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How can poor sperm count and motility be improved?

Q: My husband is 32 years old. We were trying for a child for the past one year and consulted a doctor three months ago. He advised my husband to undergo a semen analysis, which showed very poor semen. The result is as follows - colour: opaque grey; volume: 2.8 ml; reaction: alkaline; viscosity: normal; total sperm count: 2.7 million/ml; active motile: 5%; sluggish motile: 5%; non- motile: 90%; normal forms: 96%; others: 4%; pus cells: 1-2/hpf; RBC: 1-2/hpf and semen fructose: 93 mg/dl. As my husband's brother had a problem of varicocoele, a scan was also done, which showed chronic epididymitis. The doctor had started a treatment course of three months and then taken a semen test. The result of which is as follows - colour: opaque grey; volume: 3 ml; reaction: alkaline; viscosity: normal, total sperm count: 10.7 million/ml; active motile: 5%; sluggish motile: 10%; non-motile: 85%; normal forms: 89%; others: 11%; pus cells: 2-4/hpf, RBC: 1-2/hpf, peroxides stain: negative and semen fructose: 64 mg/dl. I think there is only a slight improvement in this treatment course. What are the methods to improve his sperm count and motility? What are the treatment options?

A:Your husband has low sperm count and poor motility in the semen, called oligoasthenospermia. There can be a lot of reasons resulting in the same outcome. If you take similarity to a factory producing sperms, there can be poor raw material (testes having poor germ cells), defect in machinery (defective formation processes of sperms in the testes) or a transport strike (problems occurring during the transport of sperms from testes to outside). Varicocoele is just one of the causes affecting the third segment, i.e. the transport mechanism. Hormonal profile tells us about the health of germ cells in testes. A testicular biopsy details the sperm forming processes in the testes. An ultrasound and Doppler examination of the testes tests the environment outside the testes. The urologist looking after your husband would work on these details to find the cause, and only then will it be possible to outline the treatment and prognosis.


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