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Necrozoospermia Causes, Diagnosis, and Treatment

Necrozoospermia Causes, Diagnosis, and Treatment

One of the uncommon conditions couples in Australia struggle with today is necrozoospermia. This rare condition is surrounded by many misconceptions that cause couples to make uninformed decisions when trying to get pregnant. Others don’t even know much about it, a situation that creates a lot of confusion.

Whether you suspect you have necrozoospermia or there’s a confirmed diagnosis, it’s crucial to know more about the condition and make smart choices. This post will share more information on necrozoospermia causes and treatment to keep men or couples informed.

What is Necrozoospermia and how it can be treated using IVF?
What is Necrozoospermia and how it can be treated using IVF?

What’s necrozoospermia?

Necrozoospermia is a medical word used to describe dead sperm in a fresh semen sample. Usually, necrozoospermia is classified into two: moderate with 50-80% necrotic sperm and severe with 80% or more necrotic sperm. A sperm sample can only be considered normal if 30% of the sperm or less are necrotic.

Finding someone with complete necrozoospermia is not easy. It is estimated that only 0. 2% – 0.5% of the infertile men have complete necrozoospermia.

What causes necrozoospermia?

The primary cause of necrozoospermia is not yet clear, and since the condition is also rare, there are many unknowns. But there are some theories and possible reasons for this condition which include:

  • Early testicular cancer
  • Anti-sperm antibodies (a situation whereby the body’s immune system attacks its own normal sperm cells)
  • Unusual high blood temperature (primarily affects men who use hot tubs and wheelchairs)
  • Constant exposure to toxins like pesticides, Lead, Mercury, and the cadmium
  • Advanced paternal age
  • Infection in the male reproductive tract
  • Hormonal causes like hypogonadotropic hypogonadism
  • Street drug use
  • Spinal cord injuries
  • Prolonged periods without ejaculation
  • Problems with epididymis or testicles
  • Varicocele (veins that are abnormally dilated in the scrotum)
Five Important Facts About Sperm
Necrospermia is usually confused with asthenozoospermia, which is the inability of the sperm to move even when alive.

Is necrozoospermia the same as asthenozoospermia?

One of the common misconceptions is that these two terms have the same meaning, but that’s not the case. You should not confuse necrozoospermia with asthenozoospermia or use these two terms interchangeably. Necrozoospermia defines a situation whereby the sperms in a semen sample are dead, while asthenozoospermia is when the sperm can’t swim to fertilize an ovulated egg. In asthenozoospermia, the sperm do not move but aren’t dead.

Both necrozoospermia and asthenozoospermia are potential causes of fertility issues in men and don’t usually have outward symptoms. The best way to diagnose these issues is by conducting a semen analysis. And even with the tests, the cause of 50% of the infertility cases in men is often left undetermined.

Also, the treatment options for necrozoospermia and asthenozoospermia are entirely different.  Asthenozoospermia requires in vitro fertilization or IVF with intracytoplasmic sperm injection (ICSI). With ICSI and IVF, a single sperm will be injected into an egg. With necrozoospermia, IVF with ICSI cannot be done with fresh sperm samples because you cannot inject dead sperm into an egg.

False diagnosis of necrozoospermia 

Although necrozoospermia can only be diagnosed after analyzing a semen sample, some mistakes may occur, causing false diagnoses. This may happen if:

  • You use a dirty container to collect the sperm. The semen sample needs to be collected in a dry and sterile cup or container. If you opt to use a dirty cup, the sperm cell might be killed even before the test is done.
  • You use an ordinary lubricant. Each time you need to masturbate for semen analysis, it’s vital to use the proper lubricant. Ordinary lubricants may get the job done, but they are more likely to kill the sperm. Experts recommend using fertility-friendly brands because they provide a conducive environment for the sperm. If you don’t know any fertility-friendly lubricant, you should consult your health care provider and use them as instructed.
  • You collect the sperm in an ordinary condom. Some men find it challenging to get semen samples through masturbation, so they prefer having sex to get a sample. If you cannot get your semen sample through masturbation, you will need a special condom made explicitly for medical semen collection. Buying any condom you find in the market, including those that don’t have spermicide, will be a risk because the latex material can also kill the sperm.

Once the results are out and you receive a necrozoospermia diagnosis, your physician will need to repeat the test. You will be asked to provide another sample. When repeating the test, your healthcare provider may also ask that you provide two samples in a day. This is done because the next ejaculation will likely have fresh sperm since the sperm will not have spent a long time waiting to be released. Therefore the fresher the sperm, the more accurate the analysis will be at diagnosing infertility issues.

Necrozoospermia treatment

In a case where the cause of necrozoospermia is established, the healthcare provider will first focus on treating that cause. For instance, if you have an infection, they will prescribe antibiotics. In case your necrozoospermia occurs due to drug abuse, they will recommend treatment for drug addiction.

The best and most reliable treatment for dead sperm in a sample is testicular/epididymal sperm extraction (TESE) with ICSI. During this procedure, the physician will administer local anesthesia to numb the testis and then insert a needle to extract a sample of testis tissue.

While you might not have any living sperm cells after ejaculation, some immature sperm cells are in the testicles. The immature cells can be cultured in a conducive environment in a fertility clinic lab. While they might not be able to penetrate and fertilize an egg independently, you can rely on them for IVF or ICSI. The experts will inject the mature sperm cells directly into an ovulated egg when you are ready to have children.

Additional treatment options to consider

Another unpopular but possible treatment people who produce dead sperm can consider is repeated ejaculation during the week of the treatment. Men with spinal cord injuries may consider carrying out this procedure through electro-ejaculation. This process entails using a lot of electrical shocks to force ejaculation so as to retrieve semen.

What is the treatment of dead sperm?
What is the treatment of dead sperm?


Infertility is one of the common problems that affect a significant number of couples in Australia. Suppose you try fertility treatments, but your efforts do not yield any results. In that case, you should consider alternative family options such as adopting or fostering a baby or using a sperm donor. The choice will entirely depend on you or your spouse.

While knowing that you have infertility issues may be upsetting and challenging, it’s important to remember that there are other options you can consider to become a parent. Talk to your fertility doctor to know the best approach you can consider depending on your condition and how fast you intend to have a child.