Low Sperm Count: Symptoms, Causes, Treatment

For men with low sperm count, it can be challenging. 

Global data shows that male infertility cases range from 20% to 70%. This issue impacts about 15% of couples around the globe, which means that many people struggle with it. 

The CDC reckons that 9.4% of American men are infertile. Central and Eastern Europe hold the biggest male infertility rates, from 8% to 12%. 

Take a look at what causes a low sperm count, its symptoms, and viable treatment opportunities. 

What Is a Low Sperm Count?

Also known as oligozoospermia, low sperm count is a problem that poses a challenge for those who want to conceive naturally. Even if men with reduced sperm count can still father a child, it can be difficult. 

Here are the classic features of low sperm count:

  • Sperm concentration: less than 15 million sperm per mL of semen. Compared to normal sperm concentration, which ranges from 15 million to over 200 million sperm per mL of semen.
  • Total sperm count: less than 39 million per ejaculate.
  • Sperm morphology (the shape and size of sperm): below 4% compared to a normal value found in healthy sperm ranging from 4% to 14%. 
  • Motility: less than 40% sperm motility compared to an expected normal value of 60% motility. 

Although only a single sperm is necessary to impregnate a woman, having a healthy sperm count raises the odds of a pregnancy every month. Male infertility typically happens as a result of a low sperm count. 

Do have in mind that in some cases, with normal semen quality, it can take 6 months to 1 year to conceive. This can happen in couples when there aren’t any fertility issues.

Now, when there is a fertility problem, like an abnormal sperm count, it can take longer than that. That’s where doing a semen analysis and fertility treatment might help. 

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Symptoms

Other than having to go the extra mile to conceive, there may not be other obvious signs of a low sperm count. In some cases, underlying health issues like hormonal imbalance, chromosomal genetic abnormality, varicocele, or any health problem that gets in the way of normal sperm production can cause symptoms.

For example, low sperm count could be accompanied by:

  • Reduced body/facial hair (or additional symptoms of hormone and chromosome abnormality)
  • Swelling, pain, or a lump in the testicle
  • Trouble enjoying a fulfilling sex life – i.e., poor sexual function, erectile dysfunction, plummeting sex drive, etc. 

Contact a fertility expert if you’ve been trying to conceive for more than 1 year with unprotected sex. Or talk to a doctor sooner if you have ejaculation problems, lump, swelling, pain, and a history of prostate and testicle problems.

Causes: Medical, Environmental, Lifestyle

Up to 30% of fertility issues happen because of complications with the male body. And up to 90% of these complications are down to low sperm count and low quality of the sperm, or both. Take a look at the potential factors causing the plummeting sperm health.

Medical Causes

Any illness, tumor, medication, or disorder that impacts the pituitary gland or hypothalamus (a small area of the brain found close to the pituitary gland) could lead to infertility in men. That’s because medical complications can trigger a gonadotropin deficiency. 

This can cause hypogonadotropic hypogonadism, an ailment that can end up causing testosterone deficiency. Sometimes the plunging sperm count could be genetic. And genetic testing can help reveal the abnormality.

Plenty of medical causes can lead to male infertility and motile sperm. These include:

  • Troubles with ejaculation (i.e., retrograde ejaculation happens when semen goes into the bladder, rather than coming out of the tip of the penis.)
  • Varicocele
  • Undescended testicle
  • Anti-sperm antibodies
  • Infection (some infections affect sperm production or block the passage of semen. Some STDs, like HIV and gonorrhea, can cause such a problem. This includes testicle and epididymis inflammation.)
  • Blockage or defects in the tubes that carry sperm 
  • Chromosome defects
  • Celiac disease
  • Tumor
  • Past surgical procedures (i.e., prostate surgery, vasectomy, testicular surgery, inguinal hernia repairs, can all affect the sperm. Mainly its count, quality, and motility.)
  • Certain medications (some treatments can impair sperm production and sperm motility. Chemotherapy, some antibiotics, antifungal, and ulcer meds can lead to plummeting male fertility.)

Environmental Causes

Many things predispose men to a plummeting sperm count. But, very few seem to notice the adverse impact of environmental chemicals. Especially insecticides, industrial waste, herbicides, food additives, etc. Air pollution also has a role to play. 

