Sperm Disorder

For women to get pregnant, their partner must produce healthy sperms. Under normal conditions, the male body produces testosterone which triggers the hormones and maintains the production of sperms. Sperms are produced in the testis, stored in the epididymis and travel through the vas deferens to reach the ejaculatory duct. At the ejaculatory duct, the semen, released by the seminal vesicles, takes the sperms to be ejaculated through the penis and delivered directly into the female body through vagina during the time of intercourse. The sperms travel through her uterus to her fallopian tube where sperms and eggs meet and fertilization takes place.



(Normal sperm Count)



(No sperm)



(Low sperm count)



(Low sperm motility)

This whole procedure of fertilization equally depends upon the quality of the sperms and the eggs. There have to be a good number of sperms in the semen and sperms must be functional to fertilize the eggs of the female partner for a healthy pregnancy. Thus, the sperm quality in a male should be good enough to help the female partner conceive without more efforts.

There are seven main criteria for healthy sperm:

  • Count
  • Volume
  • Motility
  • Shape and size
  • Ability to pass through the cervical mucus to fertilize the egg
  • Acrosome reaction
  • Zona pellucida binding
  • Nuclear decondensation

Sperms also need to have the right number of chromosomes for a successful pregnancy. A breakdown in any of these criteria can result in Sperm Disorder, and hence male infertility. Sperm disorders have become a big concern today not only in India but across the globe.


Azoospermia can broadly be divided into two groups:

Non-obstructive Azoospermia is a condition in which the testicles are producing such a low number of sperm that they don’t even reach the vas deferens, so the ejaculate does not contain any sperm.

  • Pre-testicular Azoospermia is caused by impaired production of the hormones responsible for creating sperm.
  • Testicular Azoospermia is caused by any abnormalities in the function or structure of the testicles.

  • Chromosomal Abnormalities
  • Varicocele
  • Medicinal Side Effects
  • Damage from Radiations or Chemotherapy
  • Lower Sperm Production within Testicles
  • Sertoli-Cell Only Syndrome which refers to a low sperm production

Obstructive Azoospermia is defined as the absence of sperm in the ejaculate despite satisfactory sperm production. This may happen due to some sort of obstruction in the reproductive tract.

  • Vasectomy which interrupts the sperm ducts which stop the flow of sperm
  • Infections in Testicles
  • Exposure to Diseases like Chlamydia
  • Blockage in Small Tubules
  • Blockage in Eaculatory Duct caused by inflammation
  • Damage or Scar in Tissue due to previous trauma or surgery
  • Retrograde Ejaculation in which semen enters the bladder instead of emerging through the penis


Azoospermia is a sperm disorder characterized by NO SPERM IN THE SEMEN.


OLIGOSPERMIA (Low sperm count)

Oligospermia is a sperm disorder characterized by a low sperm count. Other aspects of the sexual health of men with this condition are typical. This includes the ability to get and maintain an erection and timely ejaculation.

There are different types of low sperm count issues including:

Mild Oligospermia (10 to 15 million sperm/mL)

Moderate Oligospermia (5 to 10 million sperm/mL)

Severe Oligospermia (0 to 5 million sperm/mL)

Oligospermia is Caused by

  • Varicocele
  • Sexually Transmitted Infections
  • Ejaculation issues (retrograde ejaculation)
  • Medications (beta blockers, antibiotics and blood pressure medications may cause ejaculation problems and reduced sperm count)
  • Hormone Imbalance
  • Exposure to Chemicals and Heavy Metals (pesticides, cleaning agents, painting materials, lead)
  • Obesity
  • Smoking, Drug and Alcohol Use
  • Overheating of Testicles (due to sitting frequently, placing laptops over genitals, wearing tight clothing)

There are different types of sperm motility issues including:

Slow or Sluggish Progressive Motility

Non-progressive Motility, which is defined as anything less than 5 micrometers per second

No Mobility

Asthenospermia is Caused by

  • Medical Condition
  • Genetic Disorder
  • Lifestyle, like smoking
  • Environmental Factors
  • Varicocele
  • Disorder in the Male Accessory Sex Gland Secretion

ASTHENOSPERMIA (Low sperm motility)

Asthenospermia is a sperm disorder characterized by poor motility. Sperm motility refers to the sperm’s forward progressions of at least 25 micrometers per second.

Sperm Analysis: What’s Normal ?  

A semen analysis, also called ‘Seminogram’ evaluates the below characteristics of sperm contained therein:

  • Number (volume)
  • Shape
  • Movement or (sperm motility)
  • Morphology

Doctors may recommend testing up to three samples of sperm at different visits to get an accurate analysis.

A NORMAL SPERM COUNT ranges from 15 million sperm to more than 200 million sperm per milliliter (mL) of semen. Anything less than 15 million sperm per milliliter, or 39 million sperm per ejaculation, is considered low.

The following are the healthy or normal semen analysis results, as determined by the World Health Organization (WHO)

  • 39 - 928 million

    Total Sperm Count in Ejaculation

  • 1.5 - 7.6 mL

    Ejaculate Volume

  • 15 - 259 million / mL

    Sperm Concentration

  • 40 - 81%

    Total Motility (progressive and non-progressive)

  • 32 - 75%

    Progressive Motility

  • 4 - 48%

    Sperm Morphology

How to Treat it ?  

Surgery can cure obstructive azoospermia

Sperm can be directly retrieved from the testicles through different sperm-retrieval techniques.

