By Zaira Salvador BSc, MSc (embryologist).
Last Update: 12/05/2018

Most cases of oligozoospermia are detected when the man decides to have a baby and he realizes that he is unable to achieve a natural pregnancy after several months trying to conceive. When this occurs, both members of the couple have to check their fertility.

The sperm count or sperm concentration of a man’s semen is directly associated with the chances for him to achieve a pregnancy. Nonetheless, other sperm parameters such as motility and morphology affect the probability as well.

Depending on the type of oligospermia diagnoses (mild, moderate, or severe), the couple may have no alternative but to undergo fertility treatment in case no effective treatment for oligospermia is found, or the cause is unknown.

Natural pregnancy

A man with oligozoospermia always has a certain percentage of sperm in the ejaculate, no matter how low it is. Thus, the chances of achieving pregnancy naturally exist in spite of being minimum.

In this sense, males with mild oligozoospermia are more likely to get their wife or partner pregnant. As the number of sperm in the semen decreases, so do the chances of achieving pregnancy, being severe oligozoospermia the worst-case scenario.

A man with a reduced sperm concentration can achieve pregnancy naturally without having to turn to assisted reproductive technologies.

On the other hand, it is crucial that the handful of sperm available have a normal motility. This increases their ability to reach the Fallopian tubes and fertilize the egg cell inside the female reproductive tract.

Moreover, one should note that this will be possible only if the woman is fertile. For a pregnancy to be possible, both the female and male reproductive potentials are of material importance.

Assisted reproductive technology (ART)

If pregnancy did not occur after a year trying to conceive after receiving a diagnosis of oligospermia, one would have to undergo fertility treatment to have a baby.

When the cause of childlessness is due to male factor infertility, there exist various fertility treatment options, although the final decision depends on the characteristics of each patient. The following are the most important ones:

Intrauterine insemination (IUI)

Intrauterine Insemination (IUI), the most widely used type of Artificial Insemination (AI), is a simple technique that consists in inserting a sample of capacitated sperm into the womb of the intended mother. By doing this, we make it easier for the sperm to reach the egg, since we are removing some barriers that they would encounter should fertilization occur naturally.

For IUI to be successful, it is necessary that both the man and the woman meet the following minimum requirements:

  • The woman’s age is below 35 years and she has tubal patency
  • The man total sperm count contains between 2 to 3 sperm with progressive motility after performing a Motile Sperm Concentration (MSC) test

A MSC test is used to check the number of sperm retrieved after sperm capacitation.

Unfortunately, the chances for oligozoospermic males to reach the minimum amount of sperm required for a MSC test are very low. Only those with mild oligozoospermia might be good candidates for IUI.

In vitro fertilization (IVF)

Conventional In Vitro Fertilization (IVF) involves putting sperm in close contact with one egg. For this reason, the number of sperm present in the sample is less important.

As it happened in the case of IUI, a minimum level of sperm motility is required in order for them to be able to reach the egg. The MSC test should range between 1 and 3 million. In other words, conventional IVF is indicated in cases of mild-to-moderate oligospermia, or after IUI failure.

To perform an IVF with only few spermatozoa, it is necessary to retrieve the eggs of the woman after ovarian stimulation. Then, fertilization per se is done. Then, the resulting embryo is cultured in the lab.

Finally, the embryos that make it to the end and are considered high-quality embryos will be chosen for the embryo transfer and cryopreserved for future use.

ICSI

ICSI is the abbreviation for Intracytoplasmic Sperm Injection. It is an IVF technique that involves a greater degree of complexity than conventional IVF.

With ICSI technique, the ideal sperm is selected and manually injected into the egg cell with the help of a microinjector.

It is not needed that the sperm count is so high as in IUI or IVF, since the only requirement is that the number of live sperm equals the number of eggs to fertilize.

ICSI is used in the most severe cases of male infertility, like very severe oligospermia. It is also the first option when oligozoospermia is accompanied by mild, moderate, or severe asthenozoospermia.

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

With severe oligospermia, can you achieve a pregnancy through IVF?

By Zaira Salvador BSc, MSc (embryologist).

In cases of severe oligozoospermia, the most adequate treatment option is IVF with Intracytoplasmic Sperm Injection (ICSI), since it helps make sure the sperm enters the egg cell and therefore fertilization occurs. Thanks to ICSI, it is possible to select just a few sperms under the microscope, which makes sperm count less relevant.

Can you still get pregnant with low sperm count?

By Zaira Salvador BSc, MSc (embryologist).

Indeed. A natural pregnancy is still possible as long as it is a case of mild oligospermia, as the semen sample still contains some sperm. Obviously, it will be more difficult and might take more time, but pregnancy is possible provided that sperm motility is not altered.

Artificial insemination can be highly successful in cases of mild oligospermia and allow a couple to achieve pregnancy in a short period of time.

My husband has poor sperm count and motility. What is the best treatment for me to get pregnant?

By Zaira Salvador BSc, MSc (embryologist).

If a man has asthenozoospermia plus oligospermia, the treatment of choice is ICSI. Even if it is a mild case of oligospermia, the fact that he has low sperm quality makes them unable to reach the egg with other techniques such as IUI or conventional IVF.

Suggested for you

OLigozoospermia can be due to different causas, some of them undetectable. To learn more about this, visit: What Are the Potential Causes of Oligospermia?

The semen analysis (SA) is the diagnostic test used to evaluate the sperm parameters in males. Click here to continue reading about it: What Is a Semen Analysis Report? – Purpose, Preparation & Cost.

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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.

Hughes EG, Collins JP, Garner PR. Homologous artificial insemination for oligoasthenospermia: a randomized controlled study comparing intracervical and intrauterine techniques. Fertil Steril. 1987;48(2):278-81.

Liu XY, Wang RX, Fu Y, Luo LL, Guo W, Liu RZ. Outcomes of intracytoplasmic sperm injection in oligozoospermic men with Y chromosome AZFb or AZFc microdeletions. Andrologia. 2017;49(1).

Mehta A, Bolyakov A, Schlegel PN, Paduch DA. Higher pregnancy rates using testicular sperm in men with severe oligospermia. Fertil Steril. 2015;104(6):1382-7.

Plouvier P, Barbotin AL, Boitrelle F, Dewailly D, Mitchell V, Rigot JM, Lefebvre-Khalil V, Robin G. Extreme spermatogenesis failure: andrological phenotype and intracytoplasmic sperm injection outcomes. Andrology. 2017;5(2):219-225.

Schoysman R, Daniore V. Artificial insemination for oligospermia. A critical review. Acta Eur Fertil. 1991;22(2):75-86.

Xie BG, Huang YH, Zhu WJ, Jin S. Comparison of the outcome of conventional in vitro fertilization and intracytoplasmic sperm injection in moderate male infertility from ejaculate. Urol Int. 2015;94(1):111-6.

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Authors and contributors

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