Ask An Expert: Oligospermia

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Ask An Expert: Oligospermia

Question:

I suffer from oligospermia. Are there tests available to determine where exactly the problem is, e.g., the testes, epididymis or blood/testes barrier? I've already had a semen analysis, anatomical evaluation and hormone tests.

Answer:

Normal sperm production requires the close cooperation of several hormones. Luteinizing hormone (LH) is produced in the pituitary gland, then travels in the blood to the testicles. LH stimulates the production of testosterone, which teams up with a second pituitary hormone, follicle stimulating hormone (FSH), to stimulate sperm production.

Sperm cells take about 72 days to mature in the testicles. Next, they slowly make their way through a series of ducts and tubules, where they are stored until ejaculation occurs.

Fertility requires a normal number of sperm, but it also requires healthy sperm. The World Health Organization has established criteria for normal semen:

Your problem appears to be a low sperm count. The first thing to do is to eliminate any toxin, substance abuse, medication or supplement that may impair sperm production or function. The list includes alcohol, nicotine, pesticides, cocaine, and sometimes even medications such as cimetidine and nitrofurantoin.

Tests that may reveal a cause include measurements of four hormones: FSH, LH, testosterone and prolactin. In addition, fertility specialists may request ultrasound tests to image the scrotum and prostate. If the sperm delivery system appears blocked, an imaging test called vasography may be done. Finally, in a few cases testicular biopsies may be needed.

Testing is complex, and it can be arduous and frustrating. But since advanced assisted reproductive techniques can help, a thorough evaluation is worth the time and effort.

Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of Harvard Men's Health Watch (www.health.harvard.edu) and the author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan. Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.

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Last updated:	January 24, 2007