Knowledge | Male Infertility: Facing the Challenge of a Low Sperm Count
Male Infertility: A Difficult Reality
On April 3, 2000, in Atlanta, Tom, a pseudonym, accompanied his wife to a gynecologist's office to provide a semen sample. The awkward situation brought mixed feelings of helplessness and humor. Although infertility is difficult for any family, Tom found that humor sometimes helped relieve stress.
Shared Responsibility and Challenges
Many male infertility tests take place in a gynecologist's office. Male factors account for 40% of infertility cases, female factors for 40%, and combined factors for the remaining 20%. Women often seek care first and, when they are not the source of the problem, ask their husbands to attend.
Experts estimate that about one million men seek specialist infertility care each year. Many are shocked to learn they may contribute to their partner's difficulty conceiving. “Men usually arrive embarrassed, afraid, and in disbelief,” said Dr. Larry Lipshultz, clinical director of the Laboratory for Male Reproductive Research and Testing in Houston. “They cannot understand how something could be wrong when they feel completely healthy.”
Common Causes and Challenges
Dr. Eldon Schriock of the Pacific Fertility Center in San Francisco said men are often in denial. They may think they caused harm through excessive exercise or football, but struggle to accept an internal problem beyond their control.
Even under ideal conditions, conception is not highly likely. Each ejaculation contains about 100 million to 300 million sperm, of which only about 15%—15 million to 45 million—are healthy enough to fertilize an egg. Even with 300 million sperm, only about 40 may survive the vaginal environment and reach the egg. Conception falls sharply with a low count. More than 90% of male infertility is associated with low sperm count, poor sperm quality, or both.
Low Sperm Count: Standards and Assessment
A count below 20 million to 40 million was considered infertile. Even with a normal count, at least 60% of sperm were expected to have normal morphology, with an oval head and long tail. Round, pointed, or curved heads indicate abnormal development and can hinder movement to the egg. Dr. Schriock emphasized that sperm must swim quickly and straight through the cell layer surrounding the egg.
Tom's Diagnosis and Treatment
Tom's count was only 10 million, placing him statistically in the infertile range, and microscopy showed many abnormal sperm. Although he appeared healthy, sperm production was severely impaired.
He was diagnosed with varicocele, a common cause of poor sperm quality. Dr. Lipshultz explained that inflamed testicular veins allow blood to flow back and raise testicular temperature, damaging sperm cells. Sperm thrive several degrees below body temperature, one reason the testes are located in the scrotum. Men trying to conceive are often advised to avoid hot tubs, smoking, and alcohol because nicotine, alcohol, and overheating can harm sperm.
Varicocele Surgery and Recovery
Damaged veins can be surgically ligated in an outpatient procedure under anesthesia. Sperm count and quality improve in about 70% of patients, and 40% later become fathers.
Tom was among that 40%. After the challenges and embarrassment of testing and surgery, he and his wife welcomed a healthy 6-pound, 2-ounce baby girl.
Knowledge | Male Infertility: Facing the Challenge of a Low Sperm Count
Knowledge | Male Infertility: Facing the Challenge of a Low Sperm Count
Male Infertility: A Difficult Reality
On April 3, 2000, in Atlanta, Tom, a pseudonym, accompanied his wife to a gynecologist's office to provide a semen sample. The awkward situation brought mixed feelings of helplessness and humor. Although infertility is difficult for any family, Tom found that humor sometimes helped relieve stress.
Shared Responsibility and Challenges
Many male infertility tests take place in a gynecologist's office. Male factors account for 40% of infertility cases, female factors for 40%, and combined factors for the remaining 20%. Women often seek care first and, when they are not the source of the problem, ask their husbands to attend.
Experts estimate that about one million men seek specialist infertility care each year. Many are shocked to learn they may contribute to their partner's difficulty conceiving. “Men usually arrive embarrassed, afraid, and in disbelief,” said Dr. Larry Lipshultz, clinical director of the Laboratory for Male Reproductive Research and Testing in Houston. “They cannot understand how something could be wrong when they feel completely healthy.”
Common Causes and Challenges
Dr. Eldon Schriock of the Pacific Fertility Center in San Francisco said men are often in denial. They may think they caused harm through excessive exercise or football, but struggle to accept an internal problem beyond their control.
Even under ideal conditions, conception is not highly likely. Each ejaculation contains about 100 million to 300 million sperm, of which only about 15%—15 million to 45 million—are healthy enough to fertilize an egg. Even with 300 million sperm, only about 40 may survive the vaginal environment and reach the egg. Conception falls sharply with a low count. More than 90% of male infertility is associated with low sperm count, poor sperm quality, or both.
Low Sperm Count: Standards and Assessment
A count below 20 million to 40 million was considered infertile. Even with a normal count, at least 60% of sperm were expected to have normal morphology, with an oval head and long tail. Round, pointed, or curved heads indicate abnormal development and can hinder movement to the egg. Dr. Schriock emphasized that sperm must swim quickly and straight through the cell layer surrounding the egg.
Tom's Diagnosis and Treatment
Tom's count was only 10 million, placing him statistically in the infertile range, and microscopy showed many abnormal sperm. Although he appeared healthy, sperm production was severely impaired.
He was diagnosed with varicocele, a common cause of poor sperm quality. Dr. Lipshultz explained that inflamed testicular veins allow blood to flow back and raise testicular temperature, damaging sperm cells. Sperm thrive several degrees below body temperature, one reason the testes are located in the scrotum. Men trying to conceive are often advised to avoid hot tubs, smoking, and alcohol because nicotine, alcohol, and overheating can harm sperm.
Varicocele Surgery and Recovery
Damaged veins can be surgically ligated in an outpatient procedure under anesthesia. Sperm count and quality improve in about 70% of patients, and 40% later become fathers.
Tom was among that 40%. After the challenges and embarrassment of testing and surgery, he and his wife welcomed a healthy 6-pound, 2-ounce baby girl.
Story source:
Collected online