Oligospermia in men: causes, degrees, treatment

Oligospermia in men: causes, degrees, treatment.

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_ What is oligospermia in men ?;
_ Causes of oligospermia;
_ Degrees of oligospermia;
_ Diagnostics;
_ Treatment;
_ Is it possible to get pregnant with oligospermia ?;
_ Nutrition for oligospermia;
_ Prevention.

What is oligospermia in men?
Oligospermia is a condition in which a decrease in the volume of seminal fluid is observed.

Very often, men suffering from infertility, the andrologist diagnoses oligospermia, which means a reduced number of sperm in the ejaculate. This condition is rarely an isolated violation of a man’s sexual function and is often combined with erectile dysfunction and a lack of ability to ejaculate during orgasm.

The amount of sperm in the ejaculate can vary throughout a man’s life. In order to avoid problems with conception, a man in the ejaculate must have a certain, sufficient amount of sperm. The World Health Organization (WHO) considers it sufficient to conceive a sperm count of 15 million sperm per milliliter (ml) of ejaculate or more. Anything below this is considered low and diagnosed as oligospermia.

Varicose veins in the scrotum can interfere with blood flow to the testicles, which can lead to an increase in local temperature in them. Any increase in temperature can adversely affect sperm production. About 40 percent of men with low sperm count or low sperm quality have this pathology.

In many men with oligospermia, ejaculation often does not occur, but some ejaculation disorders can reduce sperm count and the chance of conception. One of these disorders is retrograde ejaculation.

Some of the most common causes of oligospermia also increase the risk for other fertility problems. This includes sperm motility problems. Very often, men with conception problems are diagnosed with oligospermia and asthenozoospermia.

A low sperm count reduces the chances of conception, but does not completely exclude it. Many men with oligospermia are able to fertilize the egg of their partner, despite lower sperm counts, which means oligospermia or oligozoospermia is not a sentence to a childless existence.

To successfully fertilize an egg, sperm must contain at least forty million active sperm, and the volume of ejaculate must be at least 1.5 – 2 ml. With oligospermia, the number of viable germ cells is less than twenty million. And although such a quantity seems large at first glance, you should not forget that only the units of the most active sperm can get to the egg – many of them die in the acidic environment of the vagina, some die already in the uterus.

So, what oligospermia means literally: “oligo” – “decrease”, “sperm” – “sperm”. At the same time, oligospermia practically does not manifest itself in any way, the male sex life remains unchanged. The presence of a disease can only be suspected if, during regular sexual intercourse for more than a year, conception does not occur in couples that do not use contraceptives.

Decreased fertility is called subfertility. Oligospermia can cause both subfertility and complete infertility.

Causes of Oligospermia
Among the most common causes of oligospermia are the following:

_ overheating, which leads to frequent visits to saunas, baths, taking hot baths, too tight fitting underwear made of synthetic fabrics;
_ circulatory disorders in the genitals, which contributes to wearing tight underwear, tight jeans;
_ stresses, both physical and emotional, which provoke hormonal malfunctions in the body and lead to a deterioration in the quality of semen;
_ unbalanced nutrition, lack of protein foods, lack of vitamins contribute to a decrease in sperm quality;
_ the presence of bad habits, such as addiction to alcoholic beverages and smoking, negatively affect sperm quality;
_ poor sleep, lack of rest, emotional and physical overload also contribute to a decrease in the quality of ejaculate;
_ overweight, obesity;
_ sperm quality can be affected even by too frequent sexual intercourse, after which the sperm do not have time to mature, or, conversely, too long abstinence;
taking certain drugs.

These reasons can be completely eliminated independently. To do this, it will be enough to abandon bad habits, reconsider the approach to nutrition, pay attention to your health, take time to sleep and have a good rest, and reconsider your lifestyle.

Serious reasons include:

_ genetic abnormalities, pathologies of the development of the reproductive system;
_ hormonal disorders, one of which is hypogonadism, characterized by a decrease in the production of the hormone testosterone;
_ sexually transmitted infections. For example, gonorrhea or chlamydia interferes with the normal progression of sperm through the genital tract;
_ the presence of viral and bacterial infections;
_ prostatitis in chronic form, inflammatory process in the testicles, other diseases of the male genital organs;
_ work in harmful conditions;
_ varicocele, in which there is venous expansion in the testes and spermatic cord;
_ age-related changes. Although it is believed that in women to a greater extent, age-related changes affect fertility, in men, the ability to produce viable offspring also decreases.