Several other components such as phthalates, heavy metals, and heat exposure can also have a drastic impact on the quality of the semen. 2022 research indicates that all of these adverse factors result in poor sperm count. Alongside plunging sperm motility, concentration, and viability. 

There is also a possibility of losing function in mitochondria and elevated sperm DNA fragmentation index. All of them can lead to infertility in men. 

The good thing is factors such as these can be modified and prevented. If you decrease the exposure, you can mitigate the risk. Making positive lifestyle changes can help. 

Health, Lifestyle and Other Causes

Plenty of lifestyle choices can influence the quality of the sperm. For example, smoking too many cigarettes, heavy drinking, and abusing substances can lead to low sperm counts. Data shows that smokers had 13-17% lower sperm density than non-smokers. 

Smoking impacts the outcome of semen analysis in infertile men. Studies show that drinking alcohol can also cause a heap of trouble in male fertility. Men who drank 40 units a week had a 33% lower total sperm count. 

Now, pair that with stress, obesity, and heavy caffeine intake, and you get a significant harmful impact on sperm. Research indicates that adverse effects from these factors can be passed on from father to child. As long as you maintain a positive or healthy lifestyle, you can overcome the burden. 

doctor

Risk Factors

Some risk factors make men more likely to have a low sperm count. Problems with male fertility can manifest as a result of:

  • Being obese or overweight
  • Having severe anxiety, stress, or depression
  • Being exposed to chemicals and toxins that affect the semen
  • Overheating the testes (such as staying too long and too often in hot tubs and sauna can temporarily affect sperm count)
  • Testicle trauma
  • Some chronic diseases and tumor
  • Radiation, chemotherapy, or other treatments for cancer
  • Having a prior pelvic, abdominal surgery, or vasectomy
  • Drug or alcohol abuse
  • Smoking
  • History of some injections
  • Genetic predisposition 

How To Prevent Low Sperm Count

To prevent low sperm count or motility, it’s best to avoid factors that are causing these problems. Fertility preservation comes down to abstaining or limiting alcohol intake. Men are also advised to stop smoking and steer clear of any illegal substances they might be using.

If you suspect that the meds you are taking affect your semen sample, talk to a specialist. Overall, it’s important to keep a healthy weight so that you can reduce the pressure on the pelvic floor and maintain adequate blood flow. 

Extra pounds can increase heart rate and decrease the body’s capability of transporting blood. Another key prevention tactic is to avoid toxins, pesticides, and other chemicals that may lead to male infertility. 

Managing daily stress can also help and any other psychological factors that might have led to reduced fertility. This includes severe depression or anxiety.

Diagnosing Low Sperm Count

To identify sperm count, men need to do a semen analysis. You can test your sperm quality at the nearest fertility testing clinic, a doctor’s office, or do an at-home test. There are testing sperm kits available. For more accurate results, have your sperm analysis clinically validated.

Complications

Dealing with infertility due to poor sperm count can be downright overwhelming. Especially if you and your partner are looking to have a baby. 

Some men might also experience complications related to the sperm count. For example:

  • Feeling stressed and on edge because you have trouble conceiving.
  • Spending a hefty sum of money on reproductive medicine, fertility surgery, and anything that can help boost the odds of conception.
  • Trying all kinds of treatments to have a baby.

Can You Get Someone Pregnant with a Low Sperm Count?

Yes. But, the odds of fertilizing the partner’s egg are relatively lower compared to individuals with a high sperm count. Couples with fertility troubles prefer to try multiple times. Others use donor insemination. 

Also, oligozoospermia shouldn’t be confused with azoospermia. Oligozoospermia means fewer sperm concentrations, while azoospermia signifies no spermatozoa in the ejaculate. 

In other words, a lack of sperm in the semen. There are different types of azoospermia, non-obstructive azoospermia (NOA) and obstructive azoospermia (OA). 

Azoospermia might or might not respond to treatment. But, men with azoospermia may still father a biological child through IVF (in vitro fertilization). For a better fertilization phase, intracytoplasmic sperm injection can help.

