Sperm problems in infertility
More than one-third of infertility cases are due to infertility problems in men. Any problem in a man’s health that reduces his wife’s chances of getting pregnant can be a reason for male infertility. The most common cause of infertility in men is related to sperm and its health problems. The volume, motility, shape, and number of normal sperm chromosomes and their ability to pass through the cervical mucosa and attach to the oocyte and its ability to fertilize are the most important criteria for sperm health.
According to statistics, about 7% of men suffer from infertility. Therefore, in examining the causes of infertility in couples, in addition to examining female fertility tests, the condition and fertility tests of men should also be considered. These tests will help doctors determine the exact cause of infertility and choose the most effective treatment plan. In the following, we will introduce the most common causes of infertility in men and the causes of its occurrence.
Low sperm count
Sperm production is a complex process that requires the normal functioning of the testicles, hypothalamus, and pituitary gland.
After the sperm are produced in the testicles, they are carried in thin tubes to combine with semen and come out of the penis during ejaculation. Disruption of these processes can affect the number of sperm in the semen and cause infertility problems in men. According to research, about 90% of infertility cases in men occur due to low sperm count.
Normal sperm count is between 15 million and more than 200 million per milliliter of semen. If the number of sperm in the semen is less than 15 million per milliliter or less than 39 million per ejaculation, the person has oligospermia or a decrease in the number of sperm, which reduces the chance of fertility. If there is no sperm in the semen, the person will have azoospermia. Azoospermia does not mean incurable infertility in all cases, however, in some cases, by performing some surgeries such as PESA, TESA, etc., by sampling the testicular tissue; a number of sperm are obtained. These sperm can fertilize eggs in the laboratory and by IVF. Learn more about IVF: Everything about IVF
Among the reasons that a person suffers from a decrease or lack of sperm, the following can be mentioned:
- Undetected testicles: Sometimes during fetal development, one or both testicles remain in the abdomen and fail to enter the scrotum, which disrupts the normal function of the testicles. This problem causes sperm problems and is the cause of most infertility in men.
- Hormonal imbalance: pituitary, hypothalamus, and testes; secrete hormones that are essential for sperm production. Changes in the secretion of these hormones and other hormones, such as those secreted by the thyroid and adrenal glands, can interfere with sperm production.
- Infections: Some infections, such as epididymitis, testicular inflammation, and sexually transmitted infections, such as AIDS, gonorrhea, and syphilis, can affect the health of the testicles and interfere with sperm production or transmission. In addition, infections such as mumps increase the risk of testicular infections.
- Genetic defects: Some genetic disorders, such as Kallmann syndrome (which causes a decrease in glandular secretion) and Klinefelter syndrome (in which men have two X chromosomes and one Y chromosome instead of one Y chromosome). It causes abnormal development of the male reproductive system and causes problems with sperm production.
- Defects in the seminal vesicles: The seminal vesicles can be damaged or blocked by various factors such as infections, diabetes, trauma, surgery, etc.
- Surgery: Some surgeries, such as vasectomy, hernia treatment, testicular surgery, prostate surgery, or major abdominal surgery, can cause male genital dysfunction. Occasionally, some corrective surgeries can be used to remove obstructions or to extract sperm from testicular tissue and fertilize it in a laboratory.
- Immune system defects: Immune system defects can cause the immune system to become sensitive to the individual’s own sperm and mistakenly produce and kill antibodies against the sperm.
- Environmental factors: One of the factors affecting male infertility is exposure to certain environmental factors such as industrial chemicals, high temperatures, X-rays, and other radiation that can impair testicular function and sperm production.
- Improper lifestyle: Having an inappropriate lifestyle is one of the factors affecting the number of sperm produced. Smoking and alcohol, unhealthy diet and being overweight, sedentary and not exercising, stress are important signs of an unhealthy lifestyle. Learn more about the effect of smoking on fertility: How smoking affects male fertility
Sperm motility is very important in male fertility because sperm has to travel a relatively long distance in the female reproductive system to reach the egg. Therefore, any disorder in sperm motility and its inactivity can affect a person’s fertility.
Sperm has two types of movement, progressive and non-progressive. In progressive motion, sperm moves in a straight line or large circles, and in non-progressive motion, sperm moves in small circles. Sperm immobility is when less than 32% of sperm have progressive motility.
In addition, sperm must move at a speed of at least 25 micrometers per second to pass through the cervix and reach the eggs. If the speed of sperm movement is less than this amount, sperm is considered sedentary. In many cases, no specific cause can be found for sperm motility. But various factors that affect the health of the testicles can also affect the quality of sperm and their motility. Some of these factors are:
- Having varicocele
- Testicular cancer
- undescended testicle
- Impact and damage to the testicles
- Some infections
- Long-term use of corticosteroids
- Deficiency of sex hormones
- Smoking and drug use
Abnormal shape of sperm
Natural sperm has an oval head 6-5 μm long and 3.5-2.5 μm wide with a healthy cap and tail. In abnormal sperm, the head of the sperm may be very large or small, or in some cases, it may have two heads. Some abnormal sperm have two tails or their tails are spring-shaped.
Having healthy sperm of the right shape and size increases the chances of fertility because the shape of the sperm also affects its movement so that abnormal sperm do not move well or effectively. In addition, the abnormal shape of the sperm can be passed on to the male fetus as a genetic disorder. Research shows that successful fertilization requires at least 4% of all sperm to be normal.
Genetic factors, exposure to toxins, and high temperature are the most common causes of sperm problems and abnormal sperm shape. Abnormal forms of sperm are not currently treatable for genetic reasons. But the abnormal shape of sperm associated with toxins and a rise in testicular temperature can be improved by changing lifestyles, quitting smoking and alcohol, and avoiding saunas and Jacuzzis.
Men’s bodies are always producing new sperm, and as they get older, their chances of producing abnormally shaped sperm increase. By changing the lifestyle, sperm quality can be increased in old age. Weight loss, regular exercise, reduced caffeine consumption, avoiding the use of hot tubs, avoiding tight pants, reducing stress, etc. can help sperm health in old age.
How can sperm quality be improved?
As mentioned earlier, improving your lifestyle, exercising regularly, maintaining a healthy weight, and avoiding alcohol and smoking can greatly improve sperm quality. In addition, proper nutrition and adequate intake of a variety of vitamins, especially vitamins C and E, are essential for the production of healthy sperm. Eating foods containing antioxidants such as fruits and vegetables is also recommended to improve sperm health.
The optimum temperature for sperm production is about 34 ° C and with increasing temperature, sperm quality decreases. Therefore, one should avoid wearing tight clothing that leads to an increase in temperature in the testicles. In addition, avoid sitting for long periods of time, using the sauna, Jacuzzi, and hot tub, and placing the laptop on your stomach.
Some supplements such as selenium and vitamins can also be effective in improving sperm motility and solving sperm problems, but it should be noted that the use of this supplement should be under the supervision of a doctor. Sometimes it may not be effective to follow all of the above and the pregnancy may not occur. In these cases, assisted reproductive techniques and fertility treatment methods such as IUI, IVF, and ICSI should be used. (Learn more about different methods of fertility treatment: Fertility Treatment in Iran)
These methods are suitable for people who are deficient in sperm or whose sperm are less motile. For more information and consultation with the best fertility treatment specialists in Iran, you can contact us.