REPRODUCTIVE ISSUES DUE TO LOW SPERM COUNT. DIAGNOSIS, TREATMENT, MANAGEMENT AND PREVENTION. For Scientific Free Lectures, Visit - http://bit.ly/VisitZofirAcademy

1. SPERM COUNT MANAGEMENT
ARMAN FIROZ
M.Sc. Biomedical Genetics

2. * Low sperm count means that the semen which is ejaculated during an orgasm
contains fewer sperm than normal. A low sperm count is also called
oligospermia.
* A complete absence of sperm is called azoospermia.
* Low sperm count, defined as fewer than 15 million sperm per millilitre of
semen.
* Having a low sperm count decreases the odds that one of your sperm will
fertilize your partner's egg, resulting in pregnancy. Nonetheless, many men
who have a low sperm count are still able to father a child.
DEFINITION OF LOW SPERM COUNT

3. SYMPTOMS
 The main sign of low sperm count is the inability to conceive a child.
 There may be no other obvious signs or symptoms.
- An underlying problem such as an inherited hormonal imbalance,
dilated testicular veins or a condition that blocks the passage of sperm.
 Low sperm count symptoms may include:
• Problems with sexual function
• Pain, swelling or a lump in the testicle area
• Decreased facial or body hair or other signs of a chromosome or hormone
abnormality

4. CAUSES
• Once sperm are produced in the testicles  delicate tubes transport them until they mix with
semen ejaculated out of the penis.
• Problems with any of these systems can affect sperm production. Also, there may be problems
of abnormal sperm shape (morphology), movement (motility) or function. Often the cause of
low sperm count isn't ever identified.
 Medical causes
Low sperm count can be caused by a number of health issues and medical treatments. Some of
these include:
• Varicocele: A varicocele is a swelling of the veins that drain the testicle. It's a common cause
of male infertility.
- Prevent normal cooling of the testicle reduced sperm count and fewer moving sperm.
- Infection: These include some sexually transmitted infections, such as chlamydia and
gonorrhea; inflammation of the prostate (prostatitis); inflamed testicles; and other infections
of the urinary tract or reproductive organs.

5.  Ejaculation problems: Various health conditions can cause retrograde ejaculation,
including diabetes, spinal injuries, and surgery of the bladder, prostate or urethra.
 Antibodies that attack sperm:. Anti-sperm antibodies are immune system cells that
mistakenly identify sperm as harmful invaders and attempt to destroy them.
 Tumors: Can affect the male reproductive organs directly, or can affect the glands that
release hormones related to reproduction (such as the pituitary gland)
 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, may impair sperm production.
 Sperm duct defects: The tubes that carry sperm can be damaged by illness or injury.
 Chromosome defects: Inherited disorders such as Klinefelter's syndrome cause abnormal
development of the male reproductive organs. Other genetic syndromes associated with
infertility include cystic fibrosis, Kallmann's syndrome and Kartagener syndrome.

6.  Certain medications. Testosterone replacement therapy, long-term anabolic steroid use,
cancer medications (chemotherapy), certain antifungal and antibiotic medications, some
ulcer medications and some other medications can impair sperm production
 Environmental causes
- Industrial chemicals: Extended exposure to benzenes, toluene, xylene, herbicides, pesticides,
organic solvents, painting materials and lead may contribute to low sperm counts.
- Heavy metal exposure: Exposure to lead or other heavy metals also may cause infertility.
- Radiation or X-rays: Exposure to radiation can reduce sperm production. It can take several
years for sperm production to return to normal. With high doses of radiation, sperm production
can be permanently reduced.
- Overheating the testicles: Frequent use of hot tubs
* Sitting for long periods, wearing tight clothing or using a laptop on your lap for long periods
of time also may increase the temperature in scrotum and reduce sperm production. The type of
underwear you choose to wear is unlikely to significantly impact your sperm count.
- Prolonged bicycling: Prolonged bicycling is another possible cause of reduced fertility due to
overheating the testicles.

7.  Health, lifestyle and other causes
- Illegal drug use: Anabolic steroids taken to stimulate muscle strength and growth
- Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm
as well.
- Alcohol use: Drinking alcohol can lower testosterone levels and cause decreased sperm
production.
- Occupation. Certain occupations may increase your risk of infertility, including those
associated with extended use of computers or video display monitors, shift work and work-
related stress.
- Tobacco smoking. Men who smoke may have a lower sperm count than do those who don't
smoke.
- Emotional stress. Severe or prolonged emotional stress, including stress about fertility itself,
may interfere with certain hormones needed to produce sperm.
- Weight. Obesity can cause hormone changes that reduce male fertility.

