By BSc, MSc (embryologist).
Last Update: 12/12/2018

Oligospermia or oligozoospermia is a cause of male infertility that is defined as having a low sperm count in the semen ejaculated.

According to the World Health Organization (WHO), a man is diagnosed with oligozoospermia when his sperm concentration is below 15 million sperm per milliliter.

There exist certain diseases that have been associated with this sperm disorder. In short, oligospermia typically appears in males along with other diseases that we will explain hereunder.

Varicocele

Testicular varicocele is an enlargement of the veins in the spermatic cord, causing abnormalities in the blood flow of the testes.

Normally, varicocele is unilateral, that is, it affect just one testicle. However, 10% of men affect have bilateral varicocele, which makes him even more infertile.

Varicocele compromises sperm formation (spermatogenesis), since it increases the temperature of the testicles. Also, it affects the hormone-regulating system that regulates spermatogenesis by decreasing testosterone levels.

As a result, the number of sperm produced is considerably low. Moreover, out of the few present, they may have alterations in motility and morphology, too. This causes a combination of several sperm disorders called oligoasthenoteratozoospermia (OAT).

Oligospermia due to varicocele can be reversed with an adequate treatment. Surgery (whether open or through laparoscopy) is the most recommendable option, especially in cases of varicocele and severe oligospermia.

To get more information on this cause of male infertility, read: What is a Varicocele? – Causes, Symptoms & Treatment.

Cryptorchidism

Cryptorchidism is a birth defect that affects newborns by causing one or both testes to fail to descend from the abdomen into the scrotum.

Being born with this condition can have fatal consequences on future fertility due to an increased temperature in the undescended testes, which affects spermatogenesis directly.

Cryptorchidism is unilateral in 80 percent of the cases, affecting most commonly the left testis. Bilateral cryptorchidism is less frequent.

To prevent infertility in the future, a treatment must be applied before the child turns 2 years old, should the testicles have failed to descent by themselves. The most indicated treatment option involves a surgical procedure to descend the testicles.

You may also enjoy some further information reading this: What Is Cryptorchidism?

Hydrocele

Testicular hydrocele is an accumulation of fluids around the testicle, particularly between the scrotum and the tunica vaginalis, which causes swelling of one (unilateral hydrocele) or both (bilateral hydrocele) testes.

Hydrocele can be a birth condition or acquired as a consequence of a trauma, infection, or cancer, with a greater incidence amongst males older than 40 years old than in females.

It is not a direct cause of infertility, although it might be associated with 10% of the cases approximately. In the case of oligospermia, it can appear as a side effect of hydrocele due to a partial blockage of the vasa deferentia, responsible of transporting sperm to the exterior. As a result, the sperm concentration in the ejaculate decreases due to failure to transport the sperm.

To get more info about this topic, continue reading here: What Is a Hydrocele? – Symptoms, Causes & Treatment.

Hypogonadism

Hypogonadism is an alteration that affects hormone secretion or other physiological activity of the gonads. In the case of males, their testicles are unable to produce enough amounts of sex hormones, including testosterone, thereby affecting sperm production and causing oligozoospermia.

Depending on what causes hypogonadism, we can classify it into two types:

Hypergonadotropic or primary hypogonadism
Testicular function is inadequate due to a failed maturation or absent testicular stem cells. The most common genetic disease in males with primary hypogonadism is the Klinefelter syndrome (KS).
Hypogonadotropic or secondary hypogonadism
It causes the pituitary gland to produce reduced levels of GnRH hormone. GnRH stands for gonadotropin-releasing hormone, and its function is to stimulate the pituitary gland to produce FSH and LH hormones, both of which play a part in the sperm formation process.

Based on the specific cause of hypogonadism, the hormonal treatment to follow may be different. In any case, a hormone-balancing therapy allows these males to recover the function of the testicles and subsequently increase their sperm count.

Considering undergoing a fertility treatment? By getting your individual Fertility Report your will see different clinics especially selected for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.

Oligoasthenoteratozoospermia (OAT)

Oftentimes, oligospermia comes along with other sperm disorders. In addition to sperm concentration, other parameters might be affected, including motility and morphology, leading to any of the following diagnosis:

Oligoasthenospermia

Asthenozoospermia is another sperm disorder that is diagnosed when the quality of sperm motility is too poor.

For a natural pregnancy to occur, it is required that sperm are able to move forward and rapidly at the same time after ejaculation. This is the only way they can complete their journey through the female reproductive tract, reach the Fallopian tubes, and finally meet the egg cell.

Men with both sperm disorder are diagnosed with oligoasthenozoospermia, and unfortunately their chances of conceiving naturally are lower. Thus, they may need to use In Vitro Fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI) to have children.

Oligoteratozoospermia

More than a single sperm parameter can affect the quality of sperm. For example, oligospermia can be associated with teratozoospermia, a disorder that refers to abnormal sperm morphology.

Sperm abnormalities make it difficult for sperm to fertilize the egg. Moreover, it is related to reduced chances of embryo development.

Thus, males with oligoteratozoospermia willing to have a child have to undergo IVF with ICSI. This way, sperm with normal morphology can be selected under the microscope and used for fertilization, thereby increasing the pregnancy success rates.

FAQs from users

What is the best treatment for severe oligospermia?

By Zaira Salvador BSc, MSc (embryologist).

For all types of oligospermia, that is, from mild to severe, the treatment to apply depends on the cause that originates a diminished sperm count. If the cause cannot be found and the patient has severe oligospermia, it is likely that he has to undergo IVF to have a baby.

Is necrospermia associated with oligoasthenoteratozoospermia?

By Zaira Salvador BSc, MSc (embryologist).

Necrospermia is the presence of an elevated percent of dead sperm in the ejaculate. Thus, the answer is yes, it might be associated with OAT (oligoasthenoteratozoospermia), especially with asthenozoospermia, since the reason why there are immotile sperm in the ejaculate might be that they are dead.

Suggested for you

When there exists male infertility, it is likely that you need a fertility treatment to become parents. To get more info about the different fertility treatments available, check this guide out: What Are Infertility Treatments? – Definition, Types & Costs.

Also, we have talked about oligoasthenoteratozoospermia as a cause of male infertility due to a sperm disorder. Want to learn more? Read: What Is Oligoasthenoteratospermia (OAT)?

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Francavilla F, Romano R, Santucci R, Poccia G. Effect of sperm morphology and motile sperm count on outcome of intrauterine insemination in oligozoospermia and/or asthenozoospermia. Fertil Steril. 1990;53(5):892-7.

Gat Y, Bachar GN, Zukerman Z, Belenky A, Gornish M: Varicocele: a bilateral disease. Fertil Steril 2004;81:424–429.

Gorelick JI, Goldstein M: Loss of fertility in men with varicocele. Fertil Steril 1993;59: 613–616.

Kirby EW, Wiener LE, Rajanahally S, Crowell K, Coward RM. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril. 2016;106(6):1338-1343.

Authors and contributors

 Zaira Salvador
Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV

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