Low sperm count or Oligospermia means that the number of sperm in a man’s ejaculate or semen is below normal. A total lack of sperm in the ejaculate is known as Azoospermia. Often semen with a decreased sperm concentration may also show significant abnormalities in sperm morphology and motility.
A sperm count in the ejaculate can vary throughout a man’s life. A healthy sperm count is necessary for fertility. The World Health Organisation (W.H.O) in its latest statement of semen quality (2010), considers a sperm count at 15 million/mL or above as normal sperm count. And anything below that is considered as sperm count low and diagnosed as oligospermia or oligozoospermia.
The primary symptom is the inability to have a baby. There can be no other noticeable signs and symptoms. In some cases, a fundamental issue, for example, a hereditary chromosomal abnormality, a hormonal imbalance, dilated testicular veins or a disorder that obstructs the passing of sperm could potentially cause warning signs. The low sperm count signs or oligospermia symptoms include:
Most of the cases of oligospermia are detected once the man tries to become a father, and when pregnancy is not achieved in a natural way, even after a year of regular unprotected intercourse, then both the male and female partner must undergo tests to check their fertility conditions.
A gynaecologist or an infertility consultant may order a semen analysis test. The diagnosis of low sperm count or oligospermia is based on low sperm count found in a semen analysis test. However, two tests should be performed to confirm the results. A semen analysis test usually checks at along with pH, etc.:
| Parameters | Values |
| Ejaculate Volume | ( > 1.5 mL) |
| Sperm Concentration | ( > 15 million/mL) |
| Total Motility | ( > 40%) |
| Progressive Motility | (>= 32%) |
It is more than just a sperm count that matters for a pregnancy to occur, in normal methods of conception as well as assisted methods such as artificial/intrauterine insemination or In vitro fertilisation.
Low sperm count in the ejaculate may at times be accompanied by an abnormality in sperm motility and morphology, and if the motility is poor, the sperm will not be able to reach the oocyte. If the morphology is poor, the sperm would not be able to penetrate the egg. Hence fertilisation is affected.
Types of Low Sperm Count or Oligospermia
When a man has less than 15 million sperm per mL, depending on how low his count is, we distinguish between different levels of severity. The levels are used to diagnose how severe the problem is on a case to case basis, and the treatment would be totally dependent on the level of oligospermia. It is classified in the following groups.
Types of Low Sperm Count
| Types | Sperm concentration in Ejaculate |
| Normozoospermia | >15 million sperm/mL |
| Mild Oligospermia | 10 million to 20 million sperm/mL |
| Moderate Oligospermia | 5 million to 10 sperm/mL |
| Severe Oligospermia | 1 to 5 million sperm/mL |
| Cryptozoospermia | 0 to rare sperm, hidden sperms found after centrifugation |
| Azoospermia | 0 sperm |
MODERATE OLIGOSPERMIA
When the number of sperm found in the semen ranges from 5 million to 10 million sperm per millilitre. Improvement can be achieved in these cases following proper treatment and a healthy lifestyle for a few months. Semen analysis should be repeated after a few months.
SEVERE OLIGOSPERMIA
When the number of sperm found in the semen ranges from 1 to 5 million sperm per millilitre. Pregnancy, in this case, can only be achieved by ART (Assisted reproductive technology).
CRYPTOZOOSPERMIA
When the number of sperm found in the semen sample after centrifugation is 0 to rare. Pregnancy, in this case, also can only be achieved by ART (Assisted reproductive technology).
AZOOSPERMIA
When there is no sperm found in the ejaculate, the condition is called azoospermia. Pregnancy, in this case, can only be achieved by ART (Assisted reproductive technology).
Even though pregnancy with oligospermia is possible, still it should be kept in mind that depending on the severity of the case, infertility treatments are available, which allow couples to overcome these obstacles and allow fertilisation to occur successfully.
Most men are completely unaware of their fertility status unless they can make a female pregnant till then they are in the dark. Many reproductive and non-reproductive causes have been reported, but in most cases, the cause remains unexplained because a low sperm count can occur as a temporary alteration. Low sperm count can be caused by a number of medical issues, environmental factors and lifestyle choices. Treatment will be totally dependent on the cause of the problem.
​Causes of Low Sperm Count
| Medical Causes | Environmental Causes | Lifestyle Choices |
| Varicocele | Industrial Chemicals | Drug Use |
| Infection | Heavy Metal Exposure | Smoking and Alcohol Consumption |
| Ejaculation Problems | Radiation or X-rays | Stress |
| Tumours | Overheating of Testicles | Weight |
| Hormonal Imbalances | ||
| Medications | ||
| Genetic Causes |
Medical Causes – A low sperm count can be caused by a number of health issues and medical treatment.
Environmental Causes b> Exposure to environmental toxins and chemicals can affect sperm production and function.
Lifestyle Choices b> Other causes of low sperm count, includes one’s lifestyle choices.
Depending on the origin where the alteration in sperm production has occurred, the causes can be categorised under three types.
