Sperm Count 27 million : Is it enough for pregnancy
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By: Dr.Bhargav Raut
- 2023-08-11T09:35:07.479+00:00
What is a normal sperm count?
A normal total sperm count is 39 million as per the WHO. For the purposes of this article we assume an ejaculatory volume of 3 ml.[1.5ml - 6ml].What is Male Infertility
Male infertility is when a man and a woman try to have a baby for a whole year without using any kind of protection, but still can't make a baby. The lady is perfectly fine and can have a baby, but the man has some kind of problem that stops them from making a baby together. And it turns out that in about 20% of these cases, the man is the only one to blame for the infertility.4What is it called when sperm count is 27 million/ml?
This condition is called oligospermia or a low sperm count.How is sperm count measured?
A sperm count is assessed by means of a semen analysis test. In this test you are asked to provide a sample of your semen, and the lab uses special techniques to analyze the semen. The count is estimated by diluting the semen in a special diluent and then using a measurement chamber to visualize the sperms. A complex mathematical formula is employed to estimate the actual sperm count.What is my grade of oligospermia?
Your sperm count is lower than what is typically considered normal. The average sperm count for men is above 39 million, but yours is 27 million. This means that there are fewer sperm present in your semen compared to what is typically expected. Additionally, the grade of your oligospermia is classified as moderate. Although your sperm count is lower than average, it is important to keep in mind that there are various factors that can affect fertility. It may be helpful to consult with a healthcare professional for further guidance and understanding of your specific situation.What are the causes of a sperm count of 27 million?
There are several different causes of oligospermia and they can be one of several categories including due to genetic factors, past cancer, secondary to other diseases, physical factors in the reproductive tract etc.5Prolactinoma
Prolactinoma is a condition where there is a tumor in the pituitary gland, which leads to high levels of prolactin hormone in the body. This hormone suppresses the hypothalamus, a part of the brain that regulates the production of other hormones. This suppression can result in low sperm count. To investigate this cause, a blood test can be done to measure the levels of prolactin. Additionally, a brain scan called an MRI may be performed to detect the presence of a pituitary tumor.Kleinfelters syndrome
Kleinfelters syndrome is a genetic condition where males have an extra X chromosome, resulting in abnormal testicular development. This can lead to either complete absence of sperm (azoospermia) or a low sperm count (oligospermia). To investigate this cause, a karyotype test can be done to analyze the chromosomes and determine if there is an extra X chromosome present.Hypothyroidism
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. This hormonal imbalance can affect sperm production and result in low sperm count. To investigate this cause, a blood test can be done to measure the levels of thyroid-stimulating hormone (TSH) and thyroid hormones (T3 and T4). Abnormal levels may indicate hypothyroidism.Testicular Injury
Testicular injury refers to damage or trauma to the testicles, which can occur due to torsion (twisting), accidents, spinal cord injury, chemotherapy, or radiation therapy. These injuries can disrupt the normal functioning of the testicles and lead to low sperm count. To investigate this cause, a physical examination of the testicles and scrotum can be performed, along with imaging tests such as ultrasound to assess any structural damage.Kallmann syndrome
Kallmann syndrome is a genetic condition characterized by delayed or absent puberty and a lack of sense of smell. This syndrome can also affect sperm production, leading to low sperm count. To investigate this cause, a hormonal evaluation can be done to measure the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone. Genetic testing may also be recommended to confirm the diagnosis of Kallmann syndrome.Medications
Certain medications, such as anabolic steroids and corticosteroids, can impact sperm production and result in low sperm count. Anabolic steroids suppress the natural hormone production in the body, while corticosteroids can interfere with the signals from the brain that stimulate sperm production. To investigate this cause, a review of the patient's medication history and consultation with a healthcare professional is necessary.Infections
Infections like mumps orchitis, which is inflammation of the testicles caused by the mumps virus, can affect sperm production and lead to low sperm count. To investigate this cause, a physical examination of the testicles and a blood test to check for the presence of specific antibodies can be done. Additionally, a viral culture or polymerase chain reaction (PCR) test may be performed to detect the mumps virus.Hyperthyroidism
