What Are The Common Causes Of Low Sperm Count?
There are several causes for male infertility, which are not all explained yet (unexplained infertility). Common causes are of structural or physical origin, including varicoceles, obstructions or undescended testes. A varicocele is a swelling of veins on the scrotum, potentially causing swelling or aching in the testicles. Undescended testes occur when a testicle does not move into the scrotum before birth and remains in the abdomen or inguinal canal (the canal between the abdomen and scrotum). Other structural abnormalities can be of acquired or of congenital/genetic origin, with various genetic conditions affecting male fertility, i.e. Cystic Fibrosis, Klinefelter syndrome. As such, patients with Cystic Fibrosis may have a bilateral absence of the vas deferens, the tube carrying sperm from the epididymis to the seminal vesicles. This would present as a translucent, azoospermic (no sperm in the ejaculate) sample, with no fructose detected – Fructose is the main energy source for sperm and is produced by the seminal vesicles. However, the bilateral absence of the vas deferens is not exclusive to Cystic Fibrosis but other disorders also. A genetic condition commonly present in patients with severely low concentrations or no sperm is a Y-chromosome deletion in the AZF region. This section of the chromosome carries the genes encoding for sperm development and production.
Hormone imbalances can also cause male infertility, which can arise due to hormone supplementation, physical changes and lifestyle factors. In women, imbalances may impair ovulation and the luteal phase, which is essential for preparing the endometrium (uterine lining) for implantation. One common condition in women is Polycystic Ovary Syndrome, causing irregular menstruation and ovulation, as well as a larger appearance of ovaries with an excessive number of follicles. In men it may affect sexual function and semen parameters including sperm concentration. Cause of this may include issues in the hormone producing glands: hypothalamus/pituitary gland, thyroid or testicles.
Does Smoking Affect Male Fertility?
Lifestyle factors are a significant contributor during the fertility journey – smoking, alcohol- or drug consumption have all shown to negatively affect semen parameters. All these habits increase the presence of reactive oxygen species in the seminal plasma and induce DNA fragmentation, a condition that in high levels may impair fertilisation and exacerbates maintaining a pregnancy. DNA fragmentation indicates breakage in the DNA strands of sperm and may affect other parameters including motility and morphology. Apart from these lifestyle choices, poor diet with lots of greasy, processed food and little exercise has shown to have similar negative effects on fertility.
On the contrary, a healthy, balanced diet and exercise can improve sperm quality. With an active, balanced lifestyle comes a reduction in stress, which can also be a contributing factor in reduced fertility.
How Does Stress Impact Sperm Quality?
Stress can cause a hormone imbalance which in turn affect fertility as stated above.
Infection and inflammation in the body may also cause poor semen parameters: With inflammatory processes occurring in the body and potentially causing a fever, spermatogenesis may be reduced or impaired due to increased temperature. With sperm production requiring a specific temperature range, increased heat can affect this biological process. As such, increased white blood cells can be noted in the semen sample along with low sperm concentrations, poor motility and morphology. Similarly, an imbalanced microbiome (dysbiosis) may not provide necessary immune responses and can lead to hormone imbalances and inflammation.
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