Low Sperm Count: “I can’t have a baby?” Of course, you can…
A low sperm count, or in scientific terms oligospermia/ azoospermia, refers to a condition where the concentration of sperm in ejaculated semen is below normal or not existing. That begs the question – What is normal sperm concentration supposed to be? World Health Organization (WHO), acclaims that concentration of <15 million sperm/ml is a low sperm count. If there appears to be no sperm in the sperm analysis it is called azoospermia.
So, what exactly causes a low sperm count?
A wide array of medical conditions are responsible for the cause of oligospermia or azoospermia i.e. only a few will be mentioned here.
- Smoking, Alcohol, and drugs (Substance abuse as well as medications such as androgens.)
- Hypogonadism – Which simply means a reduction in functionality of the gonads. (The testes in males). The causes of this also being variable i.e. genetic, congenital, or acquired (such as opioid or anabolic steroid use)
- Neoplasm- Abnormal growth of cells.
- Chromosomal abnormalities.
Mainly due to obstructive changes in the tubes of the internal genital system involved in ejaculation.
- Vas Deferens obstruction. The Vas deferens are ducts that transport sperm to the ejaculatory ducts forms the epididymis of each testis.
- Ejaculatory duct obstruction.
- Infections e.g. prostatitis.
Management of oligospermia and male infertility is cause-based. Medical and surgical interventions are the main methods used.
Example of medical modalities are:
- Lifestyle changes. Smoking cessation, stress control & weight loss for those who are overweight or obese.
- Hormonal treatments
- Medications for ejaculation disorders’
- Vitamins and minerals. Vit E, C, B, Zinc, Selenium, Carnitine.
Surgical management in patients with oligospermia/ azoospermia include:
- Transurethral resection of the ejaculatory ducts.
- Reconstruction of the obstructed ejaculatory channels
- Sperm extraction techniques (PESE-percutaneous epidydimal sperm extraction, micro-TESE- microscopic testicular sperm extraction)
And of course, lastly, there are assisted reproduction techniques. The main being in vitro fertilization or IVF.