Sperm Disorders

Diagnosis and treatment suggestions

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It is important to know how to read and understand the results of a sperm test. A correct interpretation of the sperm test is a crucial step on the path to diagnosing the problem and recommending a treatment.

A low sperm volume will appear in situations of “partial” collection, short abstinence period, developmental problem of the seminal glands, obstruction in the seminal glands and a low level of testosterone.

“Blood” colored semen (Hemospermia) is usually caused by a slight bleeding in the urethral area. However, as part of the investigation, malignancy of the sexual tracts must always be ruled out.


Azoospermia is defined as the lack of sperm in the semen fluid after the centrifugation of the semen fluid and examining the sediment using a microscope.

Sometimes it is possible to find sperm in “Azoospermia” semen fluid by performing an in-depth search which requires a skilled team and extended search time. In the event that sperm is found (even one single sperm!) it is possible to inject it into the egg. This procedure is called ICSI.

In certain cases, Azoospermia may appear sporadically, and therefore it is recommended to perform a number of tests before making a final diagnosis.

Dr. Barak investigates all types of Azoospermia. According to the type of Azoospermia, Dr. Barak will recommend the suitable surgical intervention (needle biopsy, TESE, Micro-TESE).

Oligospermia – Low sperm count

A sperm count lower than 15 Million/ml is defined as Oligospermia.

There is correlation between the sperm count and other abnormalities in the sperm sample. In most cases the sperm morphology and mobility are abnormal in cases where the concentration of sperm is low.

Asthenospermia  – Low mobility sperm

Asthenospermia is defined as mobility lower than 40%.

“Artificial” Asthenspermia is caused by the exposure of the semen to rubber products such as condom not designed for collecting sperm, spermicidal foam/cream, high temperature, low temperature, a long period between giving sperm and submitting it for the test.

Low mobility of the sperm often accompanies Oligospermia and sperm morphology disorders (resulting from a defect in the sperm production process).

In extreme cases of lack of movement, a sperm diagnosis can be performed using an electronic microscope.

Possible findings are the lack of “Dynein Arms”, mitochondrial disorders, other structural disorders of the sperm cell tail.

In a normal sperm test, very often, it is possible to observe morphological disorders of the sperm tail (short tail, thickened, etc.).  Sperm vitality tests will differentiate between a live sperm with a mobility problem and a dead sperm (Necrospermia).

Patients suffering from structural disorders of the sperm tail, will be successfully treated with – ICSI.

Another reason for low mobility is sperm antibodies.


It is important to differentiate between Necrospermia and extreme Asthenospermia, since the likelihood for a spontaneous pregnancy is considerably higher in patients with Necrospermia (as opposed to extreme Asthenospermia).

Necrospermia is defined as mobility which is lower than 20%, forward propulsion of less than 5% and a “Viability test” which is lower than 30%.

One of the most prominent characteristics of Necrospermia, is an obvious improvement following frequent ejaculation.

Causes for Necrospermia:

  • Problem with storing the sperm in the epididymis
  • Stasis of the sperm in the reproductive system
  • Spinal cord injuries
  • Polycystic Kidney Disease with a cyst inside the ejaculatory duct.

Treatment with antibiotics may sometimes help.

It is recommended to have sexual intercourse every 2-3 days up to time of ovulation.

Teratospermia – Abnormal sperm morphology

Teratospermia is defined as having a normal morphology percentage of less than 4%.

The morphological evaluation of the sperm using a microscope is highly subjective and its quality is dependent on the quality of the lab in which the test is performed.

The ability of a sperm cell to bond with the outer layer of the egg and fertilize it is tightly linked to the morphological characteristics of the sperm cell head.

Abnormal sperm test? You are invited to consult with Dr. Barak.

The sperm test is the most important test for evaluating male fertility.

The sperm test provides information about the volume of the semen, concentration, mobility and sperm cell morphology.

The sample for a sperm test is obtained by masturbation or by having sexual intercourse with a designated condom (which does not contain substances that is toxic to sperm cells).

Prior to giving a sample, an abstinence period of 2-5 days is recommended.

The “sperm sample” should arrive at the lab within one hour from producing it. Exposure to lubricants and extreme temperatures must be avoided.

Due to the vast differences which exist between tests, an “abnormal test” should be repeated at least two weeks after performing the first test.

This vast “difference” between the sperm tests of the same individual is a property which must be taken into account in order to arrive at a true and realistic interpretation of the results.