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Dr. Hrishikesh Pai,Gynaecologist & Infertility specialistA-791, Bandra Reclamation, Bandra (W)Mumbai - 400050 Necrozoospermia, also known as necrospermia, is a condition
where all the sperm are dead in the man’s fresh semen sample. However, complete
Necrozoospermia is relatively uncommon. Only 0.2 percent to 0.5 percent of
infertile males are thought to have total necrozoospermia.
Necrozoospermia is classified into:
Moderate – 50 to 80 percent dead sperm
Severe – more than 80 percent dead sperm
The best way to manage and treat necrozoospermia is an accurate diagnosis.
What causes Necrozoospermia?
The factors that can cause necrozoospermia are:
· Infection in the reproductive tract
· Hormonal imbalance
· Spinal cord injury
· Abnormally high body temperature
· Testicular cancer
· Chemotherapy and radiotherapy
· Testicle issues
· Sexual abstinence for a long period
· Anti-sperm antibodies
· A problem with the epididymis
· Consumption of stress drugs and regular alcohol
How is Necrozoospermia diagnosed?
To diagnose necrozoospermia, youmay have to undergo a few tests, which may
include:
· Eosin test
· Hypo-osmotic flagellar coiling test
· Specialized sperm function tests
· Male hormone testing
· Chromosome analysis
. Necrozoospermia is often confused with asthenozoospermia,a condition in which
sperm are non-motile but not dead.
Asthenozoospermia is easier to manage because ICSI can be done
after the living sperm have been identified using sophisticated tests like the
hypoosmotic swelling test.
It is necessary to speak with your doctor in order to receive the proper
diagnosis and treatment.
Another issue which you could face is the possibility of a false-positive
diagnosis. It usually happens when:
· The sperm is collected in condoms which are coated with spermicidal cream
· Sperm is collected in a container that is unsterile
· The lubricant used to gather the sperm are spermicidal, thereby killing all
the sperm
How to overcome the issue of the wrong diagnosis?
It will help if you use a special non-toxic Silastic condom to collect sperm
samples for semen analysis.
If a semen analysis test results in necrozoospermia, you should repeat the test
from a trusted lab.
· The lab technician must be experienced to identify between immotile sperm and
dead sperm.
· The technician may use special supravital stains, such as eosin-nigrosin, to
accomplish this.
· These tests must be performed correctly, which is why a reference andrology
lab is an ideal place to verify the diagnosis.
· Providing a second semen sample 1 hour after the first is recommended. It is
fresher and will often include a few live sperm even if the first sample did not
have any.
· The semen sample must be centrifuged in the lab to check for pellet in the
sperm.
What are the treatment options?
When the cause of necrozoospermia is established, the first step is to address
the cause. Antibiotics, for example, maybe administered if there is an
infection. If necrozoospermia is due to drug misuse, the doctor may suggest drug
addiction treatment.
Fertilization rates are low in people with necrozoospermia. However, ICSI
improves the possibilities of conception.
IVF with testicular sperm extraction (TESE-ICSI) is the best treatment option in
cases of necrozoospermia. Your doctor will use a local anesthetic to numb the
testis during this procedure. After that, a needle is inserted to extract a
small tissue.
In spite of not finding any live sperm cells in the ejaculate, sperm cells are
often found in the testicles.
These sperm may not be able to penetrate and fertilize an egg on their own.
That’s why IVF with ICSI is necessary. Here, your doctor will inject the egg
directly with the sperm. With TESE-ICSI, the success rates are high.
However, considering a sperm donor or other family alternatives may be the best
next step when fertility treatments fail.
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