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
Treatment
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.
3) Repronex.
4) Bravelle
5) Ovidrel
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
16)
Vitamins
17)
Zinc
18)
Methy-Predinisolone
19)
Antibiotics
20)
Antiestrogens
21)
Tamoxifen
22)
Clomiphene
23) Hgh
24)
Antimicrobials
25)
Anti-inflammatory
26)
AIH
27)
ART
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
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.
| Course Duration | Amount in US $ | Amount in PKR | Order By |
| 4 Months Course | $1500 | PKR126000 |
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