What is Oligospermia? Oligospermia (Lack of Sperm) Treatment

by Abbas Jahangir · June 15, 2024

Male reproductive cells are called sperm. Sperm is produced in the testicles in men. It matures in the gland called epididymis. Sperms are expelled from the body through semen. Sperm number and quality are of great importance in male infertility. Low sperm count or no sperm count is one of the most important causes of male infertility. Now “what does oligospermia mean?” Let’s explain this.

What is Oligospermia?

Low sperm count in men is called oligospermia. Oligospermia is the number of sperm in one milliliter of semen below 15 million, according to the World Health Organization’s 2010 definition. According to its severity, oligospermia is classified as follows:

Mild oligospermia:10-15 million sperm in 1 ml of semen
Moderate oligospermia: 5-10 million sperm in 1 ml of semen
Severe oligospermia:0-5 million sperm in 1 ml of semen

The absence of any sperm in the semen is called azoospermia. It is not known what percentage of men worldwide have oligospermia. This is because oligospermia can be detected in men who consult a physician due to infertility . Oligospermia may result from one or more defects in sperm production.

What are the Causes of Low Sperm Count?

There are many factors that disrupt sperm production and cause low sperm count. The main ones are:

Varicocele : The man’s testicles are covered with a skin sac and this sac hangs out of the body. Varicocele is the enlargement of the veins on the skin sac surrounding the testicles. For this reason, blood flow to the testicles may decrease and the nutrition of the testicles may be impaired. Testicles whose nutrition is impaired may shrink due to varicocele. Varicocele is a condition that disrupts sperm production and sperm quality. Varicocele is basically very similar to varicose veins in the legs. Varicocele is a very common condition in men and is seen more on the left. Observations have shown that not every varicocele affects sperm production.
Infections: Sperm production may be impaired due to viruses and sexually transmitted diseases. Sexually transmitted diseases can disrupt sperm production by causing epididymitis and orchitis (inflammation of the testicles).
Ejaculation problems: Normally, when a man ejaculates, semen flows out of the penis. In some men, retrograde ejaculation occurs. In this case, the semen is ejaculated backwards, that is, towards the bladder, rather than outwards. This type of ejaculation can be caused by diabetes, tumors, previous injuries, and previous surgeries. As a result of all these, sperm count may decrease. While some ejaculation problems are treatable, some are permanent.
Antibodies that attack sperm: Sometimes antibodies produced by the immune system can perceive sperm as enemies and attack and destroy them.
Tumors: Sperm production may be impaired due to tumors originating from the testicles or metastasis to the testicles from other organs. As a result of chemotherapy, radiation and surgical treatments used to treat testicular cancer, the testicles may be damaged and sperm production may be impaired.
Undescended testicle: In the womb, the testicles move from the abdominal cavity towards the scrotum and settle in the scrotum. Sometimes this descent does not occur and the testicles remain in the abdominal cavity. This condition is called undescended testicle. Due to undescended testicle, the testicle cannot complete its development and remains small. Testes that fail to develop cannot produce enough sperm.
Hormone imbalances: Hormones necessary for sperm production are produced in the brain by the hypothalamus, pituitary gland and testicles. Sperm production may be impaired due to imbalances in these hormones. Additionally, thyroid hormone disorders and adrenal gland diseases may result in decreased sperm production.
Defects in the tubes that carry sperm: There are many tubes that carry sperm. These tubes can become damaged and blocked during surgery, infections, injury, and diseases such as cystic fibrosis. In this case, even if sperm is produced, it cannot be transported and sperm deficiency occurs.
Chromosomal errors: A man is born with one X and one Y chromosome. Sometimes a man is born with 2 X chromosomes and one Y chromosome. This condition is called Klinefelter syndrome. In men with this disease, male reproductive organs develop abnormally. Other genetic diseases that cause sperm deficiency are Cystic Fibrosis, Kallmann syndrome and Kartagener syndrome.
Celiac disease: Celiac patients are sensitive to gluten. Sperm count may decrease in these. Sperm counts may return to normal after following a gluten-free diet.
Medications: Some blood pressure medications, cancer medications, antifungals, antibiotics, and testosterone therapy can disrupt sperm production.
Previous surgeries: After surgeries on reproductive organs, hernia surgeries, prostate surgeries and major abdominal surgeries, blockages may occur in the tubes that carry sperm. Sperm count may decrease due to these blockages.
Chemical substances: Sperm count may decrease in those exposed to benzene, pesticides, paint chemicals and lead for a long time. Long-term exposure to heavy metals may cause low sperm count.
Radiation: Sperm count may decrease in those who are exposed to radiation due to their work or cancer treatment.
Overheating of the testicles: Tight and thick clothing, frequent use of saunas and hot tubs, and long-term use of a laptop may cause the testicles to overheat and impair their function.
Excessive alcohol use: In those who consume excessive alcohol, testosterone hormone levels may decrease and this may affect sperm production.
Using tobacco: Studies have shown that the sperm count in smokers is lower than in non-smokers.
Obesity: Excessive weight can change the sperm count by both causing a disruption in the hormone balance involved in sperm production and by directly affecting the sperm.
Depression: Excessive stress and depression are thought to negatively affect sperm count.

What are the symptoms of low sperm count?

The main symptom of oligospermia is the inability to have children. When they consult a doctor because they cannot have children, if the problem is thought to be in the man, a spermiogram test is performed to check the number and quality of sperm. At the end of this process, oligospermia is diagnosed. Apart from this, the following symptoms may be observed in men with oligospermia:

Low sexual desire
Disorders in maintaining erection (erectile dysfunction)
Prominence in testicular veins, lump, pain and swelling on the testicle
Lack of facial and body hair and other symptoms of hormone disorders

How to Treat Low Sperm?

To detect low sperm count, the doctor first examines the man in detail. Detailed examination of sexual organs is important. During this examination, chronic diseases and hereditary disorders, if any, are detected and previous surgeries are learned. Then the sperm count is determined with the help of a microscope or computer. It takes approximately 3 months for sperm to be produced and mature. Therefore, a sperm analysis will give information about the last 3 months. Sometimes doctors request that two sperm samples be examined 2 weeks apart to reach a more accurate result. Apart from the sperm test, other tests that can be performed include scrotal ultrasound, hormone test, post-ejaculation urinalysis, testicular biopsy, sperm antibody level, sperm function tests and rectal ultrasound. Treatment of low sperm count (oligospermia treatment) is mainly done as follows:

Surgery: Surgery may be considered in cases of varicocele, obstruction or adhesion in the tubes. Sometimes sperm can be surgically removed from the testicle or epididymis as a reproductive technique.
Treatment with antibiotics: If infections are thought to be the cause of low sperm count, antibiotics can be used.
Erectile dysfunction and ejaculation problems are treated appropriately.
If there is a hormonal disorder or imbalance, medications are used to regulate them.
Losing weight and stopping tobacco, drug and alcohol use may be beneficial.

In some cases, sperm deficiency treatment may not be successful.

How to Prevent Low Sperm?

Quit your harmful habits such as smoking and alcohol.
If you are using medication that reduces sperm count and want to have children, talk to your doctor about this.
Lose your excess weight and stay at a healthy weight.
Avoid tight clothing, laptop use, hot tubs and saunas that heat the testicles.
Learn stress management and try to get rid of depression.
Try to avoid exposure to pesticides, heavy metals and other chemicals.

To get more detailed information on this subject, you can contact health institutions and get support from specialist physicians.