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Low Sperm Count

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Definition

Low sperm count or oligospermia is a condition characterized by production of sperms that are few in numbers and may or may not be normal in shape and motility.

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Semen

Semen is the thick, white, sperm-containing fluid excreted from the penis during ejaculation. Semen is composed of seminal fluid and sperms. Seminal fluid is produced by the prostate gland and it contains chemicals and nutrients that nourish and transport the sperms and keep semen in a liquefied gel like form.
The sperms are made by the testicles when the stimulating hormones produced from the pituitary gland prompt the cells in the testes to mature into sperms by a process called spermatogenesis. Male hormones like testosterone and androgens are necessary for optimal sperm production and sexual function.

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Causes

Abnormal Sperm Production
Varicocele
A varicocele is a varicose vein in the scrotum that may prevent normal cooling of the testicle and raise testicular temperature, thus preventing sperms from surviving.

Undescended
Testicle

Undescended testicles can cause mild to severely impaired sperm production due to exposure to higher degree of internal body heat.
Testosterone Imbalance/Deficiency
Disorders of testosterone production by the testicles or an abnormality affecting the hypothalamus or pituitary glands in the brain that produce hormones to control testosterone production.
Klinefelter's Syndrome
In this disorder of the sex chromosomes, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production.
Infections
Repeated bouts of sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, are most often associated with low sperm count. These infections can cause scarring and block the passage of sperm through the ejaculatory duct. Mycoplasma is an organism that may fasten itself to sperm cells, making them less motile. If mumps, a viral infection usually affecting young children, occurs after puberty, inflammation of the testicles can impair sperm production. Inflammation of the prostate (prostatitis), urethra or epididymis also may alter sperm production and their motility.
Retrograde Ejaculation
This occurs when semen enters the bladder during orgasm rather than emerging out through the penis. Various conditions including diabetes, surgery bladder, prostate or urethra and the use of psychiatric or antihypertensive medications can cause this problem.
Blockage of Epididymis or Ejaculatory Ducts
Congenital blockage of the epididymis or ejaculatory ducts. Antibodies may be produced that target sperm and weaken or disable them. This usually occur after surgical blockage of part of the vas deferens for male sterilization (vasectomy).
General Health

Emotional
Stress.

Excessive or prolonged emotional stress can interfere with certain hormones needed for the production of healthy sperms. This problem can be self aggravating and can sometimes become long term and discouraging, producing more stress, affecting social relationships, sexual functioning and fertility.
Malnutrition.
Deficiencies in nutrients such as vitamin C, selenium, zinc and folate may contribute to low sperm count.
Obesity
Obesity and increased body mass may be associated with low sperm count and eventually lead to infertility.
Cancer
Treatment
Both radiation and chemotherapy treatments for cancer can impair sperm production. The closer radiation treatment is to the testicles, the higher the risk of this problem.
Alcohol &
Drug Abuse
Alcohol or drug dependency can be associated with general ill health and low sperm count. For example, anabolic steroids which are taken to stimulate muscle strength and growth, can cause the testicles to shrink and sperm production to decrease.
Other Medical Conditions.
A severe injury or major surgery can to the testicles or groin can affect sperm production. Certain diseases such diabetes, thyroid disease, HIV/AIDS, Cushing's syndrome, anemia, heart attack and liver or kidney failure, may be associated with low sperm production.
Age
A gradual decline in sperm production is common in men older than 35.
Environmental Factors

Pesticides
&
Chemicals

Herbicides and insecticides may be associated with reduced sperm production. Exposure to these chemicals may contribute to testicular cancer. Men exposed to hydrocarbons, such as ethylbenzene, benzene, toluene, xylene and aromatic solvents used in paint, varnishes, glues, metal de-greasers may be at risk of low sperm production.
Heat
Frequent use of saunas or hot tubs can elevate your core body temperature which may impair sperm production and lower the sperm count. High heat could also result from wearing too tight clothing or by frequent bike riding.
Substance Abuse
Cocaine or heavy marijuana use may temporarily reduce the number and quality of your sperm.
Tobacco Smoking.
Men who smoke may have a lower sperm count than those who do not smoke.

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Implications

The most serous implication of low sperm count is male infertility. Infertility has always been considered a woman's problem. It is now known that up to half of all cases of infertility involve problems with the male partner. Infertility in a man may be the sole reason that a couple can not conceive. This may simply add to the relationship difficulties in a couple.

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What You Can Do

A Protocol to Maintain Optimum and Healthy Sperm Count

Lifestyle
Changes

Avoid excessive cigarette smoking and use of other tobacco products.
Avoid excessive use of alcohol, or at least do not have more than two drinks/day.
Drugs like marijuana can decrease sperm count and motility and increase the number of abnormal sperm.
Avoid contact with potentially toxic chemicals and do not breathe toxic fumes or vapors. Follow label instructions when using pesticides, herbicides, paints, stains, varnishes, glues, organic solvents and heavy metals.
To produce a lot of healthy sperm, the testes must be cooler than normal body temperature. Avoid saunas, steam rooms, hot tubs, whirlpools, hot baths and wear comfortably fitting underclothing.
Ask your physician about prescription and over-the-counter medications that can slow or prevent the production of sperm. Chemotherapy, radiation therapy and uro-genital surgery may cause temporary or permanent low sperm count.
Diet
Increase consumption of foods containing essential fatty acids, such as wild (not farm-raised) salmon, mackerel, sardines, nuts, avocados and olives.
Use dairy products preferably from organic sources that do not use hormones, pesticides or herbicides.
Increase consumption of organically grown fruits and vegetables, especially cruciferous vegetables like broccoli, cauliflower and brussel sprouts.

Nutritional
Supplements

Vitamin C
250-500 mg daily
Vitamin E
400 to 800 I.U. daily
Zinc
30 -60 mg daily
Selenium
200 mcg daily
Arginine
2 - 4 gms daily
Vitamin B Complex
50 mg daily
Folic acid
400 mcg daily
Carnitine
500- 1000 mg three times daily
CoQ-10
30- 100 mg daily

Hormone
Replacement
Therapy

Pills
Andriol (testosterone undecanoate)
Injections
Depo-Testosterone® (brand of testosterone cypionate)
Delatestryl® (testosterone enanthate)
Skin Patches
Testoderm® (Scrotal Patch)
Androderm® (testosterone transdermal system)
Gel
AndroGel® 1% (testosterone gel)
Testim®
Buccal Gel
Striant® (testosterone buccal system gel)

A Physician Trained in Male Hormone Replacement Therapy should Monitor any Exogenous Hormone Administration

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For More Information

American Association of Clinical Endocrinologists

Canadian Health Network

Canadian Institute for Health Information

Aging and Seniors

JobOne - Canadian Centre for Occupational Health and Safety

Sympatico Health

Health Canada

ReproMed Ltd.

ISIS Regional Fertility Centre

Canadian Fertility and Andrology Society

Infertility Awareness Association of Canada

HealthWeb

Medscape

Golden Age Health Canada

LifeMD

Men's Health Canada

C Health

MEDLINEplus

Mayo Clinic

Healthfinder

The Cleveland Clinic Glickman Urological Institute

American Society for Reproductive Medicine

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Low Sperm Count