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Terms oligospermia, oligozoospermia, and low sperm count refer to semen with a low concentration of sperm thefreedictionary.com > oligospermia Citing: Dorland's Medical Dictionary for Health Consumers, 2007 by Saunders; The American Heritage Medical Dictionary 2007, 2004 by Houghton Mifflin Company; Mosby's Medical Dictionary, 8th edition 2009; McGraw-Hill Concise Dictionary of Modern Medicine, 2002 by The McGraw-Hill Companies and is a common finding in male infertility. Often, semen with a decreased sperm concentration may also show significant abnormalities in sperm morphology and motility (technically oligoasthenoteratozoospermia). There has been interest in replacing the descriptive terms used in semen analysis with more quantitative information.Grimes DA & Lopez LM 2007 Fertility and Sterility 88(6) 1491-94.
The diagnosis of oligozoospermia requires a work-up via semen analysis (listed in Male infertility).
A review in 2013 came to the result that oligospermia and azoospermia are significantly associated with being overweight (odds ratio 1.1), obese (odds ratio 1.3) and morbidly obese (odds ratio 2.0), but the cause of this is unknown.[2] It found no significant relation between oligospermia and being underweight.
Men with mild oligospermia (semen concentration of 15 million to 20 million sperm/ml) were studied for an association of sperm DNA damage with lifestyle factors. A significant association was found between sperm DNA damage and factors such as ageing, obesity, and occupational stress.
In a number of situations direct medical or surgical intervention can improve the sperm concentration, examples are use of FSH in men with pituitary hypogonadism, antibiotics in case of infections, or operative corrections of a hydrocele, varicocele, or Vasography.
In most cases of oligospermia, including its idiopathic form, there is no direct medical or surgical intervention agreed to be effective. Empirically many medical approaches have been tried including clomiphene citrate, tamoxifen, HMG, FSH, HCG, testosterone, Vitamin E, Vitamin C, anti-oxidants, carnitine, acetyl-L-carnitine, zinc, high-protein diets. In several pilot studies, some positive results have been obtained. Clomiphene citrate has been used with modest success. The combination of tamoxifen plus testosterone was reported to improve the sperm situation.
The use of carnitine showed some promise in a controlled trial in selected cases of male infertility, improving sperm quality, and further studies are needed.
In many situations, intrauterine inseminations are performed successfully. In more severe cases IVF, or IVF - ICSI is done and is often the best option, specifically if time is a factor or fertility problems coexist on the female side.
The Low dose Estrogen Testosterone Combination Therapy may improve sperm count and motility in some men including severe oligospermia.
DNA damage
The human breast cancer susceptibility gene 2 (BRCA2) is employed in homologous recombinational repair of DNA damages during meiosis. A common single-nucleotide polymorphism of BRCA2 is associated with severe oligospermia.
Treatment
Treatment takes place within the context of infertility management and also needs to consider the fecundity of the female partner. Thus, the choices can be complex.
Fertility
Achieving a pregnancy naturally may be a challenge if the male has a low sperm count. However, chances are good if the female partner is fertile; many couples with this problem have been successful. Prognosis is more limited if there is a combination of factors that include sperm dysfunction and reduced ovarian reserve.
See also
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