Necrozoospermia is the medical term that describes presence of dead sperms in fresh semen sample. It is a common cause of male infertility.
Definition: Necrozoospermia is a condition in which there is a low percentage of live sperms and a very high percentage of immotile spermatozoa in semen.
It can be classified into :
Moderate – 50 to 80% dead sperms
Severe – >80% dead sperms
Several pathological mechanisms may be involved which can be due to
1. Testicular cause: Abnormally high Temperature as in Hyperthyroidism, varicocele, hot tub baths
2. Post testicular: Epididymal necrozoospermia, vasectomy reversal, anti-sperm antibodies, seminal plasma abnormalities, adult polycystic kidney disease
3. Toxins: Exposure to toxins such as lead, pesticides, mercury or cadmium
4. Hormonal: Hypogonadotropic hypogonadism
5. Infections of male reproductive tract
6. Advanced Paternal age
7. Testicular cancer
8. Spinal cord injuries
9. Prolonged periods of no ejaculation
It can be diagnosed by a semen analysis done in a Laboratory by using an Eosin test or Hypo-osmotic flagellar coiling test.
However it should not be confused with Asthenozoospermia where sperms are non-motile but they are not dead.
Also there can be a possibility of False Positive diagnosis in cases where
1. Sperm is collected in condoms having spermicidal cream
2. Sperm is collected by using lubricants that are spermicidal
3. Sperm is collected in an unsterile container
In cases where in Necrozoospermia is given in a report, it should be rechecked by doing a repeat semen analysis and avoiding possible spermicidal exposure and can also be done by giving 2 semen samples in a day.
1. Etiological i.e. directed towards the cause by avoiding exposure to high temperatures or toxins and giving antibiotics to treat the infections.
2. Some medications like Antioxidants or Anti-inflammatory drugs can be used but there are currently no guidelines to recommend their use.
3. IVF with ICSI: Fertilization rates are lower with Necrozoospermia but in vitro fertilization with ICSI improves the chances of conception.
4. IVF with TESE & ICSI: Also in cases of Necrozoospermia due to post testicular causes, IVF with ICSI using sperms obtained by TESE is the best treatment possible wherein sperms are obtained directly from the Testis by taking a small incision and removing a small tissue.
5. IVF with DONOR SPERMS: Alternatively in vitro fertilization with Donor sperms should be considered if other treatment fails.
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