While discussing male infertility, it is common to address the primary causes. Nevertheless, it is crucial to recognize that certain abnormalities may be associated with underlying conditions or diseases, which can lead to the development of further complications. Identifying these issues at an early stage allows for potential correction or consideration of alternative solutions that may yield better outcomes.
Oligospermy is one of the prevalent and consequential conditions that can impede conception in males. It is characterized by a reduced sperm count in the semen. According to data from the World Health Organization (WHO), a man is considered to have oligospermy if his sperm concentration is less than 15 million spermatozoa per milliliter.
Oligospermy can be caused by various diseases, such as hormonal disorders, testicular problems or infections. In many cases, Oligospermy is associated with other conditions, such as those described below:
Cryptorchidism: a condition associated with oligospermy
Cryptorchidism is a condition characterized by the failure of one or both testicles to descend into the scrotum before birth. This condition can lead to fertility challenges since the undescended testicles are exposed to higher temperatures, which can adversely affect sperm production.
Cryptorchidism primarily occurs in a single testicle, accounting for approximately 80% of cases, and the left testicle is more commonly affected. Bilateral cryptorchidism, where both testicles are altered, is less common. To prevent fertility challenges, it is recommended that boys with cryptorchidism undergo surgery to descend the testicles into the scrotum before the age of 2 years.
Varicocele
Testicular varicocele is a condition characterized by the enlargement of veins that supply blood to the testicles. This dilation can lead to an increase in testicular temperature, which can adversely affect sperm production. While it is more commonly observed in one testicle, it can also affect both. When varicocele affects both testicles, it is more likely to contribute to infertility.
Furthermore, testicular varicocele can contribute to the development of oligoasthenoteratozoospermia, a condition characterized by low-quality spermatozoa in terms of their number, motility, and morphology.
Adequate treatment can lead to notable improvement in cases of oligoasthenoteratozoospermia associated with testicular varicocele. Surgery is generally considered the most effective treatment, particularly in severe instances.
Hypogonadism and oligospermy: links in reproductive health
Male hypogonadism refers to the condition in which the testicles do not produce an adequate amount of sex hormones, including testosterone. This hormonal imbalance significantly affects sperm production and can lead to infertility.
Male hypogonadism can be divided into two main types:
- Primary hypogonadism occurs when the testes are unable to function properly due to internal issues. A well-known genetic disorder associated with this type is Klinefelter’s syndrome, which often leads to low testosterone levels, diminished muscle mass, limited facial and body hair growth, and decreased sperm production.
- In cases of secondary hypogonadism, the issue lies in the hypothalamus or pituitary glands, which are responsible for producing the hormones that stimulate the testes to produce sperm.
The treatment of hypogonadism is determined by the specific type of the condition. Hormonal therapy can be utilized in certain cases to restore testicular function and stimulate increased sperm production, ultimately improving the outlook for fertility.
Hydrocele
Testicular hydrocele is a condition that causes fluid to accumulate around one or both testicles. It can be congenital or acquired, and is more common in men over 40 years of age.
Hydrocele is generally not a direct cause of infertility, although it may be associated with infertility in around 10% of cases. In these instances, it can lead to a partial obstruction of the vas deferens, potentially resulting in a decreased sperm count in the semen.
Oligoasthenoteratozoospermia
Oligoteratozoospermia refers to a condition where the concentration of spermatozoa in the semen is low, and the shape of the spermatozoa is abnormal. This term combines two observations from a spermogram: “oligo,” indicating a low sperm concentration (less than 15 million per milliliter), and “terato,” representing a low percentage of sperm with normal morphology (less than 4%). The presence of abnormal sperm morphology can hinder fertilization and potentially affect the development of embryos.
In cases of severe oligoteratozoospermia, men who wish to have children often undergo in vitro fertilization (IVF) treatment with intracytoplasmic sperm injection (ICSI). During this procedure, sperm with normal morphology are carefully chosen under microscopic guidance and directly injected into the egg. By employing this method, the chances of obtaining a viable embryo are significantly increased.
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Although these diagnoses may dampen the hopes of men who aspire to have a family, it is essential to understand the positive significance of detecting and addressing these conditions on time. This realization can mark a transformative phase in enhancing fertility and promoting overall health.
It is advisable to keep up to date with general check-ups, not only to increase the chances of being able to start a family, but also to avoid these diagnoses that can lead to irreversible consequences. These diagnoses can compromise the health and well-being of patients.
If you are aspiring to start a family but are encountering difficulties in conception or are aware of someone facing infertility or related complications, it is essential to reach out to specialized clinics that specialize in oligospermy, male fertility, and assisted reproduction, such as Babynova Clinic by Novafem. Seeking advice and treatment from these clinics at the earliest opportunity can make a significant difference in addressing these issues.