Low Sperm Count: Causes , Symptoms, Treatment and prevention

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HEALTH DESK!!! Low sperm count which is also known as oligospermia (ol-ih-go-SPUR-me-uh) means that the fluid (semen) you ejaculate during an orgasm contains fewer sperm than normal.

Oligospermia is a major cause of male infertility. Sperm count is considered low if it dips below 15 million sperm per milliliter (mL) of semen, although the average is around 75 million sperm per mL. A complete absence of sperm is called azoospermia.

Having a low sperm count decreases the chances that one of your sperm will fertilize your partner’s egg, resulting in pregnancy. Nonetheless, many men who have a low sperm count are still able to father a child.

SYMPTOMS OF LOW SPERM COUNT

The main sign of low sperm count is the inability to conceive a child. There might be no other obvious signs or symptoms. In some men, 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.

However, low sperm count symptoms might include:

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

2). Pain, swelling or a lump in the testicle area

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

CAUSES OF LOW SPERM COUNT

The production of sperm is a complex process and requires normal functioning of the testicles (testes) as well as the hypothalamus and pituitary glands — organs in your brain that 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.

Also, there can be problems of abnormal sperm shape (morphology), movement (motility) or function.

However, often the cause of low sperm count isn’t identified.

MEDICAL CAUSES

Low sperm count can be caused by a number of health issues and medical treatments. Some of these include:

1). Varicocele: A varicocele (VAR-ih-koe-seel) is a swelling of the veins that drain the testicle. It’s the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it might be related to abnormal testicular temperature regulation. Varicoceles result in reduced quality of the sperm.

2). Infection: Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved.

3). Ejaculation problems: Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out of the tip of the penis. Various health conditions can cause retrograde ejaculation or lack of ejaculation, including diabetes, spinal injuries, and surgery of the bladder, prostate or urethra.

Certain medications also might result in ejaculatory problems, such as blood pressure medications known as alpha blockers. Some ejaculatory problems can be reversed, while others are permanent. In most cases of permanent ejaculation problems, sperm can still be retrieved directly from the testicles.

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

5). 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. Surgery, radiation or chemotherapy to treat tumors also can affect male fertility.
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.

6). 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.

7). 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.

Blockage can occur at any level, including within the testicle, in the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts or in the urethra.

8). Chromosome defects: Inherited disorders such as Klinefelter’s syndrome — in which a male is born with two X chromosomes and one Y chromosome instead of one X and one Y — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis, Kallmann’s syndrome and Kartagener’s syndrome.
Celiac disease. A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility. Fertility may improve after adopting a gluten-free diet.

9). 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.

10). 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. In most cases, surgery can be performed to either reverse these blockages or to retrieve sperm directly from the epididymis and testicles.

ENVIRONMENTAL CAUSES

Sperm production or function can be affected by overexposure to certain environmental elements, including:

1). Industrial chemicals: Extended exposure to 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.

2). 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.

3). 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.

HEALTH, LIFESTYLE AND OTHER CAUSES

Other causes of low sperm count include:

1). 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.

2). Alcohol use: Drinking alcohol can lower testosterone levels and cause decreased sperm production.

3). Occupation: Certain occupations might be linked with a risk of infertility, including welding or those associated with prolonged sitting, such as truck driving. However, the data to support these associations is inconsistent.

4). Tobacco smoking: Men who smoke might have a lower sperm count than do those who don’t smoke.

5). Emotional stress: Severe or prolonged emotional stress, including stress about fertility, might interfere with hormones needed to produce sperm.

6). Depression. Being depressed may negatively affect sperm concentration.
Weight. Obesity can impair fertility in several ways, including directly impacting sperm and by causing hormone changes that reduce male fertility.

7). Sperm testing issues: Lower than normal sperm counts can result from testing a sperm sample that was taken too soon after your last ejaculation; was taken too soon after an illness or stressful event; or didn’t contain all of the semen you ejaculated because some was spilled during collection. For this reason, results are generally based on several samples taken over a period of time.

