Oligospermia
| Oligozoospermia | |
|---|---|
| Classification and external resources | |
| Specialty | urology |
| ICD-10 | N46 |
| ICD-9-CM | 606.1 |
Terms oligospermia and oligozoospermia refer to semen with a low concentration of sperm 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.
The diagnosis of oligozoospermia is based on one low count in a semen analysis performed on two occasions. For many decades sperm concentrations of less than 20 million sperm/ml were considered low or oligospermic, recently, however, the WHO reassessed sperm criteria and established a lower reference point, less than 15 million sperm/ml, consistent with the 5th percentile for fertile men. Sperm concentrations fluctuate and oligospermia may be temporary or permanent.
Sources usually classify oligospermia in 3 classes:
The diagnosis of oligozoospermia requires a work-up via semen analysis (listed in Male infertility).
There are many causes for oligospermia including:
Pre-testicular factors refer to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health including:
Testicular factors refer to conditions where the testes produces semen of poor quality despite adequate hormonal support and include:
Mast cells releasing inflammatory mediators appear to directly suppress sperm motility in a potentially reversible manner, and may be a common pathophysiological mechanism for several of the above-mentioned factors.
Post-testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation:
In about 30% of infertile men no causative factor is found for their decrease in sperm concentration or quality by common clinical, instrumental, or laboratory means, and the condition is termed "idiopathic" (unexplained). A number of factors may be involved in the genesis of this condition, including age, infectious agents ( such as Chlamydia trachomatis), Y chromosome microdeletions, changes, environmental pollutants, and "subtle" hormonal changes.
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