It will be more difficult to correct the condition if the vas deferens are blocked, the man suffered damage to the cavernous bodies or other segments of the reproductive system (regardless of the nature of the injury). Also, oligospermia is a consequence of genetic disorders, congenital malformations of the reproductive system (cryptorchidism is common).

Degrees of Oligospermia

Distinguish oligospermia of three degrees of severity:

  1. In the first degree of pathology, the amount of ejaculate differs from normal by less than 0.5 ml and is 1.5 to 2 ml
  2. In the second degree of oligospermia during ejaculation in a man, up to 1 ml of seminal fluid is secreted
  3. In the third, most severe degree of oligospermia, the amount of sperm is negligible, and it does not exceed 0.5 ml

The volume of seminal fluid is a very important indicator of spermatogenesis, since not only the number of spermatozoa is important, but also the fluid where they are located. Seminal fluid neutralizes the acidic vaginal environment, and only when there is enough fluid, sperm cells have a chance to be in the cervix. The normal volume of ejaculate is a volume of 2-5 ml. If it is less, we can talk about oligospermia.

By the number of sperm per milliliter, the disease is divided into four degrees, the fourth degree is already an extremely serious problem.

In total, four degrees of oligospermia are known. In the first degree, the sperm count in the total volume of ejaculate is in the range of 40-60 million. Oligozoospermia of the 2nd degree is the content in the ejaculate from 20 to 40 million cells. In the third degree, the concentration of germ cells is from 5 to 20 million, and the most complex fourth degree implies the presence of less than 5 million sperm.

According to the WHO and the Ministry of Health, the normal number of sperm has different indicators. For example, in the Ministry of Health this norm is from 60 to 150 million.

The causes of oligospermia in men are poor nutrition, vitamin deficiency, recurrent colds, hypothermia. Very often, bronchitis, smoking and drinking alcohol, poor sleep, sinusitis, weakening of the immune system and some other diseases lead to oligospermia.

Severe symptoms are absent. As a rule, this disease does not cause any bright discomfort and does not interfere with a full sexual life. Men can detect this disease when they cannot conceive a child.

It is extremely rare when analyzing sperm that only a decrease in the ejaculate or the number of germ cells in it is diagnosed. Typically, these disorders are combined with these types of pathospermia:

_ asthenozoospermia – low sperm motility;
_ teratozoospermia – a large number of deformed germ cells;
_ azoospermia – complete absence of sperm;
_ leukospermia – an excess of white blood cells in the ejaculate.

To conceive a child, one viable sperm is enough – so why does their insufficient concentration in sperm prevent pregnancy? In order to achieve the goal, the sperm need to go a difficult way from the vagina to the uterus. The female vagina has a natural acidic environment, which has a destructive effect on sperm (slows down their movement or destroys). If the concentration of sperm is high enough, then at least single specimens will get to the egg and fertilize it.

Diagnosis of oligospermia is carried out in one way – by conducting a spermogram. These studies are carried out using a microscopic study of the ejaculate obtained by a man by masturbation. It is important to know that a reliable test result can only be obtained if the semen was examined by the laboratory assistant no more than 20 minutes after collecting the material. It is also necessary to pay attention to the following points:

_ For a reliable diagnosis, it is important for a man to know about the rules of preparation for the study and its immediate conduct;
_ A week before the expected date of the analysis, the man should refrain from any sexual contact, including self-satisfaction;
_ It is strictly forbidden to visit baths and saunas, to sunbathe before the examination;
You should also not drink alcohol and smoke;
It is important to notify the doctor about taking any medications during the preparation for the examination, as they can negatively affect the result of the tests, making them false.

If the diagnosis is confirmed, then the man is prescribed additional examinations. In no case do you need to refuse them, because they will help establish the true cause of the problem and find a way to solve it. Usually for this you may need:

_ general urine and blood tests;
_ tests for sexually transmitted and genital infections;
_ HIV test;
_ Ultrasound of the pelvic organs;
_ conclusion of the urologist;
_ blood test for hormones.

The main danger of oligospermia is the development of teratospermia or when the sperm mutation at the time of fertilization, the formation of cells with abnormal abnormalities, which leads to fetal death in the womb. But doctors are trying to convince men that oligospermia is still not a sentence.

