LOW SPERM COUNT
A low sperm count is also called oligospermia. Your sperm count is considered lower than normal if you have fewer than 15 million sperm per milliliter of semen. The main sign of low sperm count is the inability to conceive a child. The production of sperm is a complex process and requires normal functioning of the testicles as well as the hypothalamus and pituitary glands — organs in your brain that produce hormones that trigger sperm production. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.
CAUSES OF LOW SPERM COUNT
Varicocele - Varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it might be related to abnormal testicular temperature regulation. Varicoceles result in reduced quality of the sperm.
Infection - Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymes (epididymitis) or testicles and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved.
Ejaculation problems - Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out of the tip of the penis. Various health conditions can cause retrograde ejaculation or lack of ejaculation, including diabetes, spinal injuries, and surgery of the bladder, prostate or urethra.
Certain medications also might result in ejaculatory problems, such as blood pressure medications known as alpha blockers. Some ejaculatory problems can be reversed, while others are permanent. In most cases of permanent ejaculation problems, sperm can still be retrieved directly from the testicles.
Antibodies that attack sperm - Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to destroy them.
Tumors - Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Surgery, radiation or chemotherapy to treat tumors also can affect male fertility.
Undescended testicles - During fetal development one or both testicles sometimes fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men with this condition.
Hormone imbalances - The hypothalamus, pituitary and testicles produce hormones that are necessary to create sperm. Alterations in these hormones, as well as from other systems such as the thyroid and adrenal gland, may impair sperm production.
Defects of tubules that transport sperm - Many different tubes carry sperm. They can be blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.
Blockage can occur at any level, including within the testicle, in the tubes that drain the testicle, in the epididymes, in the vas deferens, near the ejaculatory ducts or in the urethra.
Prior surgeries - Certain surgeries might prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others. In most cases, surgery can be performed to either reverse these blockages or to retrieve sperm directly from the epididymes and testicles.
Semen analysis may be particularly helpful in receiving a diagnosis, as your sperm can be counted under a microscope and checked for motility (movement) and morphology (shape). Your doctor may even want to repeat the analysis to ensure consistent results because of high variability between samples.
Treatment -: treatment may vary according to the disease.
Testicular based male infertility can be treated with IUI, IVF , or IVF with ICSI
Obstructive causes of post testicular can be treated with IVF – ICSI.
Vitamin e help to reduce oxidation stress. Hormone antioxidation combination may improve sperm count and motility.
Hormonal therapy -: LH and FSH is very effective in treatment of male infertility low dose estrogen and testosterone combination therapy may improve sperm count and motility in some men and who is olligozoospermia