The World Health Organization (WHO) has established standardized minimum sperm parameters required for natural conception via intercourse. The following values are the WHO established minimum acceptable sperm parameters:

Volume: > 2.0 ml
Concentration: >20 million/ml
Motility: > 50%
Morphology: >30% with normal morphology
White Blood Cells (Round Cells): < 1 million/ml
pH: 7.2-7.8

However, given that these values are established for natural conception, it is possible to achieve pregnancy with values lower values during IVF treatments, especially when ICSI is used.

The following classification system is used depending on how the values on your sperm analysis report relate to the reference values established by WHO:

Oligozoospermia refers to sperm samples with count lower than 20 million/ml.

Astenozoospermia refers to the sample of sperm whose motility has been found to be lower than 50%.

Teratospermia (teratozoospermia) refers to a high level of sperm cells in the ejaculate that are considered to be morphologically "abnormal".

Azoospermia is a condition characterized by the total absence of sperm cells in the sperm. Azoospermia is further dividen into two sub-categories: Obstructive azoospermia where sperm production occurs but the duct system carrying sperm outside has an obstruction. Non-obstructive azoospermia refers to problems (either genetic or pathophysiological) where sperm production is absent.

There are a number of factors that may affect sperm quality and therefore cause male infertility. These range from genetic problems to pathophysiology and lifestyle and environmental factors. Some things that may reduce sperm viability and its ability to fertilize eggs can include: 

  • Congenital birth defects or genetic disorders can affect spermatogenesis at various stages.

  • Excessive alcohol consumption is known to negatively affect many sperm parameters.

  • Recreational drugs or some prescription drugs can possibly interfere with spermatogenesis and sperm quality. Anabolic steroids have also been shown to dramatically reduce sperm count.

  • Environmental toxins, including pesticides used during farming and exposure to lead can impact sperm viability.

  • Smoking cigarettes or other tobacco products have been shown to reduce sperm quality.  

  • Health problems associated with bodily infections and fever can severely reduce sperm count. If you had sperm testing following an infection, the sperm parameters may have been affected. We recommend a retest after three months to double check.

  • Some medication have been shown to reduce certain sperm parameters. Some antidepressants are also under scrutiny in terms of their impact on sperm DNA fragmentation.

  • Chemotherapy and radiation therapy affect cells that divide quickly. Germ cells are also such cells and they are targeted by these therapies.  Age is also an important factor in terms of decline in male fertility. 

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As part of a clinical study, North Cyprus IVF Center is getting ready to offer stem cell therapy for patients with non-obstructive azoospermia. If you have been through sperm testing where the result has indicated azoospermia, and if surgical sperm extraction methods such as TESA, PESA, TESE or Micro TESE did not result in a desirable outcome, stem cell therapy can be an option. At North Cyprus IVF Center, we are preparing to offer mesenchymal stem cell therapy to aid with spermatogenesis with some very promising preliminary results. Please contact us if you would like to take part in our stem cell therapy for azoospermia and sperm production problems. 

​​Since spermatogenesis, the process of  maturation of sperm cells from germ cells takes about 65 to 70 days, IVF treatment following stem cell therapy should be scheduled at least 3 months after stem cell injections. Patients taking part in stem cell therapy should understand that there are no guarantees that stem cell therapy will result in live sperm cells and that this is still in its experimental investigative stage. 

and/or maturation of sperm cells. The problem with non-obstructive azoospermia is more severe compared to obstructive azoospermia since surgical sperm extraction methods are not likely to produce desired results. In such cases, using donor sperm usually becomes the next best alternative. At North Cyprus IVF Center, we are currently offering stem cell therapy on a clinical trial basis for patients with non-obstructive azoospermia. Please contact us to obtain more information about this study and whether you would be suitable to take part. For more information, please see our "Stem cell therapy for non-obstructive azoospermia" link. 

If you have been diagnosed with azoospermia (total absence of sperm cells in the ejaculate), it will be important to be able to precisely identify the type of azoospermia present. As mentioned above, exposure to certain environmental factors as well as previous diseases or medication can possibly affect your sperm parameters. If a thorough investigation has been made and no direct effector has been identified, a second diagnosis will be in order. This will be to classify the type of azoospermia present.

Obstructive azoospermia refers to a condition where spermatogenesis (sperm production and possibly sperm maturation) is present, however, the channels which carry the sperm outside via ejaculate may be blocked or damaged. In such cases, surgical sperm retrieval / extraction methods are used to aspire or extract sperm cells. Depending on the type or location of obstruction, sperm aspiration, extraction or other biopsy methods can be used. 

Non-obstructive azoospermia refers to problems with production 

How to Interpret a Sperm Analysis?

Sperm testing, azoospermia and IVF treatment options

Factors Affecting Sperm Parameters and Male Fertility

Obstructive Azoospermia versus Non-Obstructive Azoospermia

Stem cell therapy for sperm production
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If your sperm analysis indicates a problem  with any one or more than one of the sperm parameters, further evaluation will be in order. Problems with sperm parameters may indicate other underlying medical conditions which can only be elucidated via proper medical history taking. Effective history taking will allow us to review possible medical issues such as recent fevers, infectious diseases, past history of cancer, problems that might be associated with previous surgeries including retroperitoneal, pelvic, bladder or prostate surgeries as well as family history of cryptorchidism or hypogonadism. Certain medications are known to interfere with spermatogenesis and sperm maturation, therefore, prescription and non-prescription medication, sports supplements or any other drugs must be evaluated in terms of their possible impact. For an effective assessment, you must be forthcoming about all the relevant information because failure to do so can affect the level and quality of your care. 

Obstructive and non-obstructive azoospermia treatment options

Stem Cell Study

Male Infertility: Causes and Investigation

North Cyprus IVF Clinic specializes in infertility investigation as much as it offers treatments. Even though there is a common misconception that majority of fertility problems are female oriented, in quite a few cases, infertility arises from a male factor. It has been estimated in 2014 that 30% of all infertility cases are male related while female related infertility is also estimated to be 30%. Both male and female factor infertility is also categorized as 30% while the remaining 10% is unexplained infertility. This tells us that around one-third of all infertility cases are solely male factor related, which makes male infertility investigation an important part of fertility/infertility assessment.