LOW SPERM COUNT. FACTS AND FICTIONS.

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LOW SPERM COUNT. FACTS AND FICTIONS.

In Infertility management, sometimes the male factors that contribute to both primary and secondary infertility are either neglected or poorly investigated and managed.

It is important to have a comprehensive evaluation of both the male and female factors before commencing management. There are so many male factors that contribute to infertility, sperm analysis offers the opportunity to pin point the exact cause.

Low sperm count is one of the parameters we check in sperm analysis, others are the appearance (morphology) and motility (movement). It is important to understand the concepts and interpretations of sperm analysis in infertility management.

SO WHAT IS LOW SPERM COUNT?

This is also called Oligospermia, your sperm count is considered lower than normal if you have fewer than 15 million sperm per milliliter of semen. This range might vary depending on your location. We also have complete absence of sperm is called azoospermia.

WHAT ARE THE SYMPTOMS OF LOW SPERM COUNT?

The main sign of low sperm count is the inability to conceive a child.

Most times, there might be no other obvious signs or symptoms.

However In some cases, an underlying problem such as an inherited chromosomal abnormality, a hormonal imbalance, dilated testicular veins or a condition that blocks the passage of sperm may cause signs and symptoms.

LOW SPERM COUNT SYMPTOMS MIGHT INCLUDE:

Problems with sexual function — for example, low sex drive or difficulty maintaining an erection (erectile dysfunction)

Pain, swelling or a lump in the testicle area

Decreased facial or body hair or other signs of a chromosome or hormone abnormality.

WHAT ARE THE CAUSES OF LOW SPERM COUNT?

The production of sperm is a very complex process and requires normal functioning of the testicles (testes) as well as other important organs in the head and neck region, the hormones too.

These organs in the brain produce hormones that trigger sperm production. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.

Problems with any of these systems can affect sperm production.

(A) MEDICAL CAUSES

Varicocele. This is a swelling of the veins that drain the testicle. It’s the most common reversible cause of male infertility.

Infection. There are infections that can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the tubes that transport sperm (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage.

Ejaculation problems. One of the commonest presentations is retrograde ejaculation, which occurs when semen enters the bladder during orgasm instead of emerging out of the tip of the penis. Various health conditions can cause retrograde or lack of ejaculation, including diabetes, spinal injuries, and surgery of the bladder, prostate or urethra.

Antibodies that attack sperm: Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to destroy them.

Tumors. Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes.

Undescended testicles. During fetal development one or both testicles sometimes fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men with this condition.

Hormone imbalances. The hypothalamus, pituitary and testicles produce hormones that are necessary to create sperm. Alterations in these hormones, as well as from other systems such as the thyroid and adrenal gland, may impair sperm production.

Defects of tubules that transport sperm. Many different tubes carry sperm. They can be blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.

Chromosome defects. Inherited disorders can cause low sperm count.

Celiac disease. A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility.

Certain medications. Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal and antibiotic medications, some ulcer medications and other medications can impair sperm production and decrease male fertility.

Prior surgeries. Certain surgeries might prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others

(B) ENVIRONMENTAL CAUSES:

Industrial chemicals, such as benzenes, toluene, xylene, herbicides, pesticides, organic solvents, painting materials and lead might contribute to low sperm counts.

Heavy metal exposure. Exposure to lead or other heavy metals also can cause infertility.

Radiation or X-rays. Exposure to radiation can reduce sperm production. It can take several years for sperm production to return to normal. With high doses of radiation, sperm production can be permanently reduced.

Overheating the testicles. Elevated temperatures impair sperm production and function. Although studies are limited and are inconclusive, frequent use of saunas or hot tubs might temporarily impair sperm count.

Sitting for long periods, wearing tight clothing or working on a laptop computer for long stretches of time also might increase the temperature in your scrotum and slightly reduce sperm production.

(C) HEALTH, LIFESYTLE AND OTHER CAUSES

Drug use. Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana might reduce the number and quality of your sperm as well.