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Birla Fertility & IVF
Birla Fertility & IVF

Male Infertility: Low Sperm Count Treatment

  • Published on April 16, 2022
Male Infertility: Low Sperm Count Treatment

Male infertility is a common health concern attributing to nearly 50% of the total infertility cases. Unfortunately, the global burden of male infertility is consistently rising at an alarming rate. There are various factors that contribute to infertility issues in men. Topping this list is low sperm count which is the absence of normal levels of sperm in the seminal fluid. Low sperm count treatment is, however, available for effective relief from infertility issues. 

Low sperm count does not necessarily mean that you would be infertile. It is possible for men to help their partner conceive even with low levels of sperm cells.

What is Low Sperm Count?

When a man ejaculates, the prostate and other reproductive glands release a fluid called the seminal fluid (semen). It is a thick, white-coloured fluid containing sperm cells and other plasma liquid. 

Before we begin to discuss what is low sperm count, let us start by understanding the normal sperm count range. 

Normal sperm count for men ranges from 15 million sperm to more than 200 million sperm per millimetre of semen. Ideally, the normal sperm count range should be at least 39 million sperm per ejaculate. 

Low sperm count is a condition characterised by low or no sperm cells in semen. If your sperm count is less than what is expected, you are considered to have a low sperm count. 

Low sperm count is medicaly known as oligozoospermia. Men who have a complete absence of sperm count are said to be experiencing a condition called azoospermia. 


Section 1: Fast facts about low sperm count 

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Section 2: Normal sperm count

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Section 3: Low sperm causes 

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Section 4: Low sperm count treatment 

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Section 5: Ways to increase sperm count 

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Low Sperm Count Symptoms 

Low sperm count symptoms vary from one man to another. Some men experience no obvious signs and symptoms of oligozoospermia while others may have a range of symptoms. 

Some common low sperm count symptoms include:

  • Low sexual drive 
  • Erectile dysfunction 
  • Pain, swelling or a lump in the testicle area
  • Decreased facial or body hair highlighting chromosomal abnormalities 
  • Ejaculation disorders
  • History of sexual and prostate problems 

Most men seek the help of a fertility specialist when they experience the above-given symptoms or have been struggling to get their partner to conceive for a long time. 


Low Sperm Count Causes 

Sperm production occurs in the testicles. It is supported by a regular and proper functioning of the testicles as well as several glands including the pituitary and hypothalamus glands. After production, sperm travel through the epididymis where they develop completely and then move to the vas deferens. 

When sexual activity is stimulated in a man, the sperm get mixed with seminal fluid and are released from the tip of the penis. 

Low sperm count causes can be attributed to any of the organs or processes affecting sperm production. Several factors can lead to poor sperm count in men, including:

Varicocele: Varicocele is the varicose veins of the testicles. In this condition, the veins supporting the transport of oxygen-depleted blood away from the testicles become enlarged. Enlargement of veins in the testicles can impact sperm quality and quantity. 

Infection: A variety of infections can occur in the male reproductive system. Certain infections including those that are sexually transmitted can cause inflammation of the epididymis or testicles. Increased inflammation and other symptoms of these infections can cause scarring resulting in testicular damage and production as well as transportation of sperm. 

Ejaculation problems: Ejaculation problems include lack of ejaculation or retrograde ejaculation (a condition in which the semen reserves and enters the bladder instead of coming out of the penis). Ejaculation problems can result from diabetes, spinal injuries, and surgery of the bladder, prostate or urethra. 

Tumours: Tumour is a mass of abnormal growth that can result from a cancerous or non-cancerous disease. Tumours can occur at any part of the male reproductive system and hamper sperm production. 

Hormonal problems: Several hormonal problems can impact the functioning of the pituitary and male sex organs altering sperm production. 

Tubal abnormalities: After being produced in the testicles, sperm get carried through several different tubes. Any type of blockage, obstruction or scarring in these tubes can impair sperm production leading to low sperm count. 

Genetic or chromosomal problems: Genetic or chromosomal defects can cause abnormal development of male reproductive organs affecting sperm production. 

History of surgery: You may as well experience difficulties in sperm production as a result of certain surgeries including vasectomy, hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers. 

Overheating of the testicles: Male reproductive system is built in a way that provides a slightly cooler temperature for the testicles for optimal sperm production. The sperm production may be affected as a result of overheating of the testicles due to tight clothing or the use of gadgets near the lap. 

