Necrospermia or necrozoospermia is a sperm disorder characterized by the presence of dead sperm in the semen.
The reasons behind this male infertility cause are varied and the treatments sparse. For this reason, it is common for men diagnosed with necrospermia to become parents via Assisted Reproductive Technology (ART), most commonly through In Vitro Fertilization (IVF).
Provided bellow is an index with the 9 points we are going to expand on in this article.
- 1.
- 2.
- 3.
- 4.
- 5.
- 5.1.
- 5.2.
- 6.
- 6.1.
- 6.2.
- 6.3.
- 6.4.
- 6.5.
- 6.6.
- 7.
- 8.
- 9.
Definition and diagnosis
Necrospermia or necrozoospermia are the medical terms used when the presence of dead sperm in a man's ejaculate is above 42%. This sperm disorder is a major cause of male infertility.
The test that evaluates male fertility is the seminogram or spermiogram. It consists of analyzing the ejaculated sample under the microscope, observing the spermatozoa, and checking their concentration, mobility, and morphology.
Cuando un hombre sufre necrospermia, en el seminograma se ve que más del 50% de los espermatozoides no se mueven, puede que estén muertos o simplemente no sean capaces de moverse. In the first case we would speak of necrospermia, while if the problem is one of motility it would be asthenozoospermia.
How to know if the spermatozoa are alive
The test consists of a hypoosmotic test based on the integrity of the membrane. When a spermatozoon is dead, its membrane presents holes or broken areas, while if the spermatozoon is alive its membrane is intact and controls the entry and exit of substances.
To check this, spermatozoa are placed in a hypoosmotic medium. Living sperm will react in this solution, absorb water and the tail will swell causing it to coil into a helix. In contrast, dead spermatozoa will not show any reaction.
A hypoosmotic medium is one with a high proportion of water and a low concentration of dissolved substances. When a living spermatozoon, with a higher content of dissolved substances, is placed in the medium, it will tend to absorb water from the outside to balance the pressures.
In addition to the hypoosmotic test, there are other tests that check sperm vitality: the eosin-nigrosin staining test or the acridine orange test. In these cases, the spermatozoa that are stained are the dead ones, since the membrane is broken and the dye enters indiscriminately.
Causes
Necrospermia can occur occasionally due to factors such as stress or taking a specific medication. However, there may be other causes that cause permanent necrospermia:
- Habitual alcohol and drug use
- Poor nutrition
- Radiotherapy and chemotherapy
- Genitourinary infections
- Hormonal disorders
- Long periods of sexual abstinence
In these cases it is more difficult to reverse necrospermia and increase sperm vitality, so it may be necessary to resort to assisted reproductive techniques to have children.
Treatment
Unfortunately, there is no cure or specific treatment for necrospermia.
If the results of the seminogram support the diagnosis of necrospermia, the test has to be repeated within three months in order to confirm such diagnosis. The presence of unviable sperm might be consequence of an isolated event, caused by temporary stressful periods, fever or even drug-induced.
If the second seminogram confirms the diagnosis, some recommendations may be given to reduce the sperm mortality rate, including leading a healthy lifestyle, with a balanced diet.
Taking dietary supplements such as vitamins and antioxidants may be helpful as well. Sperm are cells very sensitive to oxidative stress, so free radicals can severely damage or even kill them.
A diet rich in antioxidants may hinder cell death. Despite the fact that antioxidants delay cell oxidation, it should be noted that taking these supplements will not dramatically improve sperm vitality.
Finally, necrospermic men should avoid long periods of sexual abstinence, as having an elevated amount of sperms in the semen promotes their death.
Getting pregnant
In order to know a man's ability to procreate, it is important to know exactly the degree of male infertility he presents, in this case, what percentage of sperm with necrospermia is in his ejaculate.
Natural pregnancy is possible as long as there are live sperm in the ejaculate, but it is very difficult to achieve if the degree of necrospermia is greater than 42%. It also depends on other parameters such as sperm concentration and motility.
Fertility treatments
The best option for a man with necrospermia is to visit a fertility specialist and consider undergoing in vitro fertilization (IVF). In these cases, intrauterine insemination (IUI) is not recommended, since it does not assure the process to be as successful as IVF.
ICSI encompasses the selection a sperm cell with good motility and an excellent morphological structure. Once picked, it is inserted inside the egg cell. If the sperms were found to be motionless, the specialist may use pentoxifylline to find out if they are actually live or dead.
Pentoxifylline is a sperm motility activator used in ICSI procedures when the semen sample has asthenozoospermia.
Costs
The cost of an IVF cycle may vary greatly from clinic to clinic, and depending on the particularities of each case. Nonetheless, the overall cost usually ranges between $7,000 and $8,500
Typically, the cost of a single IVF cycle does not include out-of-pocket expenses such as medications, which can add up to $4,500 or over.
