Overview

A low sperm count indicates that the fluid (semen) you expel during an orgasm contains a lower number of sperm than is typical.

Oligospermia (ol-ih-go-SPUR-me-uh) is another term for a low sperm count. The absence of sperm is referred to as azoospermia. If your sperm count is less than 15 million sperm per milliliter of semen, it is considered to be below the normal range.

A low sperm count reduces the likelihood that one of your sperm will fertilize your partner's egg, thereby resulting in pregnancy. However, a significant number of men who have a low sperm count are still capable of fathering a child.

Symptoms

The primary indicator of a low sperm count is the inability to conceive a child. There may be no additional apparent indications or symptoms. In certain men, symptoms and indicators may be caused by an underlying issue, such as an inherited chromosomal abnormality, a hormonal imbalance, dilated testicular veins, or a condition that obstructs the passage of sperm.

Symptoms of a low sperm count may include:

• Issues with sexual function, such as low sexual libido or difficulty maintaining an erection (erectile dysfunction)
• A lump, enlargement, or pain in the testicular region
• A reduction in facial or body hair, as well as other indications of a chromosome or hormone abnormality

When should one consult with a physician?

Consult a physician if you have been unable to conceive a child after a year of regular, unprotected intercourse or sooner if you have any of the following:

• Low sexual drive, erection or ejaculation issues, or other sexual function issues
• A lump, enlargement, or discomfort in the testicular region
• A medical history that includes testicular, prostate, or sexual issues
• A surgical procedure that involves the pelvis, testis, penis, or scrotum

Causes

The production of sperm is a multifaceted process that necessitates the proper functioning of the hypothalamus and pituitary glands, which are brain-based organs that produce hormones that initiate sperm production from the testicles. Sperm are produced in the testicles and are transported through delicate passages until they combine with semen and are expelled from the penis. Sperm production may be adversely affected by any of these systems.

Additionally, abnormal sperm shape (morphology), motility, or function may be present.

In many cases, the underlying cause of a low sperm count remains unidentified.

Medical causes

Numerous medical remedies and health conditions may induce diminished sperm counts. Some of these are as follows:

• Varicocele: A varicocele (VAR-ih-koe-seel) is a condition in which the veins that drain the testis enlarge. It is the most prevalent reversible cause of male infertility. Although the precise cause of infertility caused by varicoceles is unknown, it may be associated with abnormal regulation of testicular temperature. Sperm quality is diminished as a consequence of varicoceles.
• Infection: Certain infections can obstruct the passage of sperm or cause fibrosis that affects sperm production or health. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and certain sexually transmitted infections, such as gonorrhea or HIV. Despite the fact that certain infections can lead to permanent testicular injury, sperm can typically still be extracted in the majority of cases.
• Ejaculation issues: Retrograde ejaculation is a condition in which semen enters the bladder during an orgasm instead of emerging from the apex of the penis. Diabetes, spinal injuries, and bladder, prostate, or urethra surgery are among the numerous health conditions that can result in retrograde ejaculation or the absence of ejaculation.
• Certain medications, including alpha blockers, which are blood pressure medications, may also induce ejaculatory issues. While certain ejaculatory issues can be rectified, others are irreversible. Sperm can still be extracted directly from the testicles in the majority of cases of permanent ejaculation issues.
• Antibodies: Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
• Tumors: Cancers and nonmalignant tumors can directly affect the male reproductive organs by affecting the glands that emit hormones related to reproduction, such as the pituitary gland, or through unknown causes. Male fertility can also be impacted by surgery, radiation, or chemotherapy used to treat malignancies.
• Undescended testicles: Occasionally, in the course of embryonic development, one or both testicles fail to descend from the abdomen into the sac that typically houses them (scrotum). In men with this condition, the likelihood of decreased fertility is higher.
• Hormone imbalances: The hypothalamus, pituitary, and testicles are responsible for the production of hormones that are essential for the production of sperm. Alterations in these hormones, as well as those from other systems, such as the thyroid and adrenal gland, may impede sperm production.
• Tubule defects that facilitate the transportation of sperm: Sperm is transported through a variety of tubes. They may be obstructed by a variety of factors, including inadvertent injury from surgery, prior infections, trauma, or anomalous development, such as cystic fibrosis or similar inherited conditions.
• Blockage may manifest at any point, such as within the testicle, in the passages that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts, or in the urethra.
• Chromosome defects: Inherited disorders, such as Klinefelter's syndrome, result in abnormal development of the male reproductive organs. In this condition, a male is born with two X chromosomes and one Y chromosome, rather than one X and one Y. Infertility is also associated with other genetic syndromes, such as cystic fibrosis, Kallmann's syndrome, and Kartagener's syndrome.
• Celiac: Celiac disease is a digestive disorder that is caused by a sensitivity to gluten and can result in male infertility. Adopting a gluten-free diet may enhance fertility.
• Certain medications: A number of medications, including testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal and antibiotic medications, some ulcer medications, and other medications, can impair sperm production and reduce male fertility.
• Prior surgeries: Vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal malignancies, among others, may prevent the presence of sperm in the ejaculate. In the majority of instances, surgery can be conducted to either reverse these obstructions or to retrieve sperm directly from the epididymis and testicles.