8. TESTS AND DIAGNOSIS
 General physical examination and medical history
- This includes examination of genitals and questions about any inherited conditions, chronic
health problems, illnesses, injuries or surgeries that could affect fertility. Doctor may also ask
about sexual habits and sexual development.
Semen analysis
- Sperm count is generally determined by examining semen under a microscope to see how
many sperm appear within squares on a grid pattern. In some cases, a computer may be used to
measure sperm count.
- New sperm are produced continually in the testicles and take about 40 to 76 days to mature.
So, a current semen analysis reflects environment over the past 2.5 months.
Semen analysis results
- Normal sperm densities range from 15 million to greater than 200 million sperm per milliliter
of semen.
There are many factors involved in reproduction, and the number of sperm in your semen is
only one.

9. Other tests
- Scrotal ultrasound. This test uses high-frequency sound waves to look at the testicles and
supporting structures.
- Transrectal ultrasound. A small lubricated wand is inserted into rectum to check prostate, and
for blockages of the tubes that carry semen .
- Hormone testing: blood test to determine the level of hormones produced by the pituitary,
hypothalamus and testicles, which play a key role in sexual development and sperm production.
- Post-ejaculation urinalysis: Sperm in your urine can indicate sperm are traveling backward
into the bladder instead of out penis during ejaculation (retrograde ejaculation).
- Genetic tests: When sperm concentration is extremely low, genetic causes could be involved.
Any changes is Y chromosome can be identified.
- Testicular biopsy: This test involves removing samples from the testicle. It may be used if your
semen analysis shows no sperm at all. The results of the testicular biopsy will tell if sperm
production is normal.
- Anti-sperm antibody tests. These tests are used to check for immune cells (antibodies) that
attack sperm and affect their ability to function.

10. TREATMENTS AND DRUGS
 Treatments for low sperm count include:
- Surgery: For example, a swelling of the veins that drain the testicle (varicocele) can often be
surgically fixed or an obstructed vas deferens tube repaired.
- Treating infections: Antibiotics can cure an infection of the reproductive tract, but this doesn't
always restore fertility.
- Hormone treatments and medications: Hormone replacement or medications may be
prescribed to change hormone levels. It can take between three and six months before you'll
notice any effects on your semen analysis.
- Assisted reproductive technology (ART). ART treatments involve obtaining sperm through
normal ejaculation, surgical extraction or from donor individuals, depending on specific. The
sperm is then inserted into the female genital tract, or used for in vitro fertilization or
intracytoplasmic sperm injection (ICSI)

11. LIFESTYLE AND HOME REMEDIES
There are a few steps can be take at home to increase chances of getting partner pregnant
- Increase frequency of sex: Having sexual intercourse every other day around the time of
ovulation increases chances of getting partner pregnant.
- Have sex when fertilization is possible: A woman is likely to become pregnant during
ovulation — which occurs around the middle of the menstrual cycle, between periods.
Experts generally recommend having intercourse every two days near the time of ovulation.
This will ensure that sperm, which can live several days, are present when conception is
possible.
- Avoid the use of lubricants: Some products such as Astroglide or K-Y jelly, lotions, and saliva
have been shown to reduce sperm movement. Ask your doctor about sperm-safe lubricants.

12. ALTERNATIVE MEDICINE
Evidence is still limited on whether — or how much — herbs or supplements might help
increase sperm count or overall sperm health.
Although there is no conclusive information on the benefit of dietary supplementation, certain
vitamins, minerals and amino-acids may improve sperm count or sperm quality. They include:
 Alpha-lipoic acid
 Anthocyanins
 Beta-carotene
 Biotin
 L-acetyl carnitine , L-carnitine
 Cobalamin
 Co-enzyme Q10
 Vitamins A, C, D and E
 Zinc

13. PREVENTION
 should avoid some known factors that can affect sperm count and quality:
 Don't smoke.
 Limit or abstain from alcohol.
 Steer clear of illegal drugs.
 Talk to your doctor about medications that can affect sperm count.
 Keep the weight off.
 Avoid the heat.
 Reduce stress.
 Avoid pesticides, heavy metals and other toxins.

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