These may be defective formation, transport, OR deposition of the sperms in the posterior fornix. The causes may affect quality or quantity of the sperm.

  1. Congenital: e.g., absent vas deferens, etc.
  2. Traumatic
  3. Inflammatory: e.g., prostatitis, STDs, etc.
  4. Neoplastic: any neoplasm destroying testicular tissues.
  5. Dysfunctions: e.g., premature and retrograde ejaculations, Abnormal seminal fluid or sperm motility / Immunological factors, varicocele.
  6. General causes: genetics, smoking, alcoholism, liver cell failure, even idiopathic.

Diagnosis

  1. Clinical: by history taking and examination of the husband:

    • Age and Occupation (radiation or heat exposure)
    • Previous marriage and if have child
    • Smoking / alcohol
    • History of some diseases, trauma, surgery (hernia repair or vasectomy), pelvis infections (e.g., mumps), hx chemo/radiotherapy, sexual dysfunction, etc.
  2. Investigations:

    • C.B.C., liver function, renal function, and Semen analysis: “the most important”.
    • The normal Semen analysis (after abstinence for 72 hrs) is characterized by:
      • Volume: 3-6 ml “at least more than 2 ml”.
      • Count: > 20 million sperms / ml.
      • Normal Motility > 50%.
      • Normal Morphology: > 40%.
    • Other investigations and treatment: should be requested and managed by a urologist if needed.