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Low Sperm Count


Low sperm count is considered a major cause of male infertility. It occurs when the semen ejaculated contains less than 15 million sperms per milliliter (mL). The medical term for this condition is known as oligospermia. On average, about 70 million sperms per mL are present in the ejaculated semen. A good sperm count increases the chance of fertilizing an egg. If the number of sperms in your semen has decreased, it might also lower the chances of fertilizing an egg and achieving pregnancy. 


It is difficult to identify the exact cause of low sperm count in a person. It can happen due to various medical, genetic, environmental, or lifestyle factors. Varicocele is one of the most common medical reasons for male infertility. In this condition, swelling occurs in the veins that drain your testicles. Infections that involve your reproductive organs can also cause low sperm count. Some include epididymitis, orchitis, and a few sexually transmitted diseases (STDs) such as gonorrhea, syphilis, HIV, etc. Alterations in the production or levels of hormones that are responsible for normal reproductive function can also lead to oligospermia. Other medical causes of low sperm count include retrograde ejaculation, undescended testicles, Klinefelter's syndrome, previous surgeries, malignancy, tube blockage, celiac disease, and use of certain medications. Chemotherapy and radiotherapy can also affect sperm production.


Some environmental factors that may cause low sperm count include exposure to industrial chemicals, heavy metals, or toxic radiation. Increased temperature in the scrotum by prolonged laptop use, tight clothing, or hot showers and saunas can also affect the functioning of your reproductive system. Lifestyle factors that may cause oligospermia include alcohol intake, drug abuse, smoking, stress, depression, obesity, and the use of anabolic steroids. 

Risk Factors And Epidemiology

Several risk factors are associated with low sperm count. Tobacco smoking, alcohol intake and drug abuse can increase the risk of this condition. Obesity is another risk factor. Occupational factors may also play a role. For example, if you have a job where you have to sit for a long time, such as heavy vehicle driving, or you work at a place with high chemical exposure, you may develop oligospermia. Previous medical and surgical history can also affect the functioning of your reproductive organs. Stress, anxiety, and depression have also been noticed to reduce sperm count and cause other sexual disorders.


Oligospermia can occur in men of any age. Still, it is more prevalent among men over the age of 40 as the risk of certain other medical conditions increases as you age. 

Signs And Symptoms

In many cases, there are no apparent symptoms of oligospermia present. The major sign for which patients seek a doctor is the inability to conceive a child. Men who have no symptoms will otherwise have a normal sex drive, but they will find it difficult to fertilize their partner even after many attempts. Those who have an underlying medical condition may experience some symptoms such as low sex drive, difficulty in maintaining an erection, pain or swelling in the testicular area, or less facial or body hair. 


If the suspected cause of your inability to conceive a child is low sperm count, your doctor will require repeated tests to make a confirmatory diagnosis. The first step will be taking history and performing a physical examination of your reproductive organs to notice any abnormalities. A sperm analysis test is done to determine the average number of sperm in your semen. If your sperm count is below 15 million per mL, it will be considered oligospermia. However, this test needs to be repeated twice or thrice to obtain an accurate diagnosis. Other tests to diagnose an underlying medical condition may include hormone testing, post-ejaculation urinalysis, scrotal ultrasound, testicular biopsy, genetic testing, and other advanced tests to check sperm functioning. 

Differential Diagnosis

Low sperm count can occur due to various reasons, and it can become difficult to identify its exact cause. In some cases, it can be due to multiple factors at once. A confirmed diagnosis should be made based on history, symptoms, sperm analysis, and other diagnostic tests. 


Treatment options can vary depending on your condition. In some cases, it is challenging to treat infertility despite trying out all possible treatment options. If your underlying cause gets identified, it can be easier to treat this condition. In case of a varicocele, surgical methods are utilized to correct the issue. If you have any infection, suitable antibiotics are given. If you have a hormonal problem, your doctor may suggest hormone replacement therapy or other medications to improve your hormone levels. In erectile dysfunction or other sexual disorders, therapy and medical help are required. Mutual understanding between both partners is also necessary to choose an appropriate treatment option and facilitate its outcome.



Medications are only given if you have an active infection or another condition that they can improve. No medicines can restore or increase your sperm count unless the original cause of the condition has been treated. 


Some men are able to conceive despite having a low sperm count, although it may require more attempts than those couples without a fertility issue. In other cases, medications, surgery, or counseling can help in improving this condition. If you are still unable to conceive a child, you may look for other options, such as using donor sperm or adoption. 


Some lifestyle modifications can help in preventing oligospermia to some extent. Avoid smoking, drinking alcohol, and using illegal or anabolic drugs. Eat healthily and exercise regularly to reduce the risk of obesity. If you have stress, depression, or any other psychological condition, consult a therapist to help with your issues. 


Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on April 30th, 2023.

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