Infections can be treated through medication.

Medications and counselling can solve the problems of low sex drive, timely ejaculation.

Hormonal imbalances can be treated by medications.

Assisted reproductive technologies like IVF, ICSI, IUI is the procedure to help conception with poor sperm motility and low sperm count.

Erectile dysfunction is curable by medicines, counseling and changing lifestyle and habits.

How to Stop it ?  

Lifestyle has a huge effect on sperm health. Change a little in it may become a Game Changer.

Losing weight, if one is obese, is one of the single-most effective things one can do to increase sperm count. Studies have shown that weight loss can significantly increase semen volume, concentration and mobility as well as the overall health of sperm.

The changes in sperm count have been found to be most significant in men who have a higher body mass index, so if one has a large amount of weight to lose, even losing a small amount of weight may help.

To accomplish weight loss goals, a change in eating habits suggested by nutritionists and exercise programmes developed by physical trainers can also help.

Some types of vitamins, including vitamins D, C, E, and CoQ10 are important for sperm health. One study showed that taking 1,000 mg of vitamin C every day can help men’s sperm concentration and mobility. The overall sperm count won’t improve, but the sperm can become more concentrated and able to move more efficiently. That can boost the chances of conceiving successfully.

Another study noted less successful rates of pregnancy among couples where the man had low levels of vitamin D. More research is needed to understand the relationship between this vitamin and fertility, but there does seem to be a correlation.

Consider changing clothes and showering as soon as possible if one has been exposed to:

  • metals
  • solvents
  • pesticides
  • paint strippers
  • degreasers
  • non-water based glues or paints
  • other endocrine disruptors

Those toxins may affect sperm count. If one is exposed to any of these things because of a hobby, it is advised to put your hobby on hold until after successful conception. Jobs that expose to excess heat or radiation, or even extreme sedentary work can also affect sperm count.

Severe or prolonged emotional stress, including stress about fertility, might interfere with hormones needed to produce sperm. Being depressed may negatively affect sperm concentration.

Even if there is no need to lose weight, staying active and leading a healthy lifestyle can help boost sperm count. One study found that weightlifting and outdoors exercise can help sperm health more than other types of exercise. Consider incorporating these kinds of activities into the routine.

Exercise can also help you maintain or lose weight, which may have additional benefits for sperm health.

Low sperm count and poor sperm have been linked to people with a history of

  • heavy drinking which is defined as drinking two or more alcoholic drinks per day
  • tobacco use of any kind
  • illegal drug use, including cocaine and anabolic steroids

If one uses any of these substances and is having trouble quitting, talk to the doctor. They can recommend programmes to help manage and treat addiction.

Severe or prolonged emotional stress, including stress about fertility, might interfere with hormones needed to produce sperm. Being depressed may negatively affect sperm concentration.

Sperm Retrieval  

  • 1 PESA
  • 2 TESA
  • 3 TESE
  • 4 MESA

It is a simple procedure whereby the sperms are extracted directly from the epididymis with the help of a syringe. After mild sedation, a small needle is inserted through the skin of the scrotum to collect sperm from the epididymis (where sperm are usually stored after produced in the testes) over the testes. The sperm is retrieved by delicate suction.

PESA is Recommended to Men Who Have

  • no sperm during the ejaculation

The reason for the absence of sperm may be because of blockage or result of prior surgery.

TESA is an invasive procedure which involves a needle penetration through the epidermis of the scrotum. The needle attached to a syringe draws out the fluid from the testicle. This is done under anesthesia.

TESA is Recommended to Men Who Have

  • obstructive azoospermia

This involves opening up the scrotum and taking a large volume of testicular tissue, derived from several regions of the testicle, under local anaesthesia. And then, few viable sperm cells that are present in that tissue are extracted using a microscope.

TESE is a breakthrough because the sperm does not have to ‘mature’ and pass through the epididymis. The procedure has reduced the need for donor sperm.

TESE is Recommended to Men Who Have

  • primary testicular failure
  • congenital absence of the vas deferens
  • non-reconstructed vasectomy

An open surgical sperm retrieval procedure that uses an operating microscope to locate the tubules of the epididymis precisely. So the tissue can be observed closely and the epididymal fluid is aspirated from areas having maximum sperm density. In this technique, larger numbers of sperm are extracted with greater precision.

MESA gives the highest number of sperm, with a hundred times more sperm being recovered compared to TESA and percutaneous biopsy. MESA also produced sperm with better motility and therefore more useful for infertility treatments like IVF and ICSI.

MESA is Recommended to Men Who Have

  • vasal or epididymal obstructions
  • blocked, severed or missing vas deferens

This procedure, used with ICSI has proved to be of tremendous advantage in cases of obstructive azoospermia.

This includes an operation, performed under general anaesthesia, through a small midline entry point in the scrotum, through which one or both testicles can be seen. The specialist looks at the testicles under the magnifying instrument for healthy areas of seminiferous tubules. The operation field is magnified 25 times to look for the limited sperms. The surgeon extracts these tissues which are analysed and processed in the lab to retrieve sperms.

This process is less damaging and the impact on tiny blood vessels and the risk of damaging them, is also considerably low.

Micro-TESE is Recommended to Men Who Have

  • non-obstructive azoospermia
  • extreme testicular disappointment

Micro-TESE is particularly useful in these men, as there are exceptionally limited territories of sperm creation that might be missed during needle biopsies.

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