Causes according to the origin of alteration – sperm production
|
PRE-TESTICULAR OLIGOZOOSPERMIC CAUSES (Refers to hormonal imbalance that interferes with sperm production and external factors that have an impact on the body) |
TESTICULAR OLIGOZOOSPERMIC CAUSES (Caused by testicular diseases) |
POST-TESTICULAR OLIGOZOOSPERMIC CAUSES (Refers to ejaculation problems, sperm production function works properly, but problem appears during the time of ejaculation) |
| Medical treatment which affects sperm production | Varicocele | Obstruction of the vas-deferens |
| Cannabis and alcohol | Age | Infection such as prostatitis |
| Junk food | Injury to the testicle | Retrograde ejaculation |
| Hypogonadism | Genetic abnormalities | Erectile dysfunction |
Causes According to the Origin of Alteration – Sperm Production
Tips to Increase Sperm Count Naturally
When a low sperm count is reported after a complete evaluation of all reports like semen analysis, along with blood work to check hormonal levels, an ultrasound, a physical examination, and a detailed family history, then if the condition is treatable, then it should be corrected before opting for assisted reproductive technology. A doctor might recommend some dietary changes, may suggest some vitamins or medicines, may tell to make some lifestyle changes to improve sperm quality and number. Some of the necessary tips include:
If sperm count doesn’t increase after this, it is recommended to visit an infertility specialist, he or she might treat you depending on the cause of the underlying condition. Might suggest some medication or suggest assisted reproductive technology for conception.
Low sperm count is a treatable area in the field of infertility, and thus the oligospermia treatment or low sperm count treatment depends on the cause of the condition. A man who is suffering from varicocele, surgery for oligospermia sperm count is the most common treatment. For low sperm counts due to infections of the urinary or reproductive tract, antibiotics are prescribed to clear the infection. Medication and hormone replacement treatment is used when the cause of low sperm count is related to a hormonal imbalance. If a couple still finds it difficult to get pregnant, then it would be advisable for them to visit an infertility specialist and assisted reproductive technology might be recommended to facilitate conception either by IUI (Intrauterine insemination), IVF (In vitro fertilisation), ICSI (Intracytoplasmic sperm injection) and in cases where no sperm are found in the ejaculate or very low sperm count testicular sperm aspiration procedures are recommended which allow sperm to be suctioned and extracted from the testicles and then to be used in conjunction with IVF.
Even though it takes only one sperm to fertilise an egg, but it takes millions of sperm to increase the chances of that one sperm to find its way to the egg and fertilise it, and thus create an embryo. In a normal sperm count, of the 40-200 million sperm present per mL of the ejaculate, only a few hundred sperm make it to the fallopian tubes. And then one healthy sperm will release an enzyme that will help to penetrate the eggshell.
Men who have low sperm count that is less than 15 million per mL are not considered infertile, but it means it will take a longer time, more finesse and planning for the couple to conceive a healthy child. If natural ways of conception or sperm enhancement fails, there is assisted reproductive technology to achieve pregnancy in such cases.
Medicover Fertility is a renowned international brand. We have a team of highly skilled and experienced doctors who help a couple to deal with infertility. Medicover Fertility has a very high fertility success rate as we use the latest technology in fertility treatments. Here the couples are carefully examined to find out the actual cause of infertility.
Receiving a diagnosis of male infertility due to low sperm count can be emotionally disturbing. Best is to speak to a doctor who will recommend a treatment plan. Dr Sweta Gupta (Clinical director in Medicover Fertility) has over 23 years of experience in infertility. A lot of cases with low sperm count are dealt with in Medicover Fertility. Depending on the type of oligospermia, a treatment plan is chalked out.IUI may be recommended in cases of very mild oligospermia, conventional IVF in moderate oligospermia cases, ICSI-IVF in cases of severe oligospermia to cryptozoospermia, at times testicular aspiration of sperm is done when no sperm or rare sperm are found in the ejaculate. The doctors, in consultation with the embryologists, will chalk out the best treatment plan by looking at the medical history of the couple.
To know more about the low sperm count treatment you can call us at +917862800700 or mail us at contact@medicoverfertility.in. Our consultant will guide you with the details of low sperm count, its cost and treatment by looking at your medical history.
Yes, a man with low sperm count can have a baby, but it might take a longer time to impregnate the female, provided the female does not have any reproductive issues. If natural conception does not happen, then depending on his level of low sperm count, he can opt for assisted reproductive technology.
A single cause of low sperm count is not identified. Causes of low sperm count can be due to hormonal disorders, illness, injury, an obstruction that prevents the release of sperm in the semen, sexual dysfunction, chronic health problems, genetic causes, lifestyle choices and environmental factors.
Yes, treatment is available, either with medications for hormonal imbalance or infections. And for men with oligospermia who are still unable to have children, assisted reproductive technology might help. In the case of mild oligospermia, they can either conceive naturally or by means of IUI. In severe cases, pregnancy can be achieved by IVF or ICSI-IVF.
Low sperm count does not cause miscarriage, but a recurrent miscarriage can depend on low sperm quality as well as DNA damage.
In most cases, there are no signs of infertility. Ejaculation usually happens in these cases without difficulty. The quantity and appearance of the ejaculated semen generally appear normal to the naked eye. Medical tests like a semen analysis test, blood tests to find out hormonal disorder, an ultrasound, a physical examination with a detailed family history is needed to find out if a man is infertile.
A man suffering from low sperm count may have symptoms like problems with sexual function, erectile dysfunction, swelling or lump in the testicles, decreased facial or body hair growth etc.
Unhealthy lifestyle choices can lead to decreased sperm count like smoking and drinking alcohol. Other causes include prolonged sickness, childhood infections, hormonal problems etc.
