Causes and Treatments for Oligozoospermia

Oligozoospermia is defined as reduced sperm concentration. The normal concentration of sperm is > 20 million/ml. When the concentration is between 5-20 million/ml, it is called mild oligozoospermia. When the concentration is <5 million /ml, it is called severe oligozoospermia. Ologozoospermia causes sub-fertility in men. Sometimes, oligozoospermia can indicate an underlying detrimental illness. Therefore, identification and treatment of the cause is very important.

There are many causes of oligozoospermia. The production of sperm involves a long process. This process involves the hypothalamus of the brain, the pituitary and the testes. The hypothalamus is the main centre regulating the production of sperm. The hypothalamus secretes gonadotrophin releasing hormone which go and acts on the pituitary to release LH and FSH. LH and FSH are two hormones that are carried via blood to the testes. These two hormones act on the cells in the testes and stimulate spermatogenesis (production of sperm) and secretion of testosterone (male sex hormone). Oligozoospermia results in when there is interruption at any point in this pathway.

The hypothalamus can be disturbed as a result of many diseases. It is mainly affected by generalized illnesses. When a person is severely ill, the normal function of the hypothalamus gets affected. As a result, the secretion of all the hypothalamic hormones gets deranged. This results in disturbance of hypothalamo-pituitary-testes axis. Therefore, if you were severely sick in the recent past, your sperm concentration will be low. This will get corrected automatically after the acute illness is corrected. Sudden weight loss and anorexia nervosa also disturb the function of hypothalamus and cause oligozoospermia. Anorexia nervosa should be treated immediately.

Pituitary causes of oligozoospermia can sometimes be life threatening. Example of one such disease is pituitary tumors. Pituitary tumors are relative common in adult age. One of the commonest pituitary tumors is prolactinoma. Prolactinomas are tumors secreting the hormone prolactin. Prolactin stimulates the production of milk. Therefore, other than oligozoospermia, the person will also have galactorrhea (milk secretion from the nipples). People with prolactinomas can also have visual disturbances. The treatment for prolactinoma is surgery. So, people with pituitary tumors will be referred to a neurosurgeon.

There are many testicular causes that can give rise to oligozoospermia. These causes include trauma, infection, malignancies, hormonal imbalances, radiation, heat, varicocoele, hydrocoele and many other causes. Well known infections that can cause oligozoospermia and sometimes azoospermia (absence of sperms) are mumps and malaria. There is no treatment for mumps. Therefore, prevention is very important. Mumps is prevented by vaccination. If you are not vaccinated with mumps, you should get yourself vaccinated. It is very important that you keep your children vaccinated on time to prevent them from future infection. Malaria is treated with antimalarial drugs. It can also be prevented by malaria prophylaxis. This is very important when you are travelling to a malaria endemic area.

Varricocoele and hydrocoele are two of surgical causes of oligozoospermia. These two conditions appear as lumps in testicles. The two should be identified and differentiated by careful examination. The treatment for both conditions is surgery.

Heat is one of the commonest testicular causes of oligozoospermia. This is commonly seen among men who work with their laptops on their laps. The testes are situated outside the abdominal cavity because the testes need a temperature less than that of the body temperature to function properly. When men use laptops on their laps, the heat generated by the laptop also increases the heat inside the testicles as well. As a result, the sperm production is impaired. Testicular cancers also results in oligozoospermia. Seminomas are the commonest testicular neoplasm seen in adult males.

Oligozoospermia can also be caused by post-testicular causes such as vas deference obstruction, prostatitis and obstruction at the ejaculatory duct etc. The patient will have to take antibiotics for a long time to cure prostatitis.

As described above, there are many causes of oligozoospermia. Identification of the cause and treatment is very important to maintain ferfitility as well as to prevent detrimental outcomes, because some of these causes can be life-threatening.