Sperm Abnormalities, The Cause of Male Infertility

Many married couples complain about how difficult it is to get pregnant and have babies, but it turns out that they haven’t had sexual intercourse regularly in the right frequency. Some do it once a week, some others even do it daily, while actually it is better to have sexual intercourse once every two days. Why so?

Pregnancy happens when the female ovum cell meets a healthy sperm. The sperm needs 2-7 days to mature in the male reproduction organ. Meanwhile, women only have one day of fertile period in their menstrual cycle. Hence, it is imperative to find the right time for sexual intercourse that will end up in pregnancy.

When the semen is spilled outside the cervix after the sexual intercourse, the sperm has to enter the womb with the strength of its tail, since the cervix has a thick cervical mucus. Sperms that manage to enter the cervix are only those with normal shape that moves forward.

The sperm that manages to enter past the cervical mucus will fertilize the ovum cell inside the fallopian tube.

The wall of the ovum cell is thick and layered, so it needs to be softened by many sperm cells. One of the factors that contribute in softening the walls is the hyaluronidase enzyme found in the head of the spem.

Therefore, if the number of sperm cells attached to the ovum cell are less than 200.000, the ovum cell will be difficult to fertilize because it is more difficult to penetrate the wall. Despite the numeous cells present, only one sperm cell will succeed in fertilizing one ovum cell.

Diagnosis of Sperm Abnormalities

One of the factors in causing the failure of pregnancy is sperm abnormality, which can be identified through the result of sperm analysis in the laboratory. What needs to be considered in assessing the sperm analysis’ result are the shape, movement, and sperm counts.

Other than that, WHO also recommends to check the shape of the head, neck, and tail of the sperm to yield better analysis result.

If the result of the sperm anaylis is deemed abnormal, then it is advised to do a re-examination at least once. However, if the result is still the same, then another examination can be carried out with no more than 3 weeks of interval from the first analysis.

Prior to doing the analysis, it is important that the couple refrains from having sexual intercourse for 2-7 days.

Types of Sperm Abnormalities

There are several types of sperm abnormalities as observed in its size, shape, and numbers, such as:

1. Agglutination

Agglutination occurs when there is an adhesion between sperm (clumping of sperms) when it enters the female reproduction organ. Supposedly, the sperm enters the female reproductive organ independently, and move individually. When they are stuck together, the sperm cannot enter the uterus.

2. Hematospermia

Hematospermia is a condition when there is blood contained in the semen ejaculation.

3. Leukospermia 

Leukospermia is an abnormality of the leucocytes presence more than 1 million per millimeter in the semen.

4. Oligospermia

Oligospermia occurs when the sperm count is fewer than 15 million per millimeter, or less than 39 million per ejaculation. If the sperm count is less than 5 million but more than 500 thousand, then the condition is called extreme or severe oligospermia. Meanwhile, if it’s fewer than 500 thousand, it’s called cryptospermia. 

5. Azoospermia 

There are no sperm cells at all during ejaculation.

6. Asthenospermia

A condition in which the sperm that moves forward are less than 32% when entering the female reproduction organ.

7. Teratozoospermia

When the normal shaped sperm are less than 4%, from head, middle section, to the tail.

8. Oligoteratoasthenozoospermia

A condition in which the sperm count, movement, and shape are abnormal.

Only hematospermia can be observed macroscopically. Other sperm abnormalities can only be observed and indentified through sperm analysis in the laboratory.

There are various ways to increase sperm quality and treat sperm abnormalities.

One of them is by modifying a healthier lifestyle, with proper and measurable exercise, and consuming nutritious and balanced foods.

Healthy lifestyle can also improve the quality of life, which will lead to healthier and stronger body, so that it will lead to positive impact on sperm quality.

Reference:

1. Mayo Clinic. Male Infertility: Symptoms and Causes. (https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773). Diakses pada 2 Maret 2024.
2. National Center for Biotechnology Information. Male Infertility. (https://www.ncbi.nlm.nih.gov/books/NBK562258/). Diakses pada 2 Maret 2024.
3. National Center for Biotechnology Information. Genetic Causes of Qualitative Sperm Defects: A Narrative Review of Male Factor Infertility. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11120687/). Diakses pada 2 Maret 2024.
4. National Center for Biotechnology Information. Sperm Morphology: Evaluating Its Clinical Relevance in Male Infertility. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194684/). Diakses pada 2 Maret 2024.
5. National Center for Biotechnology Information. Isolated Teratozoospermia: Revisiting Its Relevance in Male Infertility. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932644/). Diakses pada 2 Maret 2024.
6. National Center for Biotechnology Information. Some of the Factors Involved in Male Infertility: A Prospective Review. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008178/). Diakses pada 2 Maret 2024.