My Health and Wellness

Oligospermia- Low sperm count 

Time and again we have heard that most of the male diseases result in infertility problems. One such condition causing infertility is oligospermia; where the number of sperm is less than 20 million per milliliter in the ejaculated semen.  Diagnosing a person with low-sperm count can be a big blow to his ego. Many infertile men are deeply concerned with their low sperm count, as infertility is an embarrassing and tragic situation in marital life. The question of concern is not why and how the sperm count is reduced but it is always can I be able to father a child? This question cannot be answered right away because it needs lots of examinations to confirm your condition.

You might be wondering that after all I need one good sperm to fertilize the egg or ova but doctors have diagnosed me with more than 10 million sperms per milliliter, than what is the reason for my infertility. Even with the advancement of technology to its greatest heights the answer to this very basic question is very difficult because we are still struck up low below the axis line of not clearing knowing what exactly is the normal sperm count. Many physicians have reported that men with sperm count as low as 2-2.5 million sperms per milliliter of semen were capable of fathering a pregnancy on their own without any medical aid.

Widely accepted normal reference value for semen analysis is

 Causes

The million dollar question that needs to be answered still is – Why do I have a low sperm count? Unfortunately most of the doctors will not be able to answer this as no test will help your doctor to find out this. Convince yourself by “God only knows” concept. 

There are many predicted reasons for low sperm count, and this condition may be temporary or permanent. The predicted causative factors include

• Obstruction in the normal flow of semen due to vasectomy or testicular trauma
• Y-chromosome micro-deletion (deletion of small segment of gene in Y-chromosome)
• Klinefelter syndrome
• XX male syndrome
• FSH deficiency
• Congenital adrenal hyperplasia (deficiency of cortisol hormone)
• Scarring during surgery in the male reproductive system
• Might be due to sexually transmitted disease like Chlamydia & gonorrhea (both are sexually transmitted bacterial infection of the genital tract)
• Varicocele (swelling of the varicose vein in the scrotum)
• Imbalance in hormone production or hormonal disorders
• Isolated gonodotropin deficiency
• Obesity
• Testicular disease or inflammation
• Radiation exposure or radiotherapy
• Poor motility and abnormal morphology of spermatozoa’s (sperm)
• pH of the vaginal fluid, which if acidic kills the sperm
• Viability of sperms in female genital tract
• Stress, smoking, drugs and alcohol
• Side effects of medications
• Malnutrition or under-weight
• Vitamin-C deficiency
• Exposure to toxins

Factors resulting in temporary oligospermia are

• Fever with high temperature
• Drugs and poison
• Excessive alcohol
• Severe illness 

Symptoms

Symptoms of oligospermia can also be said as complications resulting from low-sperm count. Although every person experiences different signs and symptoms here are some common symptoms of oligospermia

• Sub-fertility or infertility
• Hypogonadism
• Testicular atrophy

If the cause is sexual transmission, then the symptoms include

• Burning or irritation during urination
• Pain in the testicles
• Thick discharge from penis

In case, the cause is varicocele

• Dilated veins in scrotum
• Scrotal pain & swelling

Symptoms of Vitamin-C deficiency

• Bruising, swollen and painful joints
• Nose bleeds
• Frequent infections
• Anemia which results in weakness, tiredness and paleness
• Fatigue
• Very slow healing of wounds

In person with XX male syndrome

• Smaller testicular size
• Gynecomastia (development of breast in males)
• Infertility
• Presence of feminine characters

Men with Klinefelter syndrome shows symptoms like

• Firm and small testicles
• Small penis
• Gynecomastia
• Sexual problems 

Diagnosing Oligospermia

Diagnosis is a very important aspect considering any medical conditions, as the treatment is entirely based on the diagnosis, any type of misdiagnosis may result in a serious condition than before. Presence of oligospermia may not be known to the man itself until he attempts to get a woman pregnant for more than a year.  Diagnosing oligospermia is very simple and includes

• Approaching a fertility clinic for semen analysis which includes analysis of the quantity and quality of semen and sperm.
• Another test called Fluorescent in situ hybridization (FISH) is done to identify chromosomal abnormalities on chromosome-21, X and Y.
• Your physician might make a note of your medical and sexual history.
• Physical examination of the testicle and the penis.
• Lab tests are also performed to check for the presence of sexually transmitted infections and the infecting organism.
• Hormonal tests for detecting the level of hormones 

