What Is Oligospermia?

Male Infertility

Dr. Suman

Jul 25, 2021

 Oligospermia refers to the fertility condition in males, and it characterizes low sperm count. Sperm count at the time of ejaculation varies in men during their entire life. A healthy amount of sperm is essential for fertilization. Indeed, Oligospermia makes conceiving of one’s female partner challenging. 

What is oligospermia

As per the WHO, a sperm count equal to or more than 15 million sperm in one-milliliter semen is the minimum sperm count required for pregnancy. Hence, Oligospermia meaning the sperm count goes below the mentioned amount. 

Types of Oligospermia

According to the experts involved in Oligospermia investigations, Oligospermia may be of three types, which include the following-

 Mild Oligospermia

 The first one is mild Oligospermia, in which sperm count ranges from 10 million sperm in one milliliter to 15 million sperm in one milliliter. 

 Moderate Oligospermia 

 Moderate Oligospermia is the second type of Oligospermia. Now, the question is, what is moderate Oligospermia? This condition occurs when the sperm count ranges between 5 million to 10 million sperm in one milliliter. 

 Severe Oligospermia 

 A severe type of Oligospermia occurs when a man’s sperm count goes down from 5 million to 10 million sperm in one milliliter. In some cases, the semen of men have no or zero sperm count. 

 How Oligospermia and Azoospermia are Different

 Oligospermia refers to a health condition when the minimum amount of sperm required in the ejaculation of a man to conceive is less than the minimum level necessary for conception. In contrast, Azoospermia is when the semen sample does not contain any sperm and the sample collected is a centrifugal one. In this way, you will find a clear difference between Oligospermia and Azoospermiahealth conditions in men.

 Common Oligospermia Symptoms in Men

 In most situations, men do not have any obvious signs symptoms associated with Oligospermia. Instead, they undergo a diagnosis with the condition when they face difficulty in conceiving a child. In contrast, if men have Oligospermia because of any underlying health issue, a few Oligospermia symptoms occur. These include the following-

  • Pain, swelling, or formation of lumps in testis
  • Erectile dysfunction, the inability of erection at the time of sexual intercourse, and related sexual functioning problems
  • Low body and facial hair growth and several signs related to hormone imbalance and chromosome abnormality
  • Thick semen discharge 
  • Swelling of scrotum veins 

Other than this, if any person has Oligospermia because of virus transmission, he experiences a burning sensation at the time of urination. 

Causes of Oligospermia

The condition of Oligospermia takes place because of the following factors-

1. Medical Factors

There are many health and medical conditions, which may cause Oligospermia. These are as follows-

  • Viral Infection: Viral infection may affect sperm quality, sperm quantity, and production. Moreover, viruses, which cause sexually transmitted diseases, may reduce your sperm count in the semen.
  •  Varicocele: Varicocele refers to a health condition where veins responsible for holding scrotum or testicles enlarge. According to doctors treating male infertility issues, Varicocele is a common cause of low sperm count in men.
  • Ejaculation Problems: Many men have retrograde ejaculation because of ejaculation problems caused by spinal injuries, bladder surgery, diabetes, and many more. The problem occurs when the ejaculated semen enters the urinary bladder instead of exiting from the penis tip.
  • Hormonal Imbalance: Both the testicles and the brain produce a large number of hormones to ejaculate and produce sperm. Any imbalance in the respective hormones may result in a low sperm count.
  • Medications: Medications like antibiotics, beta-blockers, blood pressure medications may cause low sperm count and ejaculation defects.

2. Environmental Factors

Sperm production in men may affect severely because of the consistent exposure to harmful chemicals and toxic materials present in the environment.  

  • Exposure to Chemicals and Metals: Cleaning agents, pesticides, and other paint-based chemicals may reduce the minimum required sperm count for pregnancy. Besides chemicals, continuous exposure to lead or any other heavy metal may lead to Oligospermia.
  • Radiation: X-ray and other radiation exposures may reduce the production of sperm. Consistent or high exposure may even cause Azoospermia.   
  • Overheating Testicles: Consistent sitting and placing laptops on the genitals, wearing tight clothes, and hot water tubs may contribute to testicles overheating. Moreover, an increase in the testicles’ temperature may affect both the production and quality of sperm.

3. Lifestyle Factors

The lifestyle of a man has a significant role in overcoming his health. Obesity, smoking, alcohol consumption are a few of the widespread causes of Oligospermia. 

  • Use of Drugs: Anabolic steroid medications stimulate your muscle growth and strength. However, consistent intake of those medicines may shrink your testicles, which affects the production of sperm. 
  • Smoking: Smoking is harmful to your heart, lungs and also detrimental to your sperm. Men involved in smoking activities have a relatively low sperm count compared to others who do not smoke. 
  • Alcohol Consumption: Excessive alcohol consumption may reduce both sperm quality and sperm count. 
  • Stress: Stress causes hormonal imbalance, which reduces the production of sperm. 
  • Obesity: If you are fat or overweight, your risk related to suffering from oligospermia increases in many ways. Low muscle mass and excess body fat lead to low testosterone levels and cause poor sperm quality. 

How to Treat Oligospermia to Obtain Pregnancy Easily

You can cure your condition of Oligospermia by undergoing assisted reproductive technology. ART is recommendable when a patient fails to naturally overcome his condition of low sperm count or by using medicines. A few standard Assisted Reproductive Technology treatment options are clinical extraction, natural ejaculation, and collection of sperm from a donor. Doctors recommend the best treatment according to the condition of an individual. 

How to Cure Oligospermia via Assisted Reproductive Technology Types  

Intrauterine Insemination:-

IUI, I.e., Intrauterine Insemination, is recommendable if a man has mild Oligospermia. The reason is that the treatment requires a few sperm to perform fertilization. If your female partner does not have any fertility problems, IUI gives you a good outcome. 