RISK FACTORS

A number of risk factors are linked to low sperm count and other problems that can cause low sperm count. They include:

•Smoking tobacco

•Drinking alcohol

•Using certain illicit drugs

•Being overweight

•Being severely depressed or stressed

•Having certain past or present infections

•Being exposed to toxins

•Overheating the testicles

•Having experienced trauma to the testicles

•Being born with a fertility disorder or having a blood relative, such as your brother or father, with a fertility disorder

•Having certain medical conditions, including tumors and chronic illnesses
Undergoing cancer treatments, such as radiation

•Taking certain medications

•Having a prior vasectomy or major abdominal or pelvic surgery

•Having a history of undescended testicles

DIAGNOSIS OF LOW SPERM COUNT

If you’ve been having unprotected sex regularly for the last one year and haven’t gotten your partner pregnant, you may want to see your doctor. In fact, you may want to head in for an appointment sooner if you have symptoms like trouble ejaculating, pain in the testicles, or previous surgeries.

Diagnosis usually involves a physical exam, medical history, and semen analysis.

A semen analysis may be particularly helpful in receiving a diagnosis, as your sperm can be counted under a microscope and checked for motility (movement) and morphology (shape).

Your doctor may even want to repeat the analysis to ensure consistent results because of high variability between samples.

You’ll likely be provided with a container at your doctor’s office. You’ll be asked to masturbate and ejaculate into the container either at the clinic or at home. If you opt to collect the sample at home, you’ll be instructed on how to care for the specimen until you can get it back to the lab within an hour.

Other tests your doctor may try include:

•blood tests to check hormones or chromosomes

•ultrasound to visualize the testicles or prostate

•biopsy to evaluate sperm production in the case of blockages

TREATMENT FOR LOW SPERM COUNT

The treatment you receive for low sperm count will depend on the cause. There are also some ways you can change up your trying to conceive (TTC) routine that may make pregnancy more possible.

1). Surgery :For cases involving large varicoceles, blockages, or issues with sperm leaving the body, surgery is an option. For example, a varicocele can be corrected with a minor outpatient surgery, and previous vasectomies can be reversed.

In other cases, sperm can be directly obtained for assisted reproduction procedures like in vitro fertilization (IVF) by surgically retrieving it from the testicle or epididymis.

2). Medications:Infections in the reproductive tract can be treated with medications. It’s important to treat infections promptly. Even if an infection is properly treated, sperm count may not always return to normal if permanent tissue scarring has occurred.

3). Counseling: Issues with sexual intercourse, including erectile dysfunction or premature ejaculation, may respond to a combination of medication and counseling.

4). Hormonal treatments: Since testosterone and other hormone levels that are either too high or too low can cause low sperm count, addressing the levels with medications and other treatments may help restore fertility.

Remember that the use of anabolic steroids, testosterone, or even most over-the-counter testosterone boosters can cause infertility, so avoid these.

5).Lifestyle modifications: Things you can do at home to increase the odds of pregnancy with low sperm count include having sexual intercourse more frequently and timing sex with ovulation.

For example, having sex every day or every other day within a few days before, during, and after ovulation will help ensure that the swimmers who make it all the way to the egg get there at the right time.

While you’re at it, skip all lubricants that may slow sperm travel. If you want to use lubrication, try something like Pre-Seed, but use it sparingly. Despite the common misconception, even Pre-Seed can introduce a physical barrier if used in excess.

And avoid activities that raise the temperature of the testicles, such as frequent hot tub dips, saunas, or steam rooms. Lastly, avoid excessive drug and alcohol use, as well as workout supplements that are known to lower sperm quality.

PREVENTION

To protect your fertility, avoid known factors that can affect sperm count and quality. For example:

✓Don’t smoke.

  • Limit or abstain from alcohol.
  • Steer clear of illicit drugs.
  • Talk to your doctor about medications that can affect sperm count.
  • Maintaina healthy weight.
  • Avoid heat.
  • Manage stress.
  • Avoid exposure to pesticides, heavy metals and other toxins.

African Report Files ARFs Blog Health Desk Anchored By


Dominic J. Essien

Dominic J. Essien ( MPH) is
a public Health expert in Nigeria
Whatsaapp:  +234 809 343 4126

Contact him for more health tips and counselling.

 

 

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