Oligospermia refers to semen with a low concentration of sperm (‘sperm count’). A low sperm count can be due to many different causes, and this condition may be temporary or permanent. a low sperm count would be defined as less than 20 million sperm per ml of semen.
Azoospermia is defined as the absence of spermatozoa in the ejaculation.
Primary causes of temporarily reduced sperm counts are:
Abnormalities on examination of the external genitalia and prostate are to be considered during physical examination. Abnormalities that need to be looked for are Klinefelter’s syndrome, epididymitis, testicular atrophy, urethritis, and prostatitis.
The general endocrine examination is to be done which may reveal hypothyroidism, hyperthyroidism, or hypopituitarism. The stress and marital difficulties are to be assessed as they may lead to addiction of drugs, alcoholism etc.
Routine laboratory tests include a CBC, urinalysis, chemistry panel, thyroid profile, VDRL test, and sperm count. If there is a urethral discharge, a smear and culture should be done. If the sperm count reveals Oligospermia on two separate specimens, referral should be made to urologist or endocrinologist for further evaluation.
The primary symptom of Oligospermia is sub-fertility or infertility. Other symptoms vary depending on the underlying cause of Oligospermia e.g. in sexually transmitted diseases symptoms can include burning with urination, testicular pain and a thick discharge from the penis. With a varicocele, symptoms may include dilated veins in the scrotum and swelling of the scrotum.
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