore a normal or improved sperm count.
In cases of severe testicular damage, sperm production may not recover. However, even in these situations, infertility is not absolute. Thanks to techniques such as ICSI, it is possible to find viable sperm (either in the ejaculate or through a testicular biopsy) to fertilize an egg.
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Prevention and recommendations for men
Although not all causes of oligospermia are preventable, adopting a healthy lifestyle can significantly reduce the risk and improve overall sperm health.
- Maintain a healthy weight.
- Eat a balanced diet, rich in fruits, vegetables and whole grains.
- Exercise regularly, but avoid high-intensity cycling for extended periods.
- Manage stress.
- Avoid tobacco, alcohol, and recreational drugs.
- Limit exposure to toxins such as pesticides and heavy metals.
- Avoid excessive heat in the testicular area (saunas, hot baths, laptops on the lap).
- Wear loose underwear.
- Practice safe sex to prevent infections.
- Get regular medical checkups.
Frequently Asked Questions (FAQs)
What is the difference between oligospermia and azoospermia?
Oligospermia refers to a low sperm concentration in the ejaculate (less than 15 million/ml), but sperm are still present. Azoospermia is the complete absence of sperm in the ejaculate.
When is it considered oligospermia?
According to the WHO, oligospermia is diagnosed when the sperm count in a semen sample is less than 15 million per milliliter.
Can a man with oligospermia have children?
Yes, in mild cases, pregnancy can be achieved naturally or with the help of artificial insemination. In moderate to severe cases, IVF/ICSI techniques offer a high probability of success.
Is it possible to improve sperm concentration naturally?
Yes, in many cases. Adopting a healthy lifestyle, reducing stress, and taking antioxidant supplements can improve sperm quality and concentration, especially if oligospermia is mild.
How to reverse oligozoospermia?
It depends on the cause. If it's due to a varicocele, surgery can reverse it. If it's due to lifestyle habits, changing them can normalize the count. If it's due to an obstruction, reconstructive surgery can resolve it. In cases of primary testicular failure, it may not be reversible, but it is treatable.
Reservation your first medical consultation now
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Conclusion
Oligospermia is a common condition that affects male fertilityBut this diagnosis opens the door to finding solutions. The vast majority of men with oligospermia can fulfill their dream of becoming fathers. The most important thing is to seek specialized medical help at the first sign of trouble and approach the process with information, patience, and support.
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