The main thing is to find the strength of will and desire to conquer the disease. Often, experts advise carrying out alternative methods on the path to conception and the desire to have children – IVF, ICSI. Patients should not refuse even in case of initial unsuccessful attempts. If IVF does not give positive results, then ICSI has proven to be highly effective.

To achieve success in the treatment of oligospermia, an integrated approach is important. Hoping for a case is impossible. If a man fails to become a parent for a long period, then this is an occasion to consult doctors and undergo a full study. It is also important to understand that the cause of serious consequences and many ailments in men is the unfortunate prostatitis. It is necessary to treat pathology at the first manifestations, which will help to avoid irreversible consequences in the future.

Treatment for oligospermia may include:

_ surgical interventions (in cases where the disease arose against varicose veins of the spermatic cord);
_ taking medications to restore the functions of the kidneys, adrenal glands, liver and other internal organs;
_ lifestyle correction (smoking cessation and abuse of alcoholic beverages, proper nutrition, adherence to work and rest, proper sleep);
_ the use of drugs that improve the composition of the ejaculate (Speman, Clostilbegyt).

After the start of treatment for 3-4 months, you need to re-take a spermogram to assess the dynamics. If the situation improves, doctors prescribe parallel treatment for the woman. She is recommended to take vitamins and the use of vaginal products, which should put in order the microflora, eliminate excessive acidity, so that as many male germ cells as possible get the chance to reach the target alive.

Most often, it is recommended to do this through intrauterine insemination, in which sperm is introduced into the cervix, thereby the male sex cells will be shorter and the chances of conception will increase.

But the most effective method in the fight against oligospermia is surgical intervention. Most often, an operation is prescribed after an unsuccessful conservative treatment. The largest percentage (about 40%) of patients who require surgery are men with varicocele problems in the spermatic cord region.

Vasoepididimanastomosis is one of the most effective operations in the treatment of oligospermia. The reason for its implementation may be a decrease in the number of sperm, which is associated with various diseases of the epididymis. The whole essence of this operation is to remove the vas deferens and then replace it with an implant.

Possible treatment:

_ if inflammatory or infectious processes occur in a man’s body, a course of treatment with antibacterial and antiviral agents is prescribed;
_ hormone deficiency is treated by the artificial introduction of testosterone into the body (hormone therapy);
_ neurosis and stress are removed at the reception of a psychotherapist;
_ the synthesis of estrogen is blocked by taking drugs (Clomiphene, Clomid);
_ in addition, hCG or chronic human gonadotropin is prescribed.
In addition to the chosen technique, patients are advised to streamline their lifestyle: give up smoking and alcoholic beverages, go in for sports, eat high-protein foods, sleep at least 8 hours a day, and avoid stressful situations. Sometimes biological additives (Viardo, Tribestan, Verona) are included in the course of treatment.

Is it possible to get pregnant with oligospermia?
The inability to conceive a child on your own with oligospermia is quite understandable: on the way to the egg, most of the male germ cells die, and if the number is already insufficient, then it’s quite difficult to expect at least one daredevil to reach his cherished goal.

Despite the prevalence of this ailment, oligospermia is considered the simplest form of male infertility, in which even without appropriate treatment there is a chance to conceive a baby on their own, although they are very small. When assessing a man’s fertility, it is important to assess the degree of hypospermia (this is another name for oligospermia). The probability of pregnancy is proportional to the severity of the disease.

But even the 4th degree of the disease is not a sentence, and a man may well become a dad, provided that he agrees to patiently and gradually be treated. Treatment may take from several months to a year.

Knowing what a pathology called oligospermia is, is it possible to get pregnant – the most popular question. The correlation between sperm quality and male fertility is quite certain. In order for a woman to become pregnant, the seminal fluid must enter the vagina in a certain amount (at least one and a half ml) and with certain sperm characteristics.

That is, with oligospermia, when a man ejaculates with a smaller amount of seminal fluid, the possibility of conception can remain at an optimal level with high sperm motility. Although, in general, the chances of fertilization in such a man are lower than in a healthy man.

However, as a rule, a decrease in the amount of sperm secreted during orgasm almost always coincides with a decrease in sperm motility and shape, since the list of causes of oligospermia and oligozoospermia is almost identical.

