Reduced sperm count: the causes

Sperm production is a rather complex mechanism and requires the correct functioning of organs (testes) and glands (hypothalamus and pituitary gland), and correct hormone production.

A single problem with one of these “gears” is enough for the production of sperm to be compromised with a decrease in the man’s fertility or there may be problems with the morphology (shape) or motility of the spermatozoa.

It is not always possible to trace the reason for the low sperm count. The currently known causes are mainly divided into medical and environmental.

Among the medical causes we find:

• Varicocele : This is a   swelling of the veins that drain the testicle. It is a common cause of male infertility. This could prevent the testicle from cooling normally, resulting in fewer sperm counts and fewer sperms moving around.
• Infections . Some infections can interfere with sperm production and sperm health, or they can cause scarring that blocks the passage of sperm. These include some sexually transmitted diseases, such as chlamydia and gonorrhea, inflammation of the prostate gland (prostatitis); mumps orchitis ,and other infections of the urinary tract or reproductive organs.
• Ejaculation problems . A retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging from the tip of the penis. Several health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, and surgery of the bladder, prostate, or urethra. Some medications can also cause retrograde ejaculation. These include blood pressure medications (known as alpha-blockers).
• Antibodies that attack sperm . Anti-sperm antibodies are cells of the immune system that mistakenly identify sperm as a foreign and harmful factor and attempt to destroy it. This is especially common in men who have had a vasectomy.
• Tumors . Cancers that are not malignant may affect the male reproductive organs directly, or they may affect the glands that release hormones related to reproduction (such as the pituitary gland). Surgery, radiotherapy or chemotherapy to treat cancer can also affect male fertility.
• Undescended testicles. During fetal development one or both testicles fail to descend into the scrotum. In this case there is a decrease in fertility.
• Hormonal imbalances . The hypothalamus, pituitary gland and testicles produce hormones which are required for the formation of sperm. Alterations in these hormones can compromise sperm production.
• Defects in the spermatic duct . The tubes that carry the sperms can be damaged by illness or injury.
• Chromosomal Defects . Some chromosomal defects can cause abnormal development of the male reproductive organs. as in the case of Kleinefelter syndrome. Other genetic syndromes associated with infertility include cystic fibrosis, Kallmann syndrome, Young syndrome, and Kartagener syndrome.
• Celiac disease . Celiac disease can cause male infertility.
• Some drugs . Testosterone replacement therapy, long-term anabolic steroid use, cancer drugs (chemotherapy), some antifungal drugs, some ulcer drugs, and some other drugs can impair sperm production and decrease male fertility.

There are certain environmental conditions and lifestyles that can affect male fertility. let’s see which ones:

• Industrial chemicals i. Prolonged exposure to benzene, toluene, xylene, herbicides, pesticides, organic solvents, paint materials and lead can help reduce your sperm count.
• Exposure to heavy metals . Exposure to lead or other heavy metals can cause infertility.
• Radiation or X-rays . Radiation exposure can reduce sperm production. It can take several years for sperm production to return to normal. Furthermore, with high doses of radiation, sperm production can be permanently reduced.
• Testicular overheating . Frequent use of saunas and hot tubs can temporarily reduce your sperm count. Sitting for long periods, wearing tight clothing, or holding a laptop on your lap for extended periods of time can raise the temperature of your testicles and reduce sperm production.
• Extended cycling . Being on the bike for a long time could reduce fertility as it causes overheating of the testicles.

Other causes that we have already talked about in Fertile Period concern the use of drugs, cocaine, marijuana which can temporarily reduce the number and quality of sperm. Alcohol lowers the level of testosterone in the blood and consequently decreases the production of sperm.

Smokers also typically have lower sperm counts than non-smokers.

Extreme emotional stress, including the stress of not being able to conceive a child, can interfere with some hormones needed for sperm production.

Excessive weight, obesity, can also cause infertility because being overweight can cause hormonal changes that reduce fertility.

Finally, pay attention to how to do the spermiogram.

An abnormal result of this test may be due to a sperm sample taken at the wrong time, perhaps after an illness or stressful event. Therefore, for a precise diagnosis, more samples taken in a precise time interval are needed.

Always ask the doctor prescribing the exam or the center that follows you, about the correct methods for collecting, storing and transporting the sample to the laboratory where the exam will be performed, to avoid unnecessary fears and worries.