Hyperthyroidism is a condition where the thyroid gland produces excessive thyroid hormone. This hormonal imbalance can create a hyperestrogenic state, which can negatively impact sperm production and result in low sperm count. To investigate this cause, a blood test can be done to measure the levels of thyroid-stimulating hormone (TSH) and thyroid hormones (T3 and T4). Abnormal levels may indicate hyperthyroidism.Obesity
Obesity, particularly with a high body mass index (BMI), can contribute to hormonal imbalances that affect sperm production. Increased body fat can lead to higher levels of estradiol (a form of estrogen) and lower levels of androgens (male hormones), which can result in low sperm count. To investigate this cause, a physical examination, along with measurements of weight, height, and BMI, can be performed. Hormonal tests may also be conducted to assess hormone levels.Pituitary adenoma
Pituitary adenoma refers to a benign tumor that develops in the pituitary gland. This tumor can exert pressure on the cells responsible for producing luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are essential for sperm production. This disruption can lead to low sperm count. To investigate this cause, a brain scan called an MRI is usually performed to detect the presence of a pituitary adenoma.Questions to ask yourself for a sperm count of 27 million
Age at which you had puberty
Have you ever experienced any physical changes like growth spurts, voice deepening, or the appearance of facial hair during your teenage years?Surgery on testicles
Have you ever undergone surgery on your testicles, and if so, how did it affect your fertility?Any trouble with sexual drive or function
Have you ever experienced any difficulties with your sexual desire or performance?Sexually transmitted infections
Have you ever had any sexually transmitted infections in the past?Infections of prostate or testicle
Have you ever experienced any infections or inflammation in your prostate or testicles?Current and former medications
Have you ever taken any medications, either currently or in the past, that could potentially affect your sperm count?Use of alcohol, tobacco, illicit drugs
Have you ever consumed alcohol, smoked tobacco, or used any illicit drugs?Systemic disease
Have you ever been diagnosed with or experienced any chronic medical conditions or diseases that affect your whole body?Environmental exposures, including radiation, pesticides, and occupational
Have you ever been exposed to radiation, pesticides, or worked in an occupation that involves potential environmental hazards?Any Cancer diagnosis or treatment
Have you ever been diagnosed with cancer or undergone any cancer treatments in the past?
What will be done during medical checkup for sperm count of 27 million?
Is your sexual development complete ? - Tanner stage
Tanner stage is a way for doctors to assess the sexual development of a person. It helps determine if the patient's body is going through the normal changes that happen during puberty.
During the examination, the doctor will look at different parts of the body including the genitals, pubic hair, and breast development (for females). They will compare these physical changes to a standardized scale called the Tanner scale.
This scale has five stages, ranging from stage 1 (no development) to stage 5 (full adult development). By assessing the patient's physical characteristics, the doctor can determine at which stage of sexual development they are currently in.
Knowing the Tanner stage can provide valuable information about the patient's overall health and can help doctors diagnose and treat any potential issues related to sexual development.
In the context of a patient with a sperm count of 27, the doctor will likely use the Tanner stage examination to assess if the patient's sexual development is complete or if there may be any underlying issues affecting their reproductive health.
Do you show signs of a mass in the brain? - Bitemporal hemianopsia (pituitary mass)
The doctor will examine you to check if you have any signs of a mass in your brain that could be causing a condition called bitemporal hemianopsia. This condition refers to a loss of vision in the outer portions of your visual field.The examination may involve several steps, such as checking your vision and asking you questions about any visual problems you may have experienced. The doctor may also use a special instrument called an ophthalmoscope to look at the back of your eyes and check for any abnormalities.
If the doctor suspects a pituitary mass, they may recommend further tests, such as magnetic resonance imaging (MRI), to get a detailed picture of your brain and confirm the diagnosis. It's important to undergo these examinations to better understand the cause of your vision loss and plan appropriate treatment if necessary.
