What is Necrospermia?
When semen has less of mature normal sperms & more of dead sperms this condition is abnormal. When ever there is less of normal sperm then chances of spontaneous pregnancy decreases (i.e. difficulty in conceiving i.e. wife does not becomes pregnant). This is one of the common causes of male factor infertility. This is also one of the most common semen abnormalities in men.
Causes of dead sperm: The various causes of dead sperms are as follows:
1) Deficiency of central sperm producing hormones:
Hypothalamic – pituitary deficiency: Idiopathic GnRH deficiency, Kallman syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Hypothalamic deficiency, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis) Autoimmune hypophysitis, Drugs (drug-induced hyperprolactinemia, steroids use)
Untreated endocrinopathies, Glucocorticoid excess, Hypopituitarism, Isolated gonadotropin deficiency (non acquired): Pituitary, Hypothalamic, Associated with multiple pituitary hormone deficiencies: Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Space-occupying lesions(craniopharyngioma, Rathke pouch cysts, hypothalamic tumors, pituitary adenomas), , Laurence-Moon-Beidl syndrome Prader-Willi syndrome , Frohlich syndrome, Hypergonadotropic hypogonadism : Klinefelter syndrome, Noonan syndrome, Viral orchitis, Cytotxic drugs, Testicular irradiation.
2) Testicular disorders (primary leydig cell dysfunction i.e. Hypoganadism), Chromosomal (Klinefelter syndrome and variants, XX male gonadal dysgenesis), Defects in androgen biosynthesis, Orchitis (mumps, HIV, other viral, ),Myotonia dystrophica, Toxins (alcohol, opiates, fungicides, insecticides, heavy metals, cotton seed oil), Drugs (cytotoxic drugs, ketoconazole, cimetidine, spironolactone)
3) Varicocele: varicocele is dilatation of scrotal vein in the scrotum that leads to rise in temperature of testis and raise testicular temperature, resulting in less sperm production & death of whatever sperms are produced.
4) Drugs (e.g. spironolactone, ketoconazole, cyclophosphamide, estrogen administration, sulfasalazine)
5) Autoimmunity i.e. presence of Antisperm antibody. These Antisperm antibodies bind with sperms & either make them less motile, totally immotile or even dead which is called necrospermia.
6) Undescended testicle (cryptorchidism). Undescended testis is a condition when one or both testicles fail to descend from the abdomen into the lower part of scrotum during fetal development. Undescended testicles can lead to less sperm production. Because the testicles temperature increase due to the higher internal body temperature compared to the temperature in the scrotum, sperm production may be affected.
7) Mosaic Klinefelter's syndrome. In this disorder of the chromosomes, of the man is abnormal. This causes abnormal development of the testicles, resulting in low sperm production. Testosterone production may be low or normal.
8) Viral Orchits as mumps or other viral infections.
9) Infections as tuberculosis, sarcoidosis involving testis or surrounding structures as epididymis.
10) Chronic systemic diseases as Liver diseases, Renal failure, Sickle cell disease, Celiac disease
11) Neurological disease as myotonic dystrophy
12) Development and structural defects as mild degree of Germinal cell hypo-plasia
13) Partial Androgen resistance
14) Mycoplasmal infection
15) Partial Immotile cilia syndrome
16) Partial Spermatogenic arrest due to interruption of the complex process of germ cell differentiation from spermatid level to the formation of mature spermatozoa results in decreased sperm count i.e. oligospermia. Its diagnosis is made by testicular biopsy. This is found in upto 30% of all cases of dead sperm patients.
17) Heat Exposure to testis: as febrile illness or exposure to hot ambience induces a abnormality in spermatogenesis.
19) Infection – as bacterial epididimo-orchitis, even in prostatis spermatogenic defect have been noted.
20) Hyper-thermia due to cryptorchidism
21) Chromosomal abnormality: has been found in many cases of low sperm count
22) Alcohol use, Cocaine or heavy marijuana use or Tobacco smoking may lower sperm count
23) Anti-sperm antibodies. In some people there occurs development of some abnormal blood proteins called anti-sperm antibodies, which binds with sperm and make them either immotile or dead or decrease their count.
24) Infections. Infection of uro-genital tract may affect sperm production. Repeated bouts of infections are one of the common causes associated with male infertility.
25) Klinefelter's syndrome. In this disorder of the chromosomes, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production. Testosterone production also may be lower.
26) Trauma to testis
27) Environmental toxins: as Pesticides and other chemicals in food or as ayurvedic medicines.
28) Genetic Factors: as idiopathic partial hypo-gonadotropic hypogonadism
Diagnosis of Cause of Dead Sperms
For correct diagnosis of cause of more of Dead sperm, we need detail history & physical examinations then certain relevant investigations are required.
History & Physical Examinations: First step in proper treatment is accurate diagnosis of cause of dead sperms. So we first try to find out cause. We take detailed history, thorough drug history and general physical examination, examination of testis, epididymis, testicular veins & sperm carrying duct examinations. These examinations give idea about whether testis is normally developed or not & how is its function. After that depending on likelihood of particular, cause relevant tests are done. All testing facilities are available at our centre. Thus you may consult us at our centre & at same time you may get all tests done. The time taken in getting all the reports ready is 36 hours.
Investigation & Diagnosis: For completes diagnosis of causes of dead sperms one or more of the following tests may be required as
Complete male hormone profile: This profile includes all the male hormone tests which control testicular development, functions including normal sperm Productions. The tests include L.H., F.S.H., Testosterones, prolactins, thyroids test, & other relevant hormone tests depending on history & examinations.
