Difference Between Azoospermia And Oligospermia

by Dr. Firuza Parikh

Oligospermia and Azoospermia are medical conditions that can cause infertility in men. Oligospermia refers to having a significant measure of sperm seen in your semen; this amount is lesser than the actual numbers. On the other hand, Azoospermia refers to no sperm in your semen. A sperm count of or above 15 million sperm/ml is normal. But if your sperm count is less than 15 million sperm/ml, that is considered a low sperm count. In this blog, we have discussed the types, causes and treatments of these two conditions. Let’s uncover all the essential aspects of Oligospermia and Azoospermia.

Table of Content

Difference Between Azoospermia and Oligospermia
What is Oligospermia?
Types of Oligospermia
What are the Causes of Oligospermia?
Treatment of Oligospermia
What is Azoospermia?
Types of Azoospermia
What are the Causes of Azoospermia?
Treatment of Azoospermia

Difference Between Azoospermia and Oligospermia

What is Oligospermia?

Oligospermia is a condition where less number of sperm are seen in the semen. The count of the sperm is reported in million/ml. Usually, the WHO Manual is the reference guideline for reporting sperm count. The sperm concentration is the total number of sperm in the entire volume of the ejaculated sperm. As per the WHO manual 5th Edition, Oligospermia is defined as a count of less than 15 million per ml of semen and a concentration of sperm less than 39 million in the whole ejaculate.

Types of Oligospermia

There are three types of Oligospermia

Mild oligozoospermia: This condition is defined as having a sperm count between 10 to 15 million sperm/ml.
Moderate Oligozoospermia: A sperm count between 5 to 10 million sperm/ml is considered moderate oligozoospermia.
Severe Oligozoospermia: It is considered as a serious oligospermia with sperm counts between 0 to 5 million sperm/ml.

What are the Causes of Oligospermia?

Here are several reasons behind the Oligospermia condition in men.

Oligospermia can be genetic
Presence of varicocele
Metabolic conditions such as diabetes
Regular use of medicines for High Blood Pressure
Intake of psychiatric medication
Smoking
Partial blockage in the duct
TB infection
Chemotherapy & Radiation
Higher & lower FSH & LH hormones

Treatment of Oligospermia

Hormonal Therapy: Doctors may prescribe hormone therapy if a hormonal imbalance causes this medical condition.
Medication: There are various medications that may be prescribed to stimulate the production of sperm. It includes clomiphene citrate and hCG ( human chorionic gonadotropin).
Surgery: Surgery may also be required to treat this medical condition. Surgery can be performed to remove blockages in the reproductive system to repair the varicocele.
Lifestyle Changes: Quitting smoking, reducing alcohol consumption, maintaining a healthy weight and reducing stress levels and intake of omega-3 can also help with this condition.

It’s vital to know that treating Oligospermia can take some time, and it can take a few months for sperm production. Young boys with Klinefelter’s syndrome have very low counts. In such a situation, fertility preservation by freezing sperm should be carried out. Men with declining sperm counts are advised to freeze multiple semen samples for later use.

What is Azoospermia?

Azoospermia refers to the complete absence of sperm in the semen. This medical condition refers to a total lack of sperm in men’s semen. It is a severe condition that affects about 1% of all men and can be caused by multiple factors. This condition can be detected through a sperm count test. In this test sample of semen is collected, and experts perform a microscopic test to determine the presence or absence of sperm.

Types of Azoospermia

There are two major types of Azoospermia.

Obstructive Azoospermia: Obstructive Azoospermia refers to the men’s reproductive tract blockage. Azoospermia diagnosis entails a semen analysis whereby a sample of semen is procured and microscopically examined to establish the presence or absence of spermatozoa.
Non-obstructive Azoospermia: The absence of sperm due to the absence of sperm production is called non-obstructive azoospermia. Various factors, such as genetic conditions like Y chromosome Microdeletions, SRY mutations, mumps infection in childhood and hormonal conditions with either too little FSH and LH or too much FSH and LH in the body, are responsible for this condition in men.

What are These? Why is the Distinction Important?

Obstructive and Non-obstructive Azoospermia are two definite types of Azoospermia. These have different underlying causes, diagnostic approaches, and treatment options. The distinction between these two types of Azoospermia is essential because it helps identify the underlying cause of infertility, guide treatment decisions, and predict the success rates of multiple treatment options.

What are the Causes of Azoospermia?

Cause of Obstructive Azoospermia

This condition may be caused by a blockage in the male reproductive tract, which can occur due to multiple reasons such as congenital abnormalities.
It may occur due to infections such as epididymitis or prostatitis.
Trauma and any kind of injury in the reproductive tract can also cause Obstructive Azoospermia.
Several medical conditions such as cystic fibrosis can also lead to this medical condition.

Cause of Non- Obstructive Azoospermia

Genetic disorders such as Klinefelter syndrome or Y chromosome deletions can cause Non-obstructive azoospermia.
Hormonal imbalances can also lead to this medical condition.
Environmental factors, such as exposure to toxins or radiation, can also affect sperm production.
Several medications, such as chemotherapy or testosterone replacement therapy, can also lead to this health issue.

Treatment of Azoospermia

Treatment of this medical condition entirely depends on the type of Azoospermia. Some possible treatments for obstructive and non-obstructive Azoospermia are mentioned below:

Hormonal Therapy: This treatment is helpful in some cases of non-obstructive Azoospermia. Hormonal therapy can be useful in stimulating sperm production.
Surgery: Surgical procedure can be performed to remove the blockage in case of obstructive Azoospermia. In the absence of Vas Deferens and the absence of the ejaculatory ducts, a procedure called PESA or TESA can be performed. TESA, microTESE and the use of assisted reproductive technology such as ICSI best treat non-obstructive Azoospermia. MicroTESE stands for microscopic testicular sperm extraction.
Donor Sperm: In some conditions, if there is no sperm or production, then the couple may be advised to consider donor sperm.
Lifestyle Changes: Reducing alcohol consumption, quitting smoking, maintaining a healthy weight, consumption of a healthy diet, including omega 3, can be helpful in these two conditions.

What is PESA and TESA?

PESA refers to Per cutaneous Epididymal Sperm Aspiration, and TESA refers to Testicular Sperm Aspiration. Both are surgical procedures that can be used to fetch sperm. PESA involves inserting a needle directly into the epididymis to fetch sperm. TESA consists in removing a small piece of testicular tissue with a needle or biopsy forceps, which is then examined under a microscope to identify sperm.