What Is Hypospermia and How Can It Affect Fertility?

What Is Hypospermia?

Hypospermia is a condition where the amount of semen produced during ejaculation is abnormally low (less than 1.5 milliliters). This reduced volume can make it harder for sperm to reach the egg and potentially affect fertility. 

It is important not to confuse hypospermia with oligospermia, which refers to a low sperm count rather than low semen volume.

Hypospermia may not always show symptoms. It is often discovered accidentally during fertility tests. Reduced semen volume is usually the main, and sometimes the only, sign.

This condition is different from hyperspermia, where semen volume exceeds the normal range. While hyperspermia might not always impact fertility, hypospermia frequently signals issues that require medical care. 

Causes of Hypospermia

Hypospermia can happen for several reasons, including medical conditions, genetic factors, or lifestyle habits:

Medical Conditions

Hypospermia is often linked to medical conditions that affect semen production or release, lowering volume and fertility:

• Retrograde Ejaculation: In this condition, semen flows backward into the bladder instead of exiting through the penis. This can happen due to nerve problems, diabetes, or surgeries in the pelvic area. Men with this issue may notice cloudy urine after ejaculation, as semen mixes with the urine.
• Varicocele: A varicocele is when veins in the scrotum become enlarged. This raises testicle temperature and affects sperm and semen production. It’s a common cause of reduced semen volume and male infertility.
• Anatomical Problems: Blockages in the semen ducts or an enlarged prostate can reduce semen flow. These issues may also cause discomfort during ejaculation.
• Hormonal Imbalances: Low testosterone (hypogonadism), high prolactin, or thyroid issues can disrupt this balance and lead to reduced semen production.
• Infections: Infections in the reproductive organs, such as prostatitis (inflammation of the prostate gland) or epididymitis (inflammation of the tube that stores sperm), can reduce semen volume

Genetic Causes

Mutations in the CFTR gene, linked to cystic fibrosis (a condition affecting the lungs and digestion), can harm the male reproductive system. These changes may block or remove the vas deferens, the tubes that carry sperm. It can lead to lower semen volume and fertility challenges.

Lifestyle and Environmental Causes

Smoking and drinking too much alcohol can harm the reproductive system, reducing the amount and quality of semen.

Studies show that men who smoke have 22% lower sperm concentration and 19% less sperm motility than non-smokers.

Contact with harmful chemicals like pesticides or heavy metals can damage sperm and semen production over time.

Certain medications and recreational drugs can harm semen production. For example:

• Anabolic Steroids can shrink the testicles and stop the body from making enough testosterone, reducing semen production.
• Using opioids for a long time can lower testosterone levels, which decreases semen volume.
• Cancer treatments like chemotherapy can damage the cells in the testicles that produce sperm and semen.

Maintaining a healthy weight is crucial for reproductive health

Obesity can negatively affect semen production. It disrupts hormone levels and increases the risk of reproductive issues. 

On the other hand, a study found that underweight men (BMI below 18.5) have lower semen volume and sperm concentration. 

This shows that being either too thin or overweight can harm semen quality. Keeping a healthy weight is important for good reproductive health.

How Is Hypospermia Diagnosed?

Diagnosing hypospermia starts with a semen analysis. This test measures important factors like semen volume, sperm count, and how well the sperm moves. A semen volume of less than 1.5 milliliters across 2 separate tests confirms hypospermia.

If the semen analysis shows signs of hypospermia, doctors may suggest additional tests to find out the cause:

• Ultrasound: Helps detect blockages or abnormalities in the vas deferens, prostate, or other reproductive organs.
• Hormonal Tests: Measures hormone levels like testosterone, FSH, and LH to identify imbalances.
• Genetic Screening: Identifies mutations, such as in the CFTR gene.
• Urinalysis Post-Ejaculation: Checks for retrograde ejaculation by detecting semen in the urine.

How Does Hypospermia Affect Fertility?

Hypospermia can reduce a man's ability to conceive a child. This happens because low semen volume reduces the amount of fluid needed to carry sperm to the egg. 

Semen doesn’t just transport sperm—it also gives sperm the nutrients and environment they need to survive and swim. If there isn’t enough semen, sperm may struggle to reach and fertilize the egg.

Sometimes, hypospermia occurs alongside other issues, like low sperm count or slow-moving sperm, which makes natural conception even harder.

However, hypospermia doesn’t always mean infertility. Treating the root cause can improve the chances of having a child. 

Treatment Options for Hypospermia

Hypospermia treatment depends on its cause. Once doctors identify the main issue, they recommend solutions to improve semen volume and fertility. Below are common treatment options:

Lifestyle Changes

Making healthy lifestyle choices can improve semen volume and fertility. Eating well, staying active, and avoiding smoking or heavy drinking can make a big difference.

Medical Treatments

Some medications can treat hypospermia effectively, depending on the cause:

• Retrograde Ejaculation: Medications like alpha-adrenergic agonists can help tighten the bladder neck during ejaculation. It prevents semen from flowing backward into the bladder.
• Hormonal Issues: If testosterone is low, hormone therapy or medications can boost levels and improve semen production.
• Infections: Doctors can prescribe antibiotics or antiviral medications to treat infections in the reproductive system, such as prostatitis or epididymitis.

Surgical Options

Surgery may be needed for physical blockages or varicocele. 

Varicocele repair involves correcting enlarged veins in the scrotum to improve sperm and semen production. 

For blocked ducts, doctors perform surgery to remove the obstruction, restoring proper semen flow.

Assisted Reproductive Techniques (ART)

If other treatments don’t work, assisted reproductive techniques (ART) can help couples have a baby:

• In intrauterine insemination (IUI), sperm is placed directly into the uterus to overcome issues with low semen volume. 
• In in vitro fertilization (IVF), sperm is combined with the egg in a lab to improve the chances of fertilization. 

Treating hypospermia isn’t one-size-fits-all. Each man’s situation is unique, and a fertility specialist can help find the best solution.