Is your testicle size normal ? Reduced testicular volume (<15 cc)
The doctor will check if your testicle size is normal by gently feeling them with their hands. They will look for any signs of small size or abnormal shape. If the size is below 15 cc, it means that your testicles are smaller than what is considered normal. This could be a possible reason for your low sperm count. The doctor may suggest further tests or treatments to help improve your fertility.Is there a mass in your testicle? - Testicular mass
The doctor will check if there is a lump or abnormal growth in your testicle, which is called a testicular mass. This can be done by gently feeling the testicles with their hands. They will check for any changes in size, shape, or texture of the testicles. The doctor may also use an ultrasound machine, which uses sound waves to create images of the testicles, to get a clearer picture. This examination is important to detect any potential issues or abnormalities in the testicles that may need further investigation or treatment.Is the natural tube from testicles missing from either side? - Presence of vas deferens bilaterally
The doctor will perform a simple examination to determine if the natural tubes that carry sperm from the testicles are missing on either side. This is known as the vas deferens. The examination involves gently feeling the scrotum to locate the tubes. If the tubes are present, the doctor will be able to feel them as small, firm structures on each side. If the tubes cannot be felt, it may indicate that they are missing. This examination is a quick and non-invasive way for the doctor to assess the presence of the vas deferens and help determine the possible causes of a low sperm count.Is there any cyst or swelling in the testicular sac ? - Presence of varicocele or other scrotal mass
The doctor will carefully examine the patient's testicles to check for any cysts or swelling in the testicular sac. This involves feeling the testicles with their hands to detect any abnormal lumps or masses. They will also check for the presence of varicocele, which is a condition where the veins in the scrotum become enlarged and can cause swelling. The examination is usually painless and only takes a few minutes. If any abnormalities are found, further tests or treatments may be recommended.Are the testicles missing? - Presence of cryptorchidism or hypospadias
The doctor will check if the patient has cryptorchidism, which means one or both testicles are not in their normal position in the scrotum. This will involve examining the scrotum to feel for the presence of testicles. If the testicles cannot be felt, further tests may be needed to determine their location. Additionally, the doctor will also check for hypospadias, a condition where the opening of the urethra is located on the underside of the penis instead of the tip. This will involve visually inspecting the penis to see if the urethral opening is in the correct position. Understanding if the patient has any of these conditions is important in determining the cause of the low sperm count and guiding appropriate treatment options.Is there any joint problem ? -Synovitis of second and third metacarpal-phalangeal joints, 'bronzed' appearance or stigmata of liver disease or heart failure (hemochromatosis)
The doctor will check the patient's hand joints, specifically the second and third metacarpal-phalangeal joints, to see if there is any swelling or inflammation present, known as synovitis. This can cause pain and difficulty in moving the hand. Additionally, the doctor will observe the patient's skin color, looking for a 'bronzed' appearance. This can be a sign of a condition called hemochromatosis, where the body absorbs too much iron. Furthermore, the doctor will be on the lookout for any stigmata or signs of liver disease or heart failure. These may include jaundice (yellowing of the skin or eyes), swelling in the legs or abdomen, and other symptoms related to these conditions. By conducting these examinations, the doctor will be able to assess if there are any joint problems or indications of liver disease or heart failure that may be affecting the patient's overall health.Is the patient on muscle building steroids? Presence of marked muscle hypertrophy suggesting anabolic steroid use
If a doctor suspects that a patient may be using muscle building steroids, they will look for signs of marked muscle hypertrophy. This means they will examine the patient's muscles to see if they are unusually large or well-developed. They may check for increased muscle size in areas such as the arms, chest, or legs.
This examination is important because muscle hypertrophy is a common side effect of anabolic steroid use. These steroids can help build muscle mass and strength at a faster rate than what is naturally possible. However, they also come with potential risks and side effects.
By assessing the patient's muscle size and condition, the doctor can determine if the use of muscle building steroids may be a contributing factor. This information can help guide further investigations and discussions about the patient's health, fertility, and overall well-being.