2) Antisperm antibody
3) USG or Doppler study of scrotum & testis
4) Semen culture sensitivity
5) Semen fructose
6) Immunobead test
7) Sperm Function Tests
8) Human Sperm-Zona Pellucida Binding Ratio
9) Human Sperm-Zona Pellucida Pentration test
10) Genetic Studies
11) FNAC Testis
12) Egg penetration test
13) Molecular genetic studies done in some special cases
14) Chromosome analysis i.e. Karyotype
15) Assessment of androgen receptor
16) Combined Pituitary hormone tests is performed when needed
17) MRI head if pituitary hormone defect suspected
18) Hemogram test for systemic diseases.
19) Sperm Function Tests
The hamster egg penetration assay (HEPA) and the hemizona assay (HZA) are sperm function tests which can help assess the ability of sperm to penetrate the egg. These tests will not definitively tell whether a pregnancy will occur, but an abnormal test result helps predict reduced fertilizing capability. These tests are performed only rarely today.
20) Semen Fructose
21) Sperm Coiling Test to find out whether the particular sperm is live or dead
Once the cause of low sperm count are found then with in three months of treatment sperm count & motility becomes normal in more than 90% cases.
The various treatments are as follows:
Correction of the Cause: First of all we try to find out the primary cause of infertility by above mentioned investigations. Then we correct the basic defect i.e. correction of hormone disorder & other defects. We also give following treatment for permanent cure of low sperm count & motility disorder.
1) Correction of Hormone deficiencies: Once the hormone disorder is found then it is corrected by any of the below medicines. Usually dead sperms problem is cured in three month time with proper hormone treatment.
2) Gonadotropin Therapy: Gonadotropins are most potent natural stimulators of sperm production in the testis. Once we start gonadotropin therapy, these gonadotropins stimulates the sperm producing cells in testis. Under the stimulating influence of gonadotropins dormant sperm forming cells which were not producing normal sperms, they start dividing & producing normal sperms. Thus in more than 90% cases sperm production can be normalized in three to four months time if it is started in properlyselected cases of low sperm count. Gonadotropin therapy is most successful of all the available treatment for dead sperms till now. In many cases of dead sperms, when all other treatment has failed even in those cases gonadotropin therapy is effective. Thus treatment of dead sperms with gonadotropin therapy results in pregnancy soon.
6) Gonadotropin-releasing hormone (Gn-RH) analogs
7) Growth hormone therapy in many cases where somatotropin deficiency is found.
8) Growth Factor, Mineral & Micronutrient Therapy
9) Free Radial Scavangers: These are drug to reduce the free damaging oxidative radical in the testis. For your information every minute lot of oxidant radicals are generated inside the testis which damages sperm forming cells. These special antioxidant drugs scavange these damaging oxidative free radicals thus leading to production of normal sperms by the testis. In many study these free radical scavengers have been found to be very-very effective in curing dead sperms.
10) Coenzyme ubique: These drugs improve the nutritional status of the testis. Thus testis as well as sperm forming cells get enough nutrient which helps in fast generation of normal sperms in good number with good motility & fertilizing capacity.
11) Carnititine supplementation increases the production of sperm, with normalization of normal sperms in semen in three months.
12) Fertyl: This drug is taken orally and it causes the pituitary gland to release more FSH and LH, which then stimulates the testis to produce more normal sperms.
13) Bromocriptine. This medication is for men who have elevated levels of prolactin.
14) Correction of thyroid hormone
15) Correction of congenital adrenal hyperplasia
28) Certain Newer Drugs has been found very effective
30) Surgery: Surgery is also the treatment of choice for significant varicocele. Similarly surgery may be one of the treatment options for many endocrine tumours.
32) Test tube baby is also delivered with our efforts by use of intra-cytoplasmic sperm injection (ICSI) after separating out live sperms out of dead ones then transfer of embryo to uterus of mother.
33) Semen Bank: Facility for good quality sperm is semen bank in also available. At our center we have facility for all the testing & treatment facility required for low sperm count to achieve pregnancy.
The most common forms of ART include:
a) In vitro fertilization (IVF). This is the very effective ART technique. IVF involves retrieving mature eggs from a woman, fertilizing them with a man's sperm in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilization. IVF often is recommended as a first-line therapy. It's also widely used for unexplained infertility, male factor infertility.
b) Electroejaculation. Electric stimulus brings about ejaculation to obtain semen.
c) Surgical sperm aspiration. This technique involves removing sperm from part of the male reproductive tract such as the epididymis, vas deferens or testicle. This allows retrieval of sperm if blockage is present.
d) Intracytoplasmic sperm injection (ICSI). This technique consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure. ICSI has been especially helpful in couples who have previously failed to achieve conception with standard techniques. For men with low sperm concentrations, ICSI dramatically improves the likelihood of fertilization.
34) Varicocele ligation: A varicocele is an abnormal tortuosity and dilation of veins of within the scrotum. It can be surgically treated - which might help fertility in some cases.
Response of treatment: When we start treatment, maturation of spermatocyte to mature spermatozoa start occurring in three to 4 weeks time and achievement of normal sperm count with normal sperms is achieved in three months. Thus cure rate is achieved in more than 95% of patients in three months time.
Side effects: This treatment is harmless because we prescribe well proven drugs which are prescribed in scientific literature. These medicines have to be purchased from medical store by patient himself.
Treatment for Necrospermia by Dr. & Hakeem Tariq Mehmood Taseer
Pure herbal treatment by Dr & Hakeem Tariq Mehmood Taseer to cure impotency with well proven results. Has a very high success rate in treating different causes of impotency. Dosage and duration of the treatment may vary as per the patient profile. Treatment is without any side effects.
Complete Treatment of Necrospermia
|Course Duration||Amount in US $||Amount in PKR||Order By|
|4 Months Course||$1500||PKR126000|