August 19, 2019

Low Sperm Count: Causes, Symptoms And Treatment

Sperm count or total sperm count refers to the average total number of sperm present in one sample of semen. Sperm count is one of the several qualities that are assessed during routine semen analysis and is considered an important factor for fertility.

Low Sperm Count refers to semen with a low concentration of sperm and it can be commonly found in male fertility.

When the fluid (semen) you ejaculate during an orgasm contains fewer sperm than normal it is often referred to as Oligospermia  or as popularly know Low Sperm Count.

A complete absence of sperm is called Azoospermia

Based on the most current World Health Organization guidelines, a healthy sperm count is 15 million per milliliter (ml) or at least 39 million per sample.

A sperm count lower than 10 million per ml is considered abnormal and commonly associated with male infertility.

Anything that impacts the hormones that control the production of sperm or acts as an anti-oxidant and may aid the healthy development of sperm and help improve sperm count.

Antioxidants are molecules that help remove and deactivate free radicals and other compounds that damage cells. Several vitamins and minerals have shown to act as antioxidants, and several studies have linked antioxidant consumption with increased sperm count.

Antioxidants that may contribute to a healthy sperm count include: selenium, vitamin C (ascorbic acid), vitamin E, glutathione.

In general, factors that influence testosterone levels are thought to have the most significant impact on sperm number and quality.

What are the Causes of Low Sperm Count? 

The causes of a Low Sperm count can be categorized into three (3) groups;

Medical Causes

👉 Problems with sexual function; for example, low sex drive or difficulty maintaining an erection (erectile dysfunction)

👉 Pain, swelling or a lump in the testicular area.

👉 Decreased facial or body hair or other signs of a chromosome or hormone abnormality

👉 Infection: Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the Epididymis (Epididymitis) or Testicles (Orchitis) and some sexually transmitted infections, including Gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved if properly managed.

👉 Varicocele: A varicocele is a swelling of the veins that drain the testicles. Its most common reversible cause of male infertility. Although the exact cause its unknown, it might be related to abnormal testicular temperature regulation. Which can eventually result in reduced quality of sperm.

Environmental Causes 

👉 Overheating the testicles: Elevated temperatures impair sperm production and function. Although studies are limited and are inconclusive, frequent use of saunas or hot tubs might temporarily impair sperm count.

👉 Sitting for long periods, wearing tight clothing or working on a laptop computer for long stretches of time also might increase the temperature in your scrotum and slightly reduce sperm production.

👉 X-ray  Exposure: Exposure to X-ray can reduce sperm production.

Lifestyle Causes

👉 Drug use: Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana might reduce the number and quality of your sperm as well.

👉 Alcohol use: Drinking alcohol can lower testosterone levels and cause decreased sperm production.

👉 Cigarette smoking: chemicals in cigarette smoke combine with RBC, preventing them from carrying a normal load of oxygen. This is one reason that smokers are less likely to gain weight. Studies have conclusively shown a significantly decreased fertility in smokers.


The first recommended line of treatment is to try non-pharmacologic remedies.

To protect your fertility, avoid known factors that can affect sperm count and quality. For example:

👉 Don't smoke.

👉 Limit or abstain from alcohol.

👉 Stop the use of illicit drugs.

👉 Talk to your doctor about medications that can affect sperm count.

👉 Maintain a healthy weight.

👉 Avoid heat.

NOTE: in the latest statement of semen quality (2010), the WHO now considers a sperm count of  15 million/mL to be low for fertile men.


👉 Physical examination and medical history: This includes examination of your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility.

👉 Semen analysis: A low sperm count is diagnosed as part of a semen analysis test. Sperm count is generally determined by examining semen under a microscope to see how many sperm appear within squares on a grid pattern.

👉 Scrotal ultrasound: This test uses high-frequency sound waves to look at the testicles and supporting structures.
Hormone testing:  Your doctor might recommend a blood test to determine the level of hormones produced by the pituitary gland and testicles, which play a key role in sexual development and sperm production.

👉 Testicular biopsy: This test involves removing samples from the testicle with a needle. The results of the testicular biopsy can tell if sperm production is normal. If it is, your problem is likely caused by a blockage or another problem with sperm transport. However, this test is typically only used in certain complicated situations and is not commonly used to diagnose the cause of infertility.


👉 Surgery:  For example, a varicocele can often be surgically corrected or an obstructed vas deferens can be repaired, Prior vasectomies can be reversed. In cases where no sperm are present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm retrieval techniques.

👉 Treating infections: Antibiotics can cure an infection of the reproductive tract, but this doesn't always restore fertility.
Hormone treatments and medications:

Your doctor might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones.

👉 Assisted reproductive technology (ART): ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific situation and wishes. The sperm are then inserted into the female genital tract, or used for IVF or intracytoplasmic sperm injection.

Remember Health Is Wealth 

Written by: Isikadi Precious RN. 

Please note the information here does not replace the medical advice and Evaluation given by your health care provider, but to serve as an awareness to both professional and Non-professional purposes. 
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