Low sperm count is diagnosed when the sperm count is less than 15 million sperm per milliliter of semen. The treatment depends on the cause of low sperm count. There are many known causes for low sperm count and if all of these known causes are tested and are negative, then the cause for the low sperm count comes into the category of idiopathic cause for low sperm count.
How Do You Treat Low Sperm Count?
There are different treatment methods for low sperm count. It can be broadly divided into:
- Non-surgical treatment
- Surgical treatment
Some of the causes of low sperm count are treatable and some are not, if fertility is not achieved from non-surgical or surgical treatment methods, then the couple and go for assisted reproductive techniques to become fertile.
Non-Surgical Treatment For Low Sperm Count
Hormonal And Medication Treatment: If low sperm count is caused due to a deficiency in a hormone, the necessary hormone can be replaced with hormonal therapy. If it’s due to excess hormone, medications can be given to reduce the levels of the hormone. E.g.:
Kallmann Syndrome – a genetic condition, less secretion of GnRH from the hypothalamus. Can be treated with GnRH replacement therapy.
Hyperprolactinemia – there is increased levels of prolactin hormone due to increased production by the pituitary gland due to certain drugs or a tumor. Drugs causing hyperprolactinemia should be stopped and medications can be given to bring the prolactin to normal level.
Treatment of Genital Tract Infections: Sometimes genital tract infections can cause low sperm count, if so the infection should be treated with the appropriate antibiotics. However, this will not always make the sperm count normal.
Steriod Therapy: Anti-sperm antibodies are immune cells which destroy the sperms thinking sperms are foreign cells/invaders. A good amount of healthy sperms reduce with this. Oral steroids are given to treat low sperm count, but this does not work most of the time. These patients have the option of in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).
Treatment of Retrograde Ejaculation: In retrograde ejaculation the semen flows back without going out of the penis. There are many causes such as: bladder or prostate surgery, spinal cord injury, medications like anti-depressants, anti-hypertensives, medications used to treat prostate enlargement; diabetes. Pseudoephedrine is a drug given for retrograde ejaculation due to surgery or diabetes, it is a decongestant. If the cause is medications when those medications are stopped ejaculation will occur normally. Nerve and muscle damages cannot be treated and these patients can go for assisted reproductive techniques.
Surgical Treatment For Low Sperm Count
Microsurgical Vasovasotomy: This procedure is done to reverse the vasectomy by using microsurgery to join the 2 ends of the vas deferens in each testicle and treat low sperm count.
Treatment Of Varicocele: Varicocelectomy is the procedure done to treat varicocele, this is an outpatient procedure. Treating the enlarged veins can help sperm production and maturation and treat low sperm count.
Vasoepididymostomy: Vasoepididymostomy is the microsurgical treatment for epididymal blocks; it combines the upper end of vas deferens to the epididymis.
Transurethral Resection Of The Ejaculatory Duct: Surgically by using a cystoscope ejaculatory duct blocks can be treated by making small incisions in the ejaculatory duct. Most men will improve the sperm count by this procedure.
Pituitary Tumors: Pituitary tumors can be surgically removed and this will bring the hormonal balance in the body.
Low sperm count is diagnosed when the sperm count is less than 15 million perms per milliliter of semen. The treatment depends on the cause of low sperm count. We can divide the treatment into non-surgical and surgical treatment methods. Non-surgical treatment methods include: hormonal and medication treatment for deficient or excess hormones, antibiotics for genital tract infections, and retrograde ejaculation: pseudoephedrine if the cause is surgery or diabetes, if it is due to medication those should be stopped.
Surgical treatment for low sperm count include: microsurgical vasovasotomy to reverse vasectomy, varicocelectomy to treat varicoceles, vasoepididymostomy for epididymal blocks, transurethral resection of the ejaculatory duct blocks and surgical removal of pituitary tumors to achieve normal hormonal status, if fertility is not achieved from non-surgical or surgical treatment methods, then the couple and go for assisted reproductive techniques to become fertile.
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