Fertility issues are not exclusive to women; men face their own set of reproductive challenges; necrozoospermia is one of the causes of male infertility.
Necrozoospermia is very less commonly discussed, but it significantly impacts a couple’s ability to conceive.
Let’s know about normal sperm motility:
Normal sperm motility is the ability of sperm to move or swim efficiently through the female partner’s reproductive system to fertilize an egg.
What is Necrozoospermia?
It is a condition in which a semen sample contains a high percentage of dead or immotile sperm.
How common? Not very common?
It’s detected only in 0.2-0.5 percent of infertile couples.
What are the symptoms of Necrozoospermia?
It is a condition that typically remains asymptomatic until a couple is having trouble conceiving and can seek medical help. We can diagnose this condition through a semen analysis ,In which we do microscopic examination to assess sperm vitality.
Let’s talk about types of Necrozoospermia
Necrozoospermia can be categorized into two main types:
1. Complete Necrozoospermia:
In this type of necrozoospermia, sperm present in semen sample are non-motile and non-viable.
2. Partial Necrozoospermia:
Semen sample contains high proportion of non-motile and non-viable sperm, but we also detect some healthy and motile sperm present in semen. We can determine appropriate treatment and management strategies after understanding the type of Necrozoospermia.
Causes of Necrozoospermia:
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Infections: Certain infections that involve the reproductive tract can impair sperm health and lead to necrozoospermia.
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Environmental Toxins: Exposure to various environmental pollutants like heavy metals, radiation, or toxic chemicals can damage sperm.
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Lifestyle Factors: Smoking, excessive alcohol consumption, and drug use can negatively affect sperm vitality.
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Medical Treatments: Chemotherapy or radiation therapy for cancer can result in the temporary or permanent production of non-viable sperm.
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Testicular Conditions: Varicocele, testicular torsion, or testicular trauma can impair sperm production and vitality.
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Autoimmune Disorders: Our body’s immune system fights against diseases. Sometimes the immune system misfires, targeting healthy cells and this will cause the destruction of healthy sperm cells.
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Genetic Factor: Chromosomal abnormalities and genetic mutations can impair sperm vitality.
The cause and kind of necrozoospermia determine how it is treated:
First treat underlying causes such as infection, varicocele, or other identified factors.
Before Proper patient history is essential to eliminating false results of necrozoospermia.
For example
- It should rule out the use of lubricants during masturbation.
- Unintentional leakage of water, soap, or antiseptic solution into the semen sample.
- These all can cause false results of necrozoospermia.
- Sperm vitality should be assessed to distinguish between necrozoospermia and asthenozoospermia when no motile spermatozoa are seen.
Sperm vitality assessment
- Vitality is estimated by assessing the membrane integrity of the spermatozoa
- There are several techniques that can be used to assess sperm vitality, the most frequently used being the eosin-nigrosin and the hypo-osmotic swelling test (HOST).
Eosin-nigrosin staining
Heads of dead sperms are stained dark pink or red
Hypoosmotic swelling test
This test assesses the sperm plasma membrane’s functional integrity and is a helpful predictor of reproductive potential.
(A) Components of the hypoosmotic swelling test.
(B) Semen sample observation under a phase contrast microscope and sperm differentiation according to tail swelling. (a) Non-swollen tail of a dead spermatozoon. (b–g) Variations in the enlarged tail patterns of living spermatozoa.
In the ejaculate, if absolute necrozoospermia is confirmed, then testicular sperm extraction should be considered since it allows the extraction of live spermatozoa.
Testicular Sperm Extraction (TESE)
Testicular Sperm Extraction (TESE) is a surgical procedure and it involves the extraction of sperm directly from the testes by using fine needle. Many time sperm may be more intact inside the testes than in the ejaculate.
When to decide for Donor Sperm
Men those diagnosed with necrozoospermia, donor sperm is not the first line of thought. They all should first consult with expert infertility specialists, and with the help of recently available advanced treatment options like ICSI, many men still have a chance at biological fatherhood.
Consulting with a fertility specialist in Delhi with Dr. Rashmi Sharma at the Origyn IVF center is crucial to explore all possible options before considering donor sperm.
https://youtu.be/IoKSjgRyxrc?si=nOzIl0p24jwxHqUn
About Dr. Rashmi Sharma:-
Dr. Rashmi Sharma is an IVF specialist Consultant Reproductive Medicine and Director Origyn Fertility & IVF New Delhi MBBS (BHU), MD(BHU), DNB, MNAMS, FICOG, Diploma IVF and reproductive Medicine (Kiel University, Germany) Web Editor, Indian Fertility Society (2024-26) Former HOD, IVF dept, Moolchand Hospital, Delhi (2009-13) and Max Hospital, Pitampura, Delhi (2013-17), Director, Origyn Fertility & IVF, which has 4 branches across Delhi.
Origyn IVF has been accredited for 1-year fellowship in IVF and reproductive medicine along with an MSc in Clinical Embryology under Amity University and IFS Collaboration. Recipient of the “C. S. Dawn Award” for best paper presentation on her work on IVF /ICSI with genital tuberculosis, at All India Congress Of Obstetrics and Gynecology (AICOG 2010) Recipient of “Hall of Fame – Best IVF specialist in India – North” at Economic Times – National Fertility Awards,2019 and 2023 & 2024.
Origyn IVF received “Best IVF center in North India” and “Most integrated team in IVF, India – North” at Economic Times – National Fertility Awards, 2019 & 2024 Recipient of “Best IFS Executive” at Fertivision – 2018, Kochi. Authored various chapters in infertility books of repute. Many national and international paper presentations and publications.
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