Treatment

Every patient while approaching his physician goes with the mind set-up of “pill for every ill”, they expect their doctor to prescribe medicine that will right away to increase their sperm count and cure their infertility problem as medical field has advanced so much. But despite so much of development, the sad part is that still today there is no perfect treatment available to increase the sperm count; this is why most of the physicians use assisted reproductive technology. Treatment is given considering your condition, severity and the underlying causes. Treatment is initiated by suggestions like

• Improving diet
• Losing or gaining weight as required
• Quit smoking & no alcohol
• Avoiding hot bathing tubs, tight clothing’s and any other factor that may increase the temperature and reduce sperm count

Your physician might prescribe few hormonal medications to increase your sperm count. Medications include

• HMG medication – which is nothing but follicle-stimulating hormone injection.
• HCG (Human Chrionic Gonodotropin hormone) injection

Other commonly used medications are

• Testosterone, Vitamin-C, Vitamin-E, anti-oxidants, high protein diet, homeopathic pills, Ayurveda and Unani medications. But the effectiveness of these prescriptions is not clearly known. Vitamin medications help you to increase the sperm quality rather than the sperm quantity.
• Antibiotic medications are prescribed if the condition is due to sexually transmitted infection.
• If the underlying cause is varicocele or blockage in the flow of sperm then a surgery may be needed.

A word of warning – treatment for oligospermia is not so effective and has very unpleasant side-effects, therefore always ask your physician why has he opted for that particular treatment before going for it. Make sure that semen analysis is done every 3 months and then decide whether to proceed with the treatment or not.

Homeopathic treatment

Homeopathic treatment is proved to be more effective in treating low-sperm count, poor sperm motility (movement), abnormal morphology, production of anti-sperm antibodies and semen viscosity. If you are diagnosed with minimum of 2 million sperm per ml, with zero sperm motility and more than 90% of abnormal sperm morphology, then the ideal treatment for you will be homeopathic treatment which gives more effective outcome. If the sperm count is even lesser, than the treatment period is extended. The treatment period is for about 9 months with a minimum sperm count of 1 million. This treatment not only helps you to increase your sperm count but also to improve sperm motility and abnormal sperm morphology. The treatment is so effective that you will not need any medications for the next 8-10 years and your sperm count will be normal. Homeopathic treatment is considered as the safest and no side effect as it is not a hormonal treatment and proves to be successful in about 90% of the patients. The treatment is also effective in treating varicocele, hormonal imbalance and any other existing urological abnormalities. 

Options to Improve Pregnancy Rate

For men with a sperm count of 5 million per ml, the treatment first opted for achieving pregnancy is In vitro fertilization (IVF). The rate of success is comparatively high as the fertilization is first made sure in vitro (outside the body) and then the fertilized zygote is placed inside uterus, increasing the chance of pregnancy. Failure of IVF leaves you with only one option of going for Intra Cytoplasmic Sperm Injection (ICSI), this promises the possibility of pregnancy no matter how low the sperm count is. 

Prevention

Oligospermia can be prevented by following simple steps, except in case where the causative agent is genetic factor.

The first important preventive step is avoiding sexually transmitted diseases. Having a monogamous relationship (sex with one partner) or abstinence from sex prevents the spread of infection. Using condom also protects from sexually transmitted infections.

In case, if you are predicting yourself to be inside the risk circle of oligospermia, then meeting your doctor regularly may help diagnose oligospermia in the earlier stage and prevent later complications. Avoid smoking, drinking alcohol and too much of caffeine. Avoid recreational drugs. Never expose the testicles to high temperature such as hot tubs or radiation. 

Ray of hope

Achieving pregnancy with low-sperm count is really very challenging but not impossible. Very few people have attained pregnancy even with low–sperm count; however, the chances are very less. Fertility in males is not only because of low-sperm count, it is associated with many underlying causes like poor sperm motility, abnormal sperm morphology and other type of sperm dysfunction. Effective treatments are available now-a-days but many couples opt for cervical cap conception device, artificial insemination or invitro fertilization to improve their ability to conceive.

Upon diagnosis with oligospermia many men react differently showing anger and restlessness on undergoing fertility test. He might face problems at home and at work, loss of self-esteem and no desire for sexual activity due to the guilt feeling. It is the utmost duty of the family members especially wife to understand that the urge for fatherhood is biologically as strong as the urge for motherhood, and stop looking at him like a culprit.