By Dr. Oliver Pack (Medical Doctor – Reg. No. 030308944).
Oligozoospermia, or oligospermia, is a condition that can make it more difficult—though not necessarily impossible—to achieve a natural pregnancy. This condition is present when the concentration of sperm in the semen is less than 15 million per milliliter, according to criteria established by the World Health Organization (WHO). This does not mean there is infertility, but rather that the levels fall below what is considered “normal.”
Early diagnosis not only allows potential treatments to begin more effectively but also provides access to current alternatives to achieve pregnancy.
There are several factors that can lead to male oligospermia, but one of the most frequent is varicocele, a dilation of the veins in the scrotum that can increase testicular temperature and affect sperm production. In some cases, it is also caused by hormonal imbalances, infections (such as chlamydia or gonorrhea that can damage the reproductive system), and even environmental factors, such as prolonged exposure to toxins, pesticides, radiation, or excessive heat.
Additionally, if fertility problems exist, it is important to examine the lifestyle of the affected individuals, as the use of alcohol, tobacco, or drugs, as well as poor diet or excessive stress, can have a negative influence.
Muestra de semen vista al microscopio
Typically, oligospermia does not present visible symptoms, so most men discover they have this condition when trying and failing to achieve pregnancy.
However, it should be kept in mind that if varicocele or hormonal imbalances are the cause, signs such as decreased sexual desire, pain or swelling in the testicles, or problems with erections and abnormal ejaculations may occur. Nonetheless, it is most important for a specialist to evaluate each case to determine whether oligospermia exists and begin treatment.
Oligozoospermia is diagnosed through a semen analysis (seminogram), which evaluates aspects such as volume, concentration, motility, and morphology of sperm cells.
In some cases, it may be necessary to conduct additional studies, such as hormone analyses, ultrasounds, or genetic testing.
Having a reduced number of sperm does not mean pregnancy is impossible, but it can make the process longer and more complicated. In fact, the fewer sperm in the semen, the lower the probability that one will reach and fertilize the egg.
In these situations, assisted reproduction plays a fundamental role, as it can not only select the best sperm from samples with low concentration, but also further facilitate the process by performing in vitro fertilization (IVF), that is, outside the body (in the laboratory).
Depending on the degree of oligospermia, the fertility specialist may recommend other techniques such as artificial insemination (in cases where sperm concentration is moderate and sperm have good motility) or intracytoplasmic sperm injection (ICSI), a specialized IVF technique in which a single sperm is injected directly into the egg. This is especially useful in cases of severe oligospermia or when the number of motile sperm is very low.
Thanks to advances in assisted reproduction, many men with oligospermia have been able to become fathers. Even in very severe oligospermia cases (called cryptozoospermia), it is possible to find viable sperm that can be used in ICSI.
In some exceptional cases, if no sperm are detected in the ejaculate (azoospermia), a testicular biopsy (TESA) may be performed to try to retrieve sperm directly from the testicle.