Moreover, the treatment is cost-effective and straightforward. However, it is not recommendable if you have severe Oligospermia. IUI treatment is also recommendable if you have low sperm motility. However, your semen sample must have a minimum of 2 million to 3 million motile sperm after processing. 

To perform IUI, doctors require a semen sample, which they wash to remove weak and inactive sperms. Later, they insert the sperm cells directly into the uterus by using a catheter from the cervix. The process is preferable to put the maximum number of sperms close to the formed eggs. This will reduce the distance of the sperm to reach the egg, and they have to make a short distance to reach the fallopian tube from the uterus. 

In Vitro Fertilization:-

In the case of In Vitro Fertilization or IVF type of assisted reproductive technology, doctors collect eggs and sperms in a Petri dish to fertilize. Once the eggs fertilize, doctors implant them as embryos in the uterus of a woman. IVF is recommendable in some cases related to mild or moderate Oligospermia.  IVF is a preferable option when you and your partner have multiple fertility factors. These include blocked tubes, low sperm count, difficulty in ovulation, and many more. IVF treatment intends to increase the chance of your egg fertilization in the case of low sperm count. Poor mortality of sperm is still helpful for fertilizing eggs with the help of IVF. By placing the egg and the sperm in a Petri dish nearby, any poor motile sperm does not have to travel a lot to reach the egg, and the IVF lab controls the activity of fertilization. 

Intracytoplasmic Sperm Injections:-

Abbreviated as ICSI, Intracytoplasmic Injections are useful when doctors inject the sperm into the matured egg’s cytoplasm. For this, ICSI specialists use a tiny and unique needle named micropipette. This type of ART procedure eliminates the need to penetrate the sperm to the egg’s outer layer. After fertilization occurs, the embryo, I.e., the fertilized egg, grows in the IVF lab for approximately five days. If doctors have to conduct genetic tests, they transfer the embryo to the woman’s uterus during that time or at a later date. ICSI is recommendable by doctors when-

  • A person has an excessive low sperm count.
  • A person suffers from poor morphology and has abnormally shape sperm, or he has poor sperm motility.
  • If an individual has abnormally shaped sperm or the one that cannot move normally
  • If a patient has undergone IVF treatment in the past and has only a limited number of eggs fertilized 
  • If your doctor requires collecting your sperm from the epididymis or testicles, as you had a vasectomy procedure or have a blockage in the path of sperm ejaculation. 
  • If you use relatively low-quality frozen sperm in your treatment because of the threat associated with your fertility or after retrieving your sperm surgically. 
  • If you have undergone embryo testing because of your genetic condition and the sperm sticks outside of eggs to interfere with your results

Combination of ICSI and IVF:-

When your condition of Oligospermia is challenging to treat with only ICSI or IVF, doctors recommend a combination of IVF and ICSI. ICSI injects the collected sperm directly into the eggs, which typically comes with a high fertilization rate, i.e., approximately 80 percent. Besides Oligospermia, the combination treatment is recommendable to treat a severe type of Oligospermia, Azoospermia, and cryptozoospermia. However, in the case of cryptozoospermic patients and those suffering from severe Oligospermia, doctors recommend freezing the sperm before selecting the oocyte. 

Surgical Sperm Retrieval/Extraction:-

Doctors choose surgical sperm retrieval or extraction method in men whose semen does not have any sperm or a low number of sperm. Moreover, the surgery is recommendable when there is an inferior quality of sperm or almost zero sperm. A few of the standard surgical sperm extraction methods are-

  • MESA, i.e., Microsurgical Epididymal Sperm Aspiration: MESA technique is recommendable at the time of reconstruction surgery to resolve a blockage. Here, surgeons make an incision in the scrotum skin and expose the testicle. After this, your surgeon uses an operating microscope to view the tube from where sperm travels after leaving your testicles, i.e., epididymis, under magnification. They even examine the fluid emitted from the epididymis to detect the sperm’s movement. If doctors view any motile sperm, they collect the fluid immediately or freeze it for further applications.   
  • TESE, i.e., Testicular Sperm Extraction: When there is zero sperm in your epididymis, or you have difficulty producing sperm, doctors take the sperm directly from your testicle. In this case, doctors insert a needle or a sample of tissue, i.e., a biopsy from your skin. However, such techniques are inapplicable if you suffer from Azoospermia other than obstruction. Surgeons or doctors recommend an open approach for every man going through the problem of sperm production.  
  • PESA, i.e., Percutaneous Epididymal Sperm Aspiration: In some cases, doctors or surgeons use the PESA technique instead of MESA, as doctors can do this procedure under local anesthesia. However, the method is relatively less dependable and collects only a few samples. 


What causes Oligospermia?

There are multiple causes of Oligospermia in men. However, an increase in the temperature of the testicles is the common cause. Enlarged veins across the scrotum area lead to disruption in blood flow in men, which further results in heating of the testicles. 

Can Oligospermia be corrected?

If you have Oligospermia because of vasectomy or varicocele, your condition may be corrected via surgery, and thereby, your sperm count will increase. In contrast, if medications and surgery do not help you, you must undergo ART procedures, like IVF, IUI, and ICSI. 

What is meant by severe Oligospermia?

Oligospermia takes place when the sperm count goes below 20 million sperm in one milliliter of semen. Accordingly, a severe Oligospermia type occurs when the sperm count goes below 5 million sperm in one milliliter. 

What is watery sperm?

Watery semen indicates the problem of Oligospermia or low sperm count and other fertility issues. However, the positive aspect is that thin and clear semen is a temporary problem, which does not have any severe health concerns. 


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