When discussing male infertility, the focus is often on the most common causes. However, it is important to consider that certain abnormalities may be linked to other underlying conditions or diseases, which can potentially give rise to additional complications. Early detection of these issues offers the opportunity for correction or exploration of more effective alternative solutions.

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 attributed to various factors, including hormonal disorders, testicular issues, or infections. Moreover, it is often associated with other conditions, some of which are described below:

Cryptorchidism: a condition associated with oligospermy

Cryptorchidism refers to the condition wherein one or both testicles fail to descend into the scrotum before birth. This can give rise to fertility difficulties because the undescended testicles are exposed to elevated temperatures, which can impact the production of sperm.

Cryptorchidism is most common in a single testicle (80%) and the left testicle is the most affected. Bilateral cryptorchidism is less common. To prevent fertility difficulties, boys with cryptorchidism need to have surgery to descend the testicles before the age of 2 years.

Varicocele

Testicular varicocele is a condition that causes dilation of the veins supplying the testicles. This can cause an elevation of testicular temperature, which can impact sperm production. It is most common in one testicle, but can also influence both. If it influences both testicles, it is more likely to cause infertility.

It can also cause oligoasthenoteratozoospermia, which is a condition in which the spermatozoa are of low quality, both in number and in 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 classified 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.
• Secondary hypogonadism: There is an issue in the hypothalamus or pituitary glands, which are the glands that produce the hormones that stimulate sperm production in the testes.

Treatment of this condition depends on the type of hypogonadism. In some cases, hormonal treatment can help restore testicular function and increase sperm production, leading to improved fertility projection.

Hydrocele

Testicular hydrocele is a condition where fluid builds up around one or both testicles. It can occur either from birth (congenital) or develop later in life (acquired), and it is more prevalent in men who are 40 years of age or older.

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.

For men with severe oligoteratozoospermia who desire to conceive, in vitro fertilization (IVF) treatment with intracytoplasmic sperm injection (ICSI) is typically recommended. This procedure involves the selection of sperm with good morphology under a microscope, which are then directly injected into the egg. This technique enhances the likelihood of developing a healthy embryo.

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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 wish to start a family and experience difficulties in conceiving or know someone who may be suffering from infertility or any complication associated with the symptoms described above, it is vital to contact clinics specialized in Oligospermy, male fertility and assisted gestation, such as Babynova Clinic by Novafem, to receive advice on these issues and be treated as soon as possible.