Health - How to Treat and Manage Low Sperm Count

The words, ‘low sperm count’ and ‘no sperm’, are very frightening terms for many men and couples alike, especially when there is a history of infertility. But what do they mean?

Oligozoospermia or ‘low sperm count’ refers to semen with low concentration of sperm cells. It is commonly associated with male infertility.

Based on  a recent World Health Organisation criteria, an ejaculate with a  concentration of less than 15 million sperm/ml of semen is termed oilgozoospermia.

There are also different classes of oligozoospermia (mild to severe). Mild refers to a concentration of 10 million to 15million sperm/ml while moderate is between five million and 10 million sperm/ml and severe is 15  million sperm/ml.


Azoospermia (no sperm) refers to complete absence of sperm in an ejaculate. It is a well-known cause of male-factor infertility.


Cryptozoospermia applies to a situation in which sperm cannot be seen in a fresh semen sample but later found after an extensive centrifugation and microscopic search.

In our society, the burden is placed more on the female partner when it comes to conception. When a couple can’t conceive after a year, the society automatically blames the woman. This assumption is often false. As a matter of fact, male infertility accounts for about 40 per cent of infertile couples. About seven per cent of men are said to be infertile. But a lot of men with fertility problems are reluctant to come for further testing and treatment.

The good news is that a diagnosis of oligozoospermia or azoospermia is not the ‘end of the road’. These conditions can be treated and a lot of men have benefitted from various treatment options. Furthermore, it has been observed that the success rate for the treatment of infertility is higher when both spouses face the issue and attend the clinic together like in the developed countries.

But before listing the treatment options it would be important to discuss preventive measures which would include lifestyle adjustments such as  not smoking, avoidance of recreational drugs and environmental toxins, cutting down alcohol and caffeine  intake.

It is important men avoid exposing their testicles to high temperatures such as hot tubs, long-distance driving and tight underpants and seeking prompt and regular medical care as a number of medical conditions are associated with infertility such as mumps, tuberculosis, sexually transmitted diseases, like gonorrhoea and syphilis.

Management

A detailed history and physical examination is done by a clinician  to check for possible causes like varicocoele, testicular atrophy, undescended testis and other abnormalities.  A seminal fluid analysis is done to properly assess the sperm parameters. Usually, patients are advised to abstain from intercourse for between two and seven days before doing this test for optimal results.  Further testing, including hormone profile and scrotal ultrasound may be done, especially to check for other underlying causes.

In our centre we also recommend bioenergetic testing to determine food allergies, environmental toxins or the presences of pathogens.

Medical treatment

Depending on the underlying cause, patients can benefit from various drugs. The following are commonly used:

Gonadotrophins:  Gonadotrophins, especially human chorionic gonadotrophin,  have been used successfully in treating some patients with azoospermia, especially those with underlying hormonal imbalance.

Anti-estrogens: Drugs like clomiphene citrate and tamoxifen have also been used in patients with oligospermia/azoospermia. These drugs have been used in patients with idiopathic oligozoospermia, as well as patients with low levels of the male hormone – testosterone.

Dietary supplements and anti-oxidants: The use of antioxidant therapy in treatment of patients with male infertility has been associated with statistically significant improvements in sperm parameters. This is because many of these anti-oxidants are required at different stages