Couple infertility: let's talk about oligospermia

By Cristiano Antonino Last updated Jun 6, 2023

Oligospermia represents about 30-50% of the causes of couple infertility, a problem that afflicts about 15% of couples

Obviously, the causes of infertility can be multiple and it is rather complex to provide a precise and exhaustive estimate but, considering that male infertility contributes to about 30% of cases, it is clear that oligospermia can be a widespread condition.

Many men do not realize they are suffering from oligospermia until they choose to procreate and this obviously makes it difficult to identify cases.

This is why it is very important to know what oligospermia is, what the causes are, what the symptoms are, how the therapy is carried out and, above all, whether it is possible to carry out correct prevention.

Oligospermia: what is it?

Oligospermia is the condition in which the ejaculated sperm has a low concentration of sperm and can, therefore, be a cause of male infertility.

More precisely, according to WHO indications, we can speak of oligospermia when less than 15 million sperm are present in the ejaculation per milliliter of sperm.

An individual with a concentration of 15 million or more is unaffected by the problem.

Clearly, being an assessment relating to concentration, the degree of oligospermia can be determined and 3 levels can be recognized:

Mild – when the sperm concentration is between 10 and 15 million/ml;
Medium – when the sperm concentration is between 5 and 10 million/ml;
Severe – when the concentration is between 0 and 5 million/ml.

Through the spermiogram you can make a punctual diagnosis of the presence of the condition of oligospermia and its level of severity.

Oligospermia: symptoms and diagnosis

Most people with oligospermia do not show any symptoms and, therefore, it can be difficult to diagnose this disorder.

In some cases there may be obvious physical symptoms.

For example, when you are suffering from varicocele, i.e. from the pathological dilatation of the testicular veins.

In this case, oligospermia can cause testicular pain, swelling or discomfort in the groin area.

The presence of a low concentration of sperm can cause male infertility, even if this is not always certain: there are cases in which men affected by oligospermia are still able to procreate without medical assistance.

Furthermore, when we talk about oligospermia, it is important to mention other conditions that may occur in conjunction with this condition, including asthenozoospermia and teratozoospermia.

The first concerns a reduced number of motile sperm cells in the semen, while the second concerns a significant percentage of malformed sperm cells.

It is advisable to consult a urologist or an andrologist in cases where you are trying to have children but are experiencing difficulties or if you have obvious physical symptoms.

The diagnosis of oligospermia occurs through an examination called a spermiogram

It is a laboratory investigation that allows you to analyze a sperm sample to establish:

The total number of sperm, along with their viability and motility.
Sperm morphology;
The concentration of sperm;
The ejaculate volume;
The ph;
The amount of fructose;
The number of white blood cells.

This test allows you to ascertain the presence of oligospermia but, once the diagnosis has been made, it may be necessary to undergo subsequent instrumental tests to determine the causes.

Some very important things to know for anyone undergoing a spermiogram are the following: abstention from sexual intercourse is required for at least 3 days and for no more than 5 days prior to the exam, ejaculation must take place by masturbation, in a clean place and in a sterile container having taken care to sanitize your hands correctly and, finally, it is essential to send the semen sample within 30-60 minutes to the analysis laboratory avoiding thermal shocks (<20 C° and >40 C°) .

Other investigations, associated with the spermiogram, can be sperm culture, blood tests and ultrasound of both the testicles and the abdomen.

Causes and treatment in case of oligospermia

Oligospermia can occur for various reasons: it can be idiopathic, without any triggering cause, or secondary, following some circumstances.

Only 30% of men with oligospermia can be identified as idiopathic, while the remaining 70% are secondary.

It is essential to identify what the triggering conditions are, among these there are:

Varicocele, therefore the alteration of the testicular veins;
Some sexually transmitted diseases;
A reduction in the activity of the gonads associated with a drop in sex hormones;
advanced age;
Alcohol abuse, smoking and drug use;
Prolonged exposure to toxic agents;
Prolonged use of medications such as beta-blockers, antibiotics, and blood pressure medications;
The presence of testicular tumors (benign or malignant) and related chemotherapy treatments;
The presence of genetic defects;
The obstruction of the ejaculatory ducts;
obesity;
Wear close-fitting clothing frequently.

As far as therapy is concerned, it is important to know that oligospermia can be treated and resolved when the triggering cause is constituted by a precise factor, such as for example smoking and alcohol abuse, or by the presence of a genital infection.

In these cases the first thing to do is to eliminate the triggering cause through the correction of lifestyle habits or surgery as in the case of varicocele.

In the case of idiopathic oligospermia, with an unidentifiable cause, the therapy becomes more complex and the advice is to turn to assisted fertilization techniques that can improve the characteristics of the sperm and increase the success rates of procreation. In this case the sperm is used to fertilize the partner directly, or to fertilize the ova in test tubes.

In cases where there are no sperm in the ejaculation, they can be taken directly from the testicle and used later for the ICSI (intracytoplasmic cell injection) technique. Thanks to assisted fertility techniques, it is estimated that in recent years most cases of infertility due to oligospermia have been resolved.

Prevention

Although it is a difficult condition to diagnose, because it very often does not present obvious physical symptoms, correct prevention for oligospermia can be carried out through a series of measures.

Early childhood testicular failure (cryptorchidism) should be identified and treated early.

Furthermore, the diagnosis and subsequent treatment of varicocele, one of the main causes of oligospermia, is essential.

It is very important to avoid sports that cause trauma or damage to the testicles and to avoid wearing clothes that are too tight.

In association with these preventive measures, it is necessary to follow a healthy and balanced lifestyle.

In particular, the following must be avoided: excessive alcohol consumption, cigarette smoking, drug smoking, an unregulated diet with a lack of fruit, vegetables and omega 3.

Furthermore, it is necessary to practice constant and moderate physical activity, which does not cause trauma to the groin and testicular area.

Your nutritionist can recommend a specific diet to help improve your condition

In general, it is advisable to avoid any sort of excess, both in terms of lifestyle and style: the first rule to keep your body in good health, in fact, is to take care of yourself.

Finally, we must not forget that oligospermia is a particularly delicate condition when you choose to have children with your partner: in the absence of the possibility of eliminating the triggering cause, you can rely on modern medically assisted procreation techniques that will accompany you in this path.

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