Treatment

Various options for reduced sperm count can come in handy. Depending on the results of the semen analysis, experts can suggest one of the following:

  • Counseling or meds – When there is mild ED or premature ejaculation, counseling can ease the unrest. Experts may suggest men take vitamins to ease the symptoms. Vitamin D can improve circulation, thwart inflammation, and promote nitric oxide production
  • Hormone treatment – Men with low T have lower male sex hormone levels than normal. A plummeting testosterone level isn’t the only thing that pumps up the man’s performance and sex drive. But, low testosterone can decrease the ability to have satisfying intercourse. Doctors can suggest meds or hormone replacement to help with that.
  • ART treatments – These options involve surgical extraction, taking sperm from normal ejaculation, or from a donor. The sperm cell is then used to fertilize the female egg. 
  • Surgical procedure – Many surgeries for male infertility can manage the problem. Options like varicocelectomy, varicocele embolization, vasectomy reversal, and others may be recommended. 

Procedures like sperm extraction, testicular biopsy, and fine-needle aspiration are effective in 20% to 45% of men with NOA. With OA, a more invasive treatment method may be necessary. Surgery can correct the obstruction. 

It could aid in achieving a pregnancy and curb the need for assisted reproductive technology. But, the delicacy and accuracy of the surgery will affect the outcome. After vasoepididymostomy, for example, 20% to 40% of couples can conceive with intercourse. 

Those who want to get someone pregnant without surgery may opt for intrauterine insemination. This is a type of artificial insemination. Sperm is placed into the uterus when the ovaries release eggs ready for fertilization. 

How to Naturally Increase Your Sperm Count 

Increasing the sperm count naturally can be done with dietary changes, physical activity, and natural remedies. Although you can’t expect to increase your sperm volume overnight, you can use them to keep your sex life and general health on track. 

Diet and Exercise

Research shows that relying on the Mediterranean diet with regular exercise can improve the quality of sperm in young, healthy men. 

Scientists evaluated 263 men. The patients were divided into two groups. One adhered to the Mediterranean diet and exercise, and the other didn’t. 

All outcomes were measured twice. And based on the results, the Mediterranean diet intervention proved highly beneficial. 

Fill your plate with antioxidant foods rich in vitamin C and other nutrients. Increase the healthful fat intake, such as omega-6 and omega-3 fats. Limit the soy intake and foods packed with estrogen since they can affect the quality of the sperm.

mediterranean

Holistic therapies

Other than the food you eat, complementary, holistic, and alternative therapies might help. Taking Ashwagandha roots as a supplement could aid with sperm motility and count and balance reproductive hormones. 

Fenugreek is another potential option for male fertility. But, its efficiency can vary from person to person. Don’t expect holistic approaches to be more effective than medical treatment. 

Weight management

With that in mind, there is ample research that supports weight reduction. Losing a few extra pounds can restore proper bodily functions, circulation, and ease the pressure on the joints. 

Stop Smoking and Heavy Drinking

It is also necessary to stop smoking and heavy drinking. As previously mentioned, smoking can have a drastic impact on male fertility. 

It can cause DNA damage in sperm. A study indicates that men who smoked 20 cigarettes daily had a 19% drop in sperm concentration compared to non-smokers. 

While heavy drinking raises estrogen levels, lowers testosterone, and reduces sperm production. So, when trying to improve male infertility naturally, it’s important to focus on all factors that can impact the quality of the sperm. 

Conclusion

Many couples have trouble conceiving. The causes will vary from person to person. Luckily, the reduced sperm count can be managed with adequate treatment. 

To increase the odds of conception, contact a specialist. They can suggest the best form of treatment tailored to your needs. They may also suggest some dietary changes and alternative medicine. 

Keep a well-balanced diet to work on your sperm count and do a sperm analysis to identify the problem. With expert help, you can get all the answers you need.

Explore More

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Sources

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  8. Luigi Montano, Elisabetta Ceretti, Francesco Donato, Paolo Bergamo, Claudia Zani, Gaia Claudia Viviana Viola, Tiziana Notari, Sebastiana Pappalardo, Danilo Zani, Stefania Ubaldi, Valentina Bollati, Claudia Consales, Giorgio Leter, Marco Trifuoggi, Angela Amoresano, Stefano Lorenzetti,Effects of a Lifestyle Change Intervention on Semen Quality in Healthy Young Men Living in Highly Polluted Areas in Italy: The FASt Randomized Controlled Trial, European Urology Focus, Volume 8, Issue 1,2022, Pages 351-359. https://www.sciencedirect.com/science/article/pii/S2405456921000419
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