Men with oligospermia should not despair: according to statistics, even with a pronounced stage of the disease and a complete rejection of drugs for the treatment of oligospermia, the chance to conceive a child is at least 5 percent. With the right treatment, the possibility of conception can be quite high, except in cases where the pathology, which is the cause of the decrease in sperm count, is incurable.

Also, reproductive technologies, which are involved in the process of fertilization of a woman’s egg with the help of a sperm, provide significant assistance. And if a man’s seminal fluid contains active sperm, the chance of fertilization, natural or artificial, remains.

Oligospermia and IVF are interrelated concepts, since a deficiency of full sperm can serve as the basis for artificial insemination. If the problem is to block the vas deferens, a man takes a sample of biological material directly from the testicles as a medical intervention. Then the sperm is combined with the egg to carry out fertilization.

Only now it becomes known about him only when the couple goes to the doctor with a request to help in the conception of the baby, that is, after long and unsuccessful independent attempts.

According to the results of a spermogram, a man can be diagnosed with a disease such as Oligospermia. Oligozoospermia is often referred to as oligospermia, considering it a variant of the second. There is a difference between the two names, but, as a rule, both phenomena mean the same problem.

Oligospermia is a decrease in the amount of ejaculate, and oligozoospermia is a decrease in the concentration of sperm in the seminal fluid.

Most often, these phenomena are directly interrelated, but there may be exceptions in which a decrease in the number of germ cells in the seminal fluid is recorded in the normal volume of sperm.

The greater the severity of the disease, the more difficult it is for a couple to become pregnant naturally.

Nutrition for oligospermia
The decrease in sperm count in the ejaculate sample is directly related to the deficiency of protein and zinc in the body. Therefore, the diet for oligozoospermia is aimed at replenishing protein and trace elements.

It is advisable to eat lean meats, nuts, lean fish, beans, dairy products. To normalize the level of trace elements, you need to take care of the presence of fortified foods in the diet – fruits, vegetables and fresh herbs. It is also a source of natural antioxidants.

Seafood is a source of zinc. If you use as many oysters, mussels and shrimp as possible, after a month the blood count will show an increase in the concentration of this element.

It is equally important to increase the presence of tocopherol in the body. Vitamin E is present in eggs, liver, nuts, soy, cereals, potatoes, cabbage.

In the diet of men must be present meat products, seafood, legumes and nuts. Diversify the intake of fruits from vegetables, which are rich in vitamins and antioxidants. These can be bananas, avocados, spinach, broccoli and pumpkin.

Products containing vitamin C will help improve sperm quality. These include bell peppers, currants and citrus fruits. For the male body, trace elements such as selenium and zinc are also important. Zinc can be replenished with egg yolk, oysters and legumes. But selenium is found in marine fish, yellow rice and broccoli.

But it is worthwhile to understand that even the most proper nutrition will not help to solve the problem if a man has diseases in the genital area that are inflammatory in nature.

Knowing what oligospermia is in men and what causes it, it is possible to identify preventive measures for those diseases that cause a change in sperm quality. It is impossible to completely eliminate the risk of pathology, but with the help of the rules of a healthy lifestyle, there is a high probability of maintaining male fertility for a long time.

Prevention of oligospermia:

_ Physical activity with the necessary level of intensity allows not only to increase the production of testosterone, but also favorably affect the work of the circulatory, nervous and endocrine systems, which also positively affects fertility;
_ Proper nutrition is necessary to maintain the general tone of the body and the prevention of endocrine disorders;
_ Control over the course of chronic diseases, especially those localized in the genitourinary system, allows you to avoid the development of diseases that are a provocateur of oligospermia;
_ Safe and regular sex life plays a role in maintaining and maintaining male fertility.

What can be done to prevent this disease from arising? Doctors recommend that men avoid overheating of the testicles, because nature itself has placed the genetic fund outside the internal organs. Overheating contributes to pathologies in the process of formation of seminal fluid. Therefore, too hot baths, wearing tight or too tight genitalia underwear are not recommended for the stronger sex. It is advisable to avoid nervous stress, since stress inhibits spermatogenesis.

Men who are overweight, it is advisable to lose weight with the help of sports activities and proper diet. The regularity of sexual activity is also important (three to four times in seven days). In most cases, the diagnosis of oligospermia is not a sentence and is successfully amenable to medical or surgical treatment. In especially severe chronic cases, a married couple can become parents through artificial insemination. I wish you good health!