The male factor infertility represents approximately 40% of all causes of infertility. The abnormal quality of the sperm affects practically half of the couples that present fertility issues. Since in these cases the chances of achieving a natural pregnancy are significantly reduced, the male factor must be meticulously evaluated.

In this article, we want to get you in contact with the so-called ‘male factor’ in more detail: its causes, diagnosis and treatment.

We will start off by clarifying the difference between male infertility and sterility. A man is sterile when he is unable of producing fertilisation, whilst he is infertile when he has fertility problems that hinder or prevent the woman from conceiving a healthy baby with his sperm.

Causes of male infertility – from least to most common:

• Hypothalamus or hypophysis disease (1-2%)

In this case, the problem is in the production of male hormones that regulate the male sexual organs.

• Post-testicular defects (10-20%)

Infertility occurs due to a blockage in the seminal duct through which the sperm cells should circulate.

• Testicular disease (30-40%)

In this case, the problem is in the testes, which do not correctly produce sperm cells due to either genetic or acquired issues.

• Idiopathic sterility (40-50%)

In these cases the concrete cause of sterility is unknown. Within this cause, we may find alterations in the concentration, motility and morphology of the sperm cells.

Diagnosing the male factor of any patient is extremely complex.

To do it, an anamnesis (information to put together a medical history) is needed, which includes: personal and familiar background, sexual habits of the couple, the consumption of noxious substances for fertility such as alcohol, drugs and cigarettes,  the possible exposure to excessive heat or radiation; and a complete physical examinationsto analyse the phenotype and the secondary sexual features, the state of the penis, the prostate, the testes, etc.

Treatments for male sterility:

• Counselling about habits and/or situations that compromise the reproductive capacity.
• Hormonal treatment in the case of sterility of endocrine origin.
• Treatment with antibiotics in the case of infectious processes.
• Surgical treatment in cases of Varicocele, obstructive Azoospermia, Cryptozoospermia, etc.

What is oligospermia?

Oligospermia is the term defined by a low concentration of sperm cells in the ejaculated sperm of a man of reproductive age. The World Health Organisation (WHO) has established that a concentration of less than 15 million sperm cells per millilitre of sperm should be considered oligospermia.

To diagnose it we must perform a spermiogram, which consists of a sperm analysis using a microscope to study both the amount and quality of the sperm cells (for example, if they have motility issues or a defective morphology).

Types of oligospermia

• Mild Oligospermia: 14-5 millions/ml
• Moderate Oligospermia: 5-1 millions/ml
• Severe Oligospermia: <1million/ml

What is asthenospermia?

Asthenospermia or asthenozoospermia happens when the sperm cells’ motility is abnormal. To diagnose it we perform a spermiogram in which the motility of the sperm cells is evaluated based on their progressivity, straight movement ability and speed.

What is teratozoospermia?

When a man presents morphologic alterations in more than 96% of his sperm cells we are facing teratozoospermia.

The morphology of an ideal sperm cell should be as follows: ovoid head, regular contour, single and straight tail, fixed and transparent nucleus. All this can be observed in a spermiogram.

What are the consequences when trying to achieve a pregnancy?

• A defective sperm morphology hinders the correct movement of the sperm cells and therefore prevents them from reaching the woman’s oocyte (egg).
• A sperm cell with a defectively formed head, even if it reaches the egg, will have great difficulties to successfully enter and fertilise it.
• Lastly, in the case of abnormal sperm, it is very important to know that repeated miscarriages are very common due to the genetic alterations associated with this type of pathology.

The issue with oligospermia, asthenospermia and teratozoospermia is that they are asymptomatic pathologies, because they present no evident symptoms, such as pain, to detect them. Normally men who suffer from them do not find out until the time when the couple wishes to have a child and they undergo fertility tests.

Conclusions

Male fertility depends on many factors, it is not static.

The spermiogram results alone are not enough, they must be interpreted together with other tests and a personalised clinical evaluation.

If a man wishes to have children and the medical treatments do not remedy his fertility issues, it becomes necessary to resort to assisted reproduction techniques.

Lastly, we would like to remind those of you who are trying to form a family, that in IVF Spain we have solutions so that all the above-mentioned fertility issues do not prevent you from becoming parents. You can request an informative appointment by clicking here.