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Can oligospermia cause miscarriage?

Oligospermia, a condition characterized by a lower-than-normal sperm count, is a common factor in the challenge of male fertility, potentially impacting a couple’s ability to conceive.

While the direct implications of oligospermia on fertilization are widely recognised, its role in the viability of pregnancy, specifically concerning the risk of miscarriage, necessitates further exploration.

Understanding this association is critical as it could lead to better diagnostic insights and targeted treatments, offering hope to couples striving for successful pregnancies.


What is Oligospermia?

Oligospermia is defined by a sperm count that falls below the threshold of 15 million sperm per milliliter of semen, as established by the World Health Organisation (WHO). Diagnosis typically involves semen analysis, where the sperm concentration is evaluated in a laboratory setting after two to seven days of sexual abstinence.

The condition is classified into three categories: mild, moderate, or severe, based on the sperm concentration. Confirming oligospermia may require multiple semen analyses due to the natural variations in sperm count that can occur over time.

Also read : Low sperm count – Causes, Diagnosis and Treatment

Common Causes and Risk Factors

The aetiology of oligospermia is multifactorial with several identified causes and risk factors.

These can include genetic factors, such as chromosomal abnormalities; lifestyle influences like smoking, excessive alcohol intake, and obesity; medical conditions like varicocele, infections, or hormonal imbalances; and environmental exposure to toxins and radiation.

It is also influenced by age and can be associated with certain medications and treatments, notably chemotherapy and anabolic steroids.

Statistical Prevalence in the Male Population

Oligospermia affects a significant portion of the male population, with estimates suggesting that approximately 10-15% of men in the general population experience a sperm count level that would classify as oligospermia.

However, this figure is considerably higher in men presenting to fertility clinics, where the prevalence can exceed 30%. This indicates a considerable potential impact of oligospermia on male reproductive health on a global scale.

Impact on Male Fertility

The relationship between low sperm count and fertility is quite pronounced – oligospermia directly reduces the likelihood of a man’s sperm successfully fertilizing an egg. The fewer the sperm available, the lower the chance of one reaching and fertilizing an ovum.

In cases of severe oligospermia, the chances of natural conception are greatly diminished, often necessitating the need for assisted reproductive technologies such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) to achieve pregnancy.


The Intricacies of Miscarriage

Miscarriage, medically known as spontaneous abortion, is the unplanned loss of a pregnancy before the fetus reaches viability – typically defined as 20 weeks of gestation.

There are different types of miscarriage, including a threatened miscarriage where pregnancy may continue despite early symptoms, an inevitable miscarriage where the loss is certain, and a missed miscarriage where the fetus has died but there are no symptoms.

Complete miscarriages involve the body expelling all pregnancy tissue, while incomplete ones might require medical intervention.

Known Causes and Risk Factors

The causes of miscarriage can be multifaceted and vary from one case to another. Chromosomal abnormalities in the developing fetus account for the majority of lost pregnancies.

Other factors include maternal age, with higher risks associated with women over 35 years old, as well as poorly controlled chronic diseases like diabetes, lifestyle factors such as smoking and excessive caffeine consumption, and certain medical conditions like autoimmune disorders. Environmental toxins and certain infections can also raise the risk of miscarriage.

Frequency & Occurrence

Research shows that miscarriages are a common occurrence, with about 10-20% of known pregnancies ending in miscarriage. However, the actual number is likely higher as many occur before a pregnancy is clinically recognised.

The risk of miscarriage diminishes as the pregnancy progresses, with most losses happening within the first 13 weeks of pregnancy.

Scientific Insights into the Oligospermia-Miscarriage Connection

Research suggests that sperm health can affect both the fertilization process and the subsequent development of the embryo, with genetic factors within sperm seen as key contributors to miscarriage risks.

One study published in the journal Fertility and Sterility suggests that sperm with fragmented DNA could lead to an increased risk of miscarriage. The potential mechanisms proposed include compromised chromosomal integrity and subsequent impaired embryonic growth.

Furthermore, oxidative stress has been identified as a contributing factor to DNA fragmentation in sperm, suggesting environmental and lifestyle variables may influence this relationship.

Interestingly, other variables also appear to play a role. For instance, paternal age, much like maternal age, has been associated with increased miscarriage rates, potentially due to age-related decline in sperm quality.

However, the exact pathways through which oligospermia increases miscarriage risks remain only partially understood, necessitating further research to identify precise causal mechanisms. More comprehensive studies are required to establish stronger evidence for direct causation, which could eventually lead to more targeted interventions for couples experiencing recurrent pregnancy loss.

Medical Approaches and Interventions for Oligospermia

Fertility treatments tailored for individuals with oligospermia have the potential to not only increase the likelihood of conception but also may help in reducing the risk of miscarriage.

One common approach is Intrauterine Insemination (IUI), whereby concentrated sperm are directly introduced into the uterus around the time of ovulation.

Another sophisticated intervention is In Vitro Fertilisation (IVF) with Intracytoplasmic Sperm Injection (ICSI), where a single sperm is injected into an egg, bypassing many of the natural barriers to fertilization.

These treatments may improve the odds of a successful pregnancy but come with considerations. They can offer the option of preimplantation genetic testing to identify potentially viable embryos and reduce miscarriage risk due to genetic abnormalities.

However, the physical demands, financial costs, and emotional strain on couples cannot be understated.

Risks associated with fertility treatments include multiple births, which can lead to complications for both the mother and children. Ethically, interventions such as IVF with ICSI raise questions about the implications of selecting embryos and the fate of unused embryos.

Future Research Directions in Oligospermia Treatment

While current treatments offer hope for many couples, significant gaps in knowledge persist. Future research must explore the long-term health outcomes for children conceived via these methods, as well as better comprehension of the psychological impacts on parents.

Studies that compare the efficacy of different interventions could provide clearer guidance on optimal treatment pathways. Additionally, examining the socio-economic factors that influence access to treatments will be crucial, given the varying availability of resources across populations.

The importance of ongoing scientific inquiry cannot be overstated. Breakthroughs in genetic and reproductive technologies have the potential to transform lives but must be approached with a careful balance of optimism and ethical scrutiny.

With the rapid pace of scientific advancements, continuous research is essential not only to advance clinical practice but also to ensure that it is done responsibly, addressing both the health of individuals and the broader societal implications.


In concluding, the journey towards resolving oligospermia and related fertility challenges intertwines medical innovation with deep ethical deliberations. It requires a multi-faceted approach that encompasses not only the development of effective treatment options but also an understanding of the psychological, societal, and ethical dimensions.

As we advance, the research community must continue to work closely with affected individuals and society at large to navigate this complex terrain.

The shared goal must remain clear: to offer sustainable, accessible, and ethically responsible solutions that support the aspirations of couples longing to build a family, while also safeguarding the wellbeing of future generations.

  • About Author

    Dr. Supriya Puranik

    Gynaecologist & IVF Specialist

Often known as the last glimmer of hope for people who have lost all hope for conceiving a child, Dr. Supriya Puranik is a leading gynaecologist, high risk obstetrician and Head of IVF & Gynaecology department at Ankura Hospital for Women & Children.

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