Male factor contributes equally as the female factor. Hence evaluation of a male partner is very important.
Normal Semen Analysis (WHO 2010)-
Normal Concentration – 15 million per ml / 39 million per ejaculate
Normal motility – 40% (Rapidly progressing – 32%)
Normal Volume – 2 ml
Normal morphology – 4 %
Abnormalities
Oligospermia – Reduced count of sperm
Teratospermia – Abnormal morphology (<4% of normal sperms) – the structure of sperms is defective. The problem can be at the level of the head, neck, or tail of the sperm.
Asthenospermia – Abnormal motility (movement) of sperm.
Oligoasthenoteratozoospermia (OATS) – Problem at all levels of sperm. ICSI is indicated in these cases.
Azoospermia – No sperm in the semen.
Cryptozoospermia – No sperm in the semen, but found after centrifugation of semen in the lab.
Hypospermia – Decreased volume of the semen.
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Causes of Azoospermia (absent sperms in semen) –
Testicular failure – The Testes are not able to produce sperms. FSH hormone will be high in these cases.
Hypogonadotropic Hypogonadism – The brain will not be able to stimulate the testes to produce sperms.
Obstructive Causes – Sperms will be produced but will not be able to come in the ejaculate due to obstruction.
Idiopathic – When no cause can be found. This is most commonly seen.
Maturation defects – Sperm precursors are produced but are not able to mature.
Genetic defects – Y microdeletions, Klinefelter’s syndrome etc.
Causes of Sperm defects –
Obesity
Stagnated lifestyle
Smoking
Alcohol
Drug abuse
Excessive heat exposure (occupational)
Poor nutrition
Idiopathic – where no cause can be found
Tests for male partner
Usually if semen analysis is normal, no further evaluation is done.
For minor issues medical treatment is tried for a few months, before advanced tests and treatments.
In case of azoospermia, further evaluation is done which includes-
Examination
Ultrasound
Hormonal evaluation
FNAC – Fine Needle Aspiration Cytology – Some cells are extracted with the help of a thin needle and they are studied under microscope.
If sperms are found on FNAC – ICSI (Intra Cytoplasmic Sperm Injection) is the best technique to have pregnancy. In ICSI, sperms are directly injected inside the eggs with the help of a very advanced machine and microscope.
Other advanced treatments are based on requirement.
Low Sperm Count Treatment In Jalandhar
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