Issues pertaining to sperm quality can be sole cause of infertility in 20-30% of infertility cases and contribute to 40- 50% of cases of infertility overall.
Further evaluation when sperm count is low :
1 more repeat semen analysis as per WHO 2021 guidelines
Post-ejaculation urine analysis ( in few cases )
Male hormones evaluation : Testosterone, FSH,LH, TSH, Prolactin
Sperm vitality ( to check if the sperms are alive when the sperm motility is low)
Karyotype , Y chromosome microdeletion
Parallel evaluation of wife for fertility status
Risk factors for low or nil sperm count include following :
Cryptorchidism : testes not located in the scrotal sac
Exposure to environmental toxins
Cancer survivors – who had prior chemotherapy or radiotherapy
Use of anabolic steroids
Varicocele (dilated veins surrounding testes)
Obesity ,life style & environmental factors
Many time no risk factor is found
Treatment options for men with very low sperm count or nil sperm :
Correction of life style factors , smoking cessation , weight reduction if obese.
Oral hormonal medications might be needed for some men to boost sperm production.
Oral antioxidant therapy can be used.
Men with hypogonadotrophic hypogonadism can be treated with combined hormone therapy with hCG & FSH.
Treatment of Male Accessory Gland Infection (MAGI)
Intrauterine insemination (IUI) can be done if sperm count increases above 5 million/ml.
Intracytoplasmic sperm injection (ICSI) with sperms in semen ejaculate if count does not improve above 5 million/ml.
ICSI with surgically retrieved sperms if azoospermia (no sperms) in the ejaculate.
Hope this was helpful for basic understanding. The aim of this discussion is to make anyone with curious
mind to understand these condition better. It is not equivalent to detailed in person individualised
consultation. Please contact us if you want to understand your treatment options.