Infertility is often attributed with women and considered women’s issues. In fact, men can also be infertile. The inability of a man to impregnate his partner is known as male infertility. It can be caused due to various reasons. Mostly, male infertility is caused due to issues with sperm cells which in most cases are a result of oligospermia or azoospermia. About 12% to 15% of couples suffer with infertility world wide.
The major sign of male infertility is his inability to achieve pregnancy. It also has some other symptoms such as,
Genetic / Hormonal disorders
Low sperm count
Condition blocking the passage of sperm to flow
Chromosomal abnormalities
Low sex drive
Ejaculation issues
Decreased facial / body hair
Dilated veins around testicles
Sperm motility issues
Gynecomastia
Azoospermia and Oligospermia are two terms, having Greek origin, which are often used in the world of male infertility. Basically, oligospermia means there is not adequate amount of sperm cells present in the semen whereas, azoospermia means that there is no sperm cells present in the semen at all.
Azoospermia is a medical term used to indicate the absence of sperm cells in the ejaculate. It is a severe condition which often a time leads to infertility in men. It is classified into obstructive and non-obstructive azoospermia.
Obstructive Azoospermia is when the sperm cells are blocked from combining with the ejaculate.
Non-Obstructive Azoospermia happens when there is a lack or complete absence in production of sperm by the testicles.
Obstructive Azoospermia is treatable but non-obstructive azoospermia is comparatively severe and can only be treated if there is little production of sperm by the testicles
Azoospermia is a rare condition affecting only 1% of global men population however, about 15% cases of male infertility are due to azoospermia.
In contrast to azoospermia, oligospermia is a condition which refers to low sperm count in semen. According to WHO, if sperm count is less than 500 million sperm per millilitres then the condition is called oligospermia. It can be mild, moderate or severe.
Mild Oligospermia: it is diagnosed when the sperm count is between 10-15 million sperm per millilitre.
Moderate Oligospermia: it is diagnosed when the sperm count is between 5-10 million sperm per millilitre.
Severe Oligospermia: it is diagnosed when the sperm count is 0-5 million sperm per millilitre.
Men diagnosed with oligospermia can conceive but the degree of oligospermia can effect the probabilities of having children.
Chromosomal abnormalities such as, kleinfelter’s syndrome, kallmann’s syndrome and kartagener syndrome.
Hormonal imbalances due to any alteration in the pituitary gland and hypothalamus. As, these two hormones are required for sperm production.
Medications such as ulcer medication, antibiotics or antifungal medicines, testosterone replacement therapy or chemotherapy drugs.
Retrograde ejaculation can also be a cause of such condition when semen instead of flowing out of the penis reverses back to the bladder.
Anti-Sperm antibodies can kill the sperm cells by mistakenly identifying them as harmful invaders which subsequently affects the sperm count.
Environmental toxins including, exposure to chemicals, heavy metals or radiations.
Sertoli-cell-only syndrome due to which no sperm is produced by the testicles.
Undescended testicles if during the fetal development the testicles didn’t descend from the abdomen to the scrotum then fertility of that person is affected and such people are unlikely to be fertile.
Anorchia is the absence of testicles which can also lead to azoospermia.
Obstruction can be a reason of low or no sperm count. It can be caused due to blockage in the duct because of abnormal developments such as cystic fibrosis or surgeries in the past.
Trauma or Injury as a consequence of vasectomy, scrotal surgery, hernia repair surgery, etc.
A person might never know that he is suffering with oligospermia or azoospermia unless he tries to conceive and fails. Upon consulting a specialist and after diagnosis, he gets to know the cause of infertility which most the times in male factor infertility is, oligospermia and azoospermia.
Azoospermia and Oligospermia can be diagnosed through semen analysis after a detailed physical examination and questionnaire about medical history. To determine whether or not a person is suffering with oligospermia some other tests are also recommended which includes, urinalysis, trans-rectal and scrotum ultrasounds, endocrine system and genetic disorders tests.
Azoospermia can be treated depending upon its type e.g., obstructive or non-obstructive azoospermia.
Obstructive azoospermia can be treated by removing the blockage preventing the sperm from flowing. It can be done either by reconnecting or reconstructing the ducts which are preventing the sperm flow. This is mostly done through surgery.
Non-Obstructive Azoospermia is rather severe and it may not respond to medical treatment. In such cases, pregnancy can be achieved through assisted reproductive technology.
If azoospermia is caused due to low hormone production then it can be treated through hormonal treatment and medication.
Oligospermia can be treated through various medical procedures depending upon its underlying cause. If the condition is due to varicocele or vasectomy, then it can be reversed/corrected through surgery. It can also be treated through hormonal treatment and medications as well as adapting a healthy lifestyle to increase the sperm count. If all the treatments fail to aid in increasing sperm count, assisted reproductive technology can be used to achieve biological fatherhood.
People diagnosed with non-obstructive azoospermia and severe oligospermia can benefit from IVF. In vitro fertilization (IVF) is the most successful and common type of assisted reproductive technology which has helped a number of couples in conception.
