The necrozoospermia or necrospermia is the medical term which is used when all the sperm is dead in the fresh semen sample. The necrozoospermia is an uncommon diagnosis. It is a rare condition. Because it is so uncommon, there is still a lot of confusion about the right way to manage with it. The incomplete necrozoospermia is when many, but not all of the sperm in the semen sample are dead. This is usually happening when less than 45%, but more than 5% are viable. [1]
The complete necrozoospermia is happening when all the sperm in the semen sample are dead. The complete necrozoospermia is a very rare condition. There are some studies in which are said that it is happening in only 0.2% – 0.5% of infertile men which suffer from complete necrozoospermia. [2] You should not confuse the necrozoospermia with asthenozoospermia. The asthenozoospermia is when the sperm motility, or how the sperm swim, is abnormal. In this case, the sperm is not moving, but it is not dead.
In many cases, the diagnosis for necrozoospermia is made incorrectly, usually because the semen sample was not collected properly either this was caused by the man who used a spermicidal lubricant while masturbating or the container may have been dirty and the contamination could kill the semen. When the sperm is looked under microscope, then it looks like a tiny tadpole, with a round head and a slender tail which helps them swim. For complete diagnosis, your doctor will require to undergo various tests, including male hormone tests, tests of sperm function, karyotype – chromosome analyses, tests of egg penetration, etc. It is very important to talk with your doctor for the proper diagnosis and treatment.
Symptoms
There are no clinical symptoms associated with necrozoospermia or dead sperm. Some men who have necrozoospermia suffer from other related disorders or diseases which have a series of symptoms. In these cases, the most common signs which are derived from other pathologies which can lead this diagnosis include:
- Abdominal discomfort
- Perineum pain
- Orchialgia (long – term pain of the testes)
- Testicular diseases: vesiculitis, epididymitis, orchitis, prostatitis, etc.
- Lack of sexual desire
- Prospermia or premature ejaculation (PE)
- Spermatorrhea (excessive, involuntary ejaculation)
But you should know that these symptoms do not always appear and men realize that they have necrozoospermia after taking a semen test and getting medical confirmation.
Causes
It can happen as an isolated event due to factors, such as stress or the intake of certain medicines. [3] But, also there are other factors which can cause permanent necrozoospermia in men, such as
- Long periods of sexual abstinence
- Hormonal imbalances
- Problems with the epididymis (which is a long, coiled tube just above each testicle, where sperm are collected and mature before ejaculation) [4]
- Spinal cord injuries
- Abnormally high body temperature (high temperature kill sperm)
- Genitourinary diseases, including urinary tract infections (UTIs) [5]
- Radiotherapy and chemotherapy [6]
- Problems with the testicles
- Hormonal cause, as with hypogonadtropic hypogonadism (HH)
- Unhealthy eating habits
- Early testicular cancer
- Regular alcohol and stress drug consumption [3]
- Anti – sperm antibodies (where the body’s immune symptom attacks its own healthy, normal cells – sperm cells, in this case)
In the mentioned cases, the treatment of necrozoospermia and reviving sperm is more challenging. The treatment of infertility may be the only option to conceive. There is no cure or specific treatment for necrozoospermia. In the cases when the cause for necrozoospermia is found, the treatment of it is the first step.        If doctor notice that there is an infection, then antibiotics can be prescribed. If it is caused by drug abuse, then the treatment of drug addiction can be recommended. The most common treatment for the complete necrozoospermia is the testicular sperm retrieval with IVF – ICSI, which is also known as TESE – ICSI. [7] The less common treatment of this is the repeated ejaculation of the week of treatment. For those people who suffer from spinal cord injuries, this can be carried out through electroejaculation, which is involving the use of electrical shocks to force ejaculation, in order to retrieve the semen.
References:
[1] Vasan SS. Semen analysis and sperm function tests: How much to test? Indian Journal of Urology. 2011;27(1):41–8. doi:10.4103/0970-1591.78424
[2] Doddamani SH, Shubhashree MN, Giri SK, et al. Ayurvedic management of necrozoospermia – A case report. Ayu. 2019;40(1):44–7. doi:10.4103/ayu.AYU_120_15
[3] Columbia University’s Mailman School of Public Health. Stress degrades sperm quality, study shows. Science Daily. 2014. Retrieved from www.sciencedaily.com/releases/2014/05/140529100719
[4] Elbashir S, Magdi Y, Rashed A, et al. Epididymal contribution to male infertility: An overlooked problem. Andrologia. 2020. Retrieved from onlinelibrary.wiley.com/doi/epdf/10.1111/and.13721
[5] Ortega C, Verheyen G, Raick D, et al. Absolute asthenozoospermia and ICSI: what are the options? Human Reproduction Update. 2011;17(5):684-92.
[6] Okada K, Fujisawa M. Recovery of spermatogenesis following cancer treatment with cytotoxic chemotherapy and radiotherapy. The World Journal of Men’s Health. 2019;37(2):166–74. doi:10.5534/wjmh.180043
[7] Negri L, Patrizio P, Albani E, et al. ICSI outcome is significantly better with testicular spermatozoa in patients with necrozoospermia: a retrospective study. Gynecological Endocrinology. 2014;30(1):48-52. doi:10.3109/09513590.2013.848427