Smoking & alcohol consumption: Consuming tobacco (cigarette smoking) or drinking excess alcohol can affect the production of testosterone leading to low sperm count. 

Mental health problems: Mental health conditions such as depression caused a result of high levels of stress can affect sperm concentration. 


Low Sperm Count Diagnosis 

Low sperm count diagnosis is usually performed when a man presents with the aforementioned symptoms or difficulty in getting his partner to conceive. If you visit a fertility clinic with difficulty in achieving conception, your fertility specialist will order certain tests and procedures to understand the cause of your problem.


Common tests done for low sperm count diagnosis are: 

General health exam – Your fertility doctor will perform a detailed examination of your physical health. He/she will also review your personal as well as family medical history. 

Semen analysis – A semen analysis is a lab test that allows the fertility specialist to check your sperm for its motility, morphology, count and other parameters. You will be asked to submit a semen sample for analysis. The obtained sample is washed and concentrated and sent to a laboratory for close examination under a microscope. You may be asked to submit a semen sample twice or thrice for accurate analysis. 

Additionally, your fertility doctor may order several other tests, including: 

  • Scrotal ultrasound
  • Hormone testing
  • Post-ejaculation urinalysis
  • Genetic tests
  • Testicular biopsy
  • Anti-sperm antibody tests
  • Transrectal ultrasound


Low Sperm Count Treatment 

Depending on the cause of your condition, your fertility doctor will design a personalised low sperm treatment. Your healthcare provider will perform thorough testing to confirm your diagnosis. 

Common low sperm count treatment protocols include:

  • Surgery 

Your fertility specialist may advise surgical intervention if the cause of low sperm count is varicocele. Some common conditions leading to infertility that can be corrected with surgery are varicocele and vasectomy. Through surgery, your doctor can repair the obstructions in the vas deferens leading to varicocele. Similarly, prior vasectomies can be reversed with surgery. 


  • Medicines 

If the low sperm count is caused by infections, your fertility doctor will offer certain medications to treat it. You may also be given certain medications to relieve the symptoms. In case of bacterial infections, antibiotics can be given to treat it. Medicinal treatment is also offered in case of hormonal problems leading to low sperm count. 


  • Counselling 

Along with medication, your fertility team will provide empathetic counselling for a range of issues causing infertility. Some top reasons why people seek counselling are erectile dysfunction and ejaculation problems. 


  • Assisted Reproductive Technology (ART) 

ART is a state-of-the-treatment for couples who are struggling to conceive due to low sperm count causes. There is a range of options that can help support conception:

IVF – In vitro fertilisation is an effective and the most common fertility treatment. In this procedure, your doctor retrieves healthy eggs from the female partner after stimulating her ovaries. If you are experiencing a low sperm count, your IVF cycle will have certain additional steps such as IUI or ICSI. For these steps, your fertility doctor may utilise sperm aspiration techniques like TESA, PESA or MicroTESE. 


The Concluding Note 

In India, there are a lot of stigmas associated with male reproductive issues that discourage men to seek help at the right time. It should be noted that male infertility, especially that caused by low sperm count, is a highly common problem. 

Low sperm count treatment is an effective measure to help couples achieve conception as well as boost men’s confidence and self-esteem.


How much sperm is normal?

The normal sperm count range is between 15 million to 200 million sperm per millimetre of semen. When a man has a sperm count less than the above-mentioned range, he is said to have low sperm count. 


How can I increase my sperm count naturally?

There are several natural measures you can take to increase your sperm count. Common measures include getting enough exercise and sleep, avoiding smoking, avoiding consumption of alcohol, and getting enough Vitamin D. 


At what age do men stop producing sperm?

Men experience sperm production in several million numbers each day. However, it gradually decreases as a man grows old. You are likely to have fewer sperm cells after the age of 40.           


How can a man tell if he is fertile?

While there are no obvious signs of male infertility, some men experience certain signs and symptoms related to the condition they are experiencing. Common signs include lower sex drive, pain, swelling or lump in the testicles, changes in hair growth, erectile dysfunction and problems with ejaculation.

Written by:
Dr. Anjali Chauhan

Dr. Anjali Chauhan

Dr. Anjali Chauhan is a fertility specialist with over 6 years of experience and has performed more than 100+ IVF cycles. She specializes in laparoscopy, hysteroscopy, and minimally invasive surgeries for complex infertility cases.
Preet Vihar, Delhi

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