You need sperm to conceive — that much is obvious. When you begin to undergo tests for fertility problems, one thing that is easily done is to test the man for problems in sperm production. A problem with the production of his sperm can have a devastating effect on your ability to conceive. There are new advances making it possible for people with sperm production issues more capable of conceiving than ever before.
Oligospermia and Azoospermia
Oligospermia is the production of too little sperm. Clinically, oligospermia is defined as less than 20 million sperm per milliliter of semen. It is also possible that there is no sperm in the semen. Only a test of the semen can determine this diagnosis. Azoospermia, a condition in which the man produces no sperm, is fairly uncommon.
However, men with no sperm are completely sterile without medical intervention. There are two categories of azoospermia: obstructive and nonobstructive. The nonobstructive azoospermia can be caused by many factors in your partner's life including genetic issues, testicular injury, and congenital anomalies.
Testing the sperm of your partner is one of the easiest fertility tests that can be done. It is usually checked before testing is done on the female partner because of the ease, lack of invasiveness, and the lowered cost. Your doctors will look at several factors including the number of sperm present, the shape of that sperm, and how the sperm moves.
The most common cause of lowered sperm counts is Klinefelter's syndrome — a genetic problem in which the man has an additional X chromosome (XXY instead of XY). This results in little or no sperm production because of the abnormal development of his testicles. He may also suffer from a decreased level of testosterone.
Another potential source of problems with male fertility is a situation in which the man's Y chromosome is missing some genetic material, called Y micro-deletions, affecting his ability to produce sperm.
To solve a problem with a sperm count that is too low, doctors can perform a testicular procedure to retrieve some sperm. This sperm can then be used for other procedures, such as intracytoplasmic sperm injection (ICSI), in which the sperm is injected directly into the egg just before an in vitro procedure.
Other potential difficulties with sperm production can be due to other genetic problems such as the XX Male Syndrome, Kallmann's Syndrome, and Prader-Willi Syndrome. Your partner may be tested for these and other problems during the testing phase of your fertility treatments.
Abnormal Shape and Poor Motility
The shape of a normal sperm is a long tail with an oval-shaped head. These features of the shape of sperm help the sperm reach the egg and eventually penetrate the egg. A deformity of any kind in the shape of the sperm can affect the quality of movement and the ability of the sperm to penetrate the egg.
If there are problems with the sperm like this it is said to be low-quality sperm. This can be a greater problem than low numbers of sperm. If the sperm that is present is low in quality it can prevent other treatments from being used. However, advances in the treatment of male factor infertility are growing and becoming more widely available.
If the sperm has difficulty is getting to the egg this can also present problems to the couple trying to conceive. The movement of the sperm is called its “motility.” The tail of the sperm moves and thrashes in a spiral-like motion to go forward and move toward the egg. Motility is said to be impaired if the sperm is unable to move through the cervical fluid, or if the sperm has problems with its ability to swim. This can be the result of a defective sperm or the result of a shape that is abnormal.