Abnormal Semen Parameter – Cause & Treatment

Abnormal Semen Parameter – One of the most common finding for any patient who gets a semen analysis done. But, is the report of abnormal parameter worth worrying always ? Let’d find out.

What is a normal semen report?

Your semen test results may vary depending on your age, health history, and other factors like abstinence maintained before the semen analysis test. Your test results may also be different depending on the lab parameters which is processing your sample. But some internationally acceptable parameter cut offs have been designated by the WHO (World Health Organization) to help in the assessment of semen report.
The normal ranges/ cut offs for common semen parameters, according to the World Health Organization, are:

• Volume: Greater than 1.3 milliliters (mL)
• pH: 7.2 to 7.8
• Sperm count: 35 million sperm per ejaculate
• Total motility (sperms showing movement) – 50%
• Sperm progressive motility, or the ability to move rapidly in forward direction: Greater than 35% actively moving
• Sperm morphology showing normal shape and size: Atleast 14% normally shaped

What is abnormal semen report?

Any semen report which shows the results less than the lower level of cut off for normalcy or does not show the required number of sperms in any particular said parameter in the normal range is considered an abnormal semen report.
Based on the particular parameter affected and the severity of abnormality your fertility specialist will advise treatment accordingly.

What is the cause of low sperm count?

There can be many reasons of getting low sperm count on your semen report, some common reasons are:

• A hormone imbalance due to hypogonadism: in many men the hormones essential for proper functioning of testes which eventually produce sperms are not produced in the adequate amount. Thus, the testes don’t produce the sperms in sufficient quantity and it can lead to a low sperm count.
• A genetic problem such as Klinefelter syndrome: In some men, there is a genetic condition which in which the chromosomes are not correct in number and type, i.e. instead of 46XY, the man has 47XXY karyotype, which eventually leads to many physical abnormalities including reduced or absent sperms.
• Having had undescended testicles in childhood: When the testes are not located in their natural location i.e. scrotal pouch in a boy, it can also impact sperm production when the child grows up and later as a man may face infertility. It is important to get timely surgical correction in the childhood, preferably in the early years of life to ensure such problems don’t arise when the boy grows up. Still a certain number of boys even after getting surgical correction fail to produce sperms in adulthood.
• Structural problems in the tubes– there are many conditions which can affect the tubes which transfer sperm out of the testis. Following causes are common causes of tubal blockage –
  1. Injury to the tubes due to trauma: leading to healing with scarring, causing blockage, common causes could be genital trauma doe to any cause.
  2. Infections of the genital tract causing tubal scarring and later blockage.
  3. Congenital absence of vas deference – it is a condition where tubes of one or both sides are absent by birth.
• A genital infection: such as chlamydia, gonorrhea or prostatitis (infection of the prostate gland), can impair the functioning of testes and eventually effect sperm production.
• Varicoceles (enlarged veins in the testicles): Sometimes the blood vessels surrounding testis can become dilated and that can impact sperm production by the testes.
• Any surgery done on the testicles or any hernia repair surgery done previously: these can sometimes injure the delicate blood vessels or the nerves supplying the testes and can impact sperm production by the testes.
• Overheated Testicles: For normal functioning of testes, it is important that the right temperature is present in the genital area of the body. High temperature around the testes will impair the sperm production. Wearing tight undergarments and working in high temperature environment can have that effect, and is not favorable for sperm production.
• Excessive alcohol consumption: alcohol is toxic for sperm production in high amounts, and it is advised to limit or if possible, stop alcohol consumption if facing infertility due to sperm abnormalities.
• Smoking: it is also harmful as smoke contains many chemicals which are toxic to sperms and hence it is important that smoking is stopped or at least limited by anyone who is trying to improve the semen parameters.
• Recreational drugs such as marijuana or cocaine and others: these substances contain many toxic chemicals and are responsible for impairing sperm production. Hence all such substance use should be stopped if a man is facing infertility due to abnormal semen.
• Certain prescription medications: cancer medications (chemotherapy), some antibiotics, some antidepressants and drugs for other psychiatric conditions can be harmful for sperm production. If at all you are being prescribed any of the possible medications, ensure that you get them checked by your fertility doctor and they might suggest to change them to safer drugs.
• Testosterone replacement therapy: If you are using testosterone by self or on prescription for any reason, ensure that you mention that to your fertility doctor, because that can impact your sperm production.
• Anabolic steroid use: Men who are enthusiastic about building body might sometimes use anabolic steroids to enhance their gym performance or get the right muscle mass they desire, but there is a very well-known side effect of these supplements on sperm count and quality being reduced. Hence it is advisable to be open and honest about using such substance with your infertility specialist.
• Being overweight or obese: It has been a topic of the recent research worldwide and it is becoming more and more evident that apart from other health risks, obesity is harmful for men who are planning family. Having a BMI above 29 is known to impair fertility in men. Mostly because it affects sperm quality as well as sexual performance in men.
• Testicular cancer: sperm production is affected in any man who has been diagnosed with cancer of the testes. If you have been diagnosed with such a condition or even any other cancer in the body, it is important that you consult with an infertility specialist because certain treatments for cancer like chemotherapy, radiotherapy and even if going for a surgery on the testis can impair the normal sperm production. Your fertility doctor can advise you about options like semen cryopreservation so that you can enjoy parenthood even if your testicular function gets effected.
• Stressful lifestyle: a very common yet underrated cause of semen abnormality is emotional stress, or even living a hectic lifestyle. The stress hormones produced in the body as a reaction to such an environment is the reason that semen parameters are also affected. It is advised by fertility specialists, that trying to live a stress-free life is essential in improving the semen quality. Practicing yoga, meditation and mindfulness can help in achieving this goal.