In case pregnancy couldn't be achieved using the husband's sperm, the specialist may recommend using donor sperm. In this case, and provided that the woman has no fertility issues, turning to artificial insemination by donor (AID) may be an option to have a baby. The cost is $300-$4,000 approximately.
If you need to undergo IVF to become a mother, we recommend that you generate your Fertility Report now. In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.
FAQs from users
Can I have a natural pregnancy with necrospermia?
Necrospermia is the presence of dead sperm in the semen, so there is very little chance of getting pregnant naturally. However, since semen production is cyclical (every two or three months), if the cause of necrospermia is reversible, we can obtain a normal semen after that time.
What causes necrospermia?
The term necrospermia refers to a sperm disorder where 85 percent of sperm present in the ejaculate are dead.
The factors leading to necrospermia are unclear yet, but the most common include:
- Alcohol or street drug consumption
- Unbalanced diet
- Radiotherapy or chemotherapy
- Genitourinary infections
- Hormonal disorders
In these cases, curing necrospermia is complicated, as well as increasing sperm vitality. In short, it is likely that the affected man has to turn to assisted procreating to have children.
To what extent can smoking affect necrospermia?
Tobacco consumption is very negative for the vitality of spermatozoa, since nicotine is a very toxic substance for them. There is a study that shows that the consumption of about 20 cigarettes a day causes necrospermia in men.
Does necrospermia increase with age?
This is not always the case, but age is a factor that can affect sperm vitality through cellular aging and increased oxidative stress.
Can dead sperm be treated?
Yes, a man can reduce the number of dead sperm in his semen by leading a healthy lifestyle, taking vitamin supplements, avoiding long periods of sexual abstinence, etc. Unfortunately, in the most severe cases, turning to Assisted Reproductive Techniques may be required to conceive a child.
Does cancer cause necrospermia?
In this case, necrospermia is not caused by cancer, but by treatments such as chemotherapy or radiotherapy. Therefore, it is important for patients who are going to undergo these treatments to visit a clinic beforehand to cryopreserve a semen sample so that they can have children in the future.
Suggested readings
Aside from necrospermia, there are other sperm disorders that can compromise a man's fertility. Want to find them out? Just follow this link: Guide to Sperm Disorders.
You can learn more about the different methods to detect the presence of dead sperms in the ejaculate with this post: Methods of Sperm Vitality Assessment.
We have made several references to the seminogram or semen analysis, a basic test that is performed to evaluate the quality of a man's semen sample in terms of sperm count, sperm morphology, sperm motility... Click here to learn more about it: What is a Semen Analysis Report?
We make a great effort to provide you with the highest quality information.
🙏 Please share this article if you liked it. 💜💜 You help us continue!
References
FAQs from users: 'Can I have a natural pregnancy with necrospermia?', 'What causes necrospermia?', 'What does dead sperm look like?', 'What's the normal range of dead sperm in a semen sample?', 'To what extent can smoking affect necrospermia?', 'Can dead sperm be revived?', 'Does necrospermia increase with age?', 'Can dead sperm be treated?', 'Can dead sperm still fertilize?', 'Does cancer cause necrospermia?', 'Does dead sperm smell like fish?', 'Is dead sperm dangerous?', 'Where do dead sperm go?' and 'Does dead sperm leave the woman's body?'.
Authors and contributors

More information about Cristina Algarra Goosman
Hello everyone,
We, my husband and I, have been trying to conceive for over 2 years with no luck so far, and we did a fertility test and the result of his seminogram showed a dead sperm (necrospermic) sample. I’d like to know what are our chances of getting pregnant despite this fertility problem…
Thanks a lot!
Dear Angelina,
If the rate of dead sperm in the ejaculate was 50% or less, I’m afraid chances of getting pregnant naturally are quite low. Conversely, if this figure was lower than 50%, there may be still a chance to achieve pregnancy, but it will be still rather difficult. Therefore, my advice is that you consider starting a fertility treatment like IVF or ICSI.
Best wishes
Hello,
We are planning for a baby and my wife’s fertility reports are fine but in my semen report we figured out some issues as below:
Sperm count: 312M/ml
Volume: 3.9 ml
pH: 7.5
Viscosity: hyper viscous
Round cells: 1M/ml
Sperm vitality: 45%
Sperm progressive: 43%
Sperm immobile: 55%
Sperm abnormal form: 63%
In the conclusion of the report they mentioned that the volume and count are normal but necrozoospermia moderate (30-60%) and abnormal form is Teratozoospermie polymorphe. Presence of round cells and sperm is hyperviscous.
Please, suggest what are the chances of conception or if a treatment is required. Many thanks.
Hello Kumar,
According to the WHO’s reference values, your values cannot be considered as teratospermia (you have more than 4% of normal sperm). However, necrospermia due to low vitality is present. Your chances of achieving a natural pregnancy are low for that reason, although it is not a severe case, and besides your sperm concentration is good, so you could give artificial insemination by husband (AIH) a chance.
I hope this helps,
All the best