Environmental causes

Overexposure to specific environmental elements, such as: can impact sperm production or function.

Low sperm counts may be induced by prolonged exposure to industrial chemicals, including benzenes, toluene, xylene, herbicides, pesticides, organic solvents, painting materials, and lead.

• Heavy metal exposure: Infertility can also be a result of exposure to lead or other toxic metals.
• Radiation or X-rays: Sperm production may be diminished by exposure to radiation. The restoration of normal sperm production may necessitate several years. Sperm production can be permanently diminished by administering excessive doses of radiation.
• Overheating of the testicles: Sperm production and function are impaired by elevated temperatures. However, the sperm count may be temporarily impaired by the frequent use of saunas or hot baths, despite the fact that studies are limited and inconclusive.
• Additionally, prolonged periods of sitting, the use of tight apparel, or prolonged periods of working on a laptop computer may elevate the temperature of the scrotum and slightly diminish sperm production.

Health, lifestyle, and other factors

Additional factors that contribute to a low sperm count include:

• Drug abuse: The consumption of anabolic steroids to enhance muscle strength and growth can result in a reduction in sperm production and the shrinkage of the testicles. As well, the quantity and quality of your sperm may be diminished by the use of cocaine or marijuana.
• Alcohol consumption: The consumption of alcohol can result in a reduction in testosterone levels and a reduction in sperm production.
• Occupation: Certain occupations, such as welding or truck transportation, may be associated with a risk of infertility. Nevertheless, the data that substantiates these associations is inconsistent.
• Tobacco smoking: Men who smoke may have a lower sperm count than those who do not smoke.
• Emotional stress: Hormones that are essential for the production of sperm may be disrupted by severe or protracted emotional stress, including stress related to fertility.
• Depression: Sperm concentration may be adversely affected by depression.
• Weight: Obesity can impede fertility in a variety of ways, such as directly affecting sperm and causing hormonal changes that reduce male fertility.
• Sperm testing complications: Sperm counts that are lower than average may be the consequence of testing a sperm sample that was obtained too soon after your most recent ejaculation, was obtained too soon after a stressful event or illness, or did not contain all of the semen you ejaculated due to spillage during collection. Consequently, the results are typically derived from a series of samples that were collected over a period of time.

Risk factors

Low sperm count and other conditions that may result in low sperm count are associated with a variety of risk factors. They consist of:

• Smoking tobacco
• Consuming alcohol
• Utilizing specific illicit substances
• Being overweight Experiencing severe stress or depression
• Carrying specific infections from the past or present
• Exposure to toxic substances
• The genitalia are overheated.
• Having sustained testicular trauma
• Being born with a fertility disorder or having a blood relative, such as your brother or father, who has a fertility disorder
• Having specific medical conditions, such as chronic ailments and tumors
• Experiencing cancer treatments, including radiation
• Taking specific medications
• Having undergone a vasectomy or significant abdominal or pelvic surgery in the past
• Having a propensity of undescended testicles

Complications

An infertility that results from a low sperm count can be distressing for both you and your partner. Complications may encompass:

• An underlying cause of reduced sperm count may necessitate surgery or other treatments.
• In vitro fertilization (IVF) is an assisted reproductive technique that is both costly and complex.
• Stress associated with the inability to conceive

Prevention

In order to safeguard your fertility, it is important to avoid known factors that can impact the quality and quantity of your sperm. For instance:

• Refrain from smoking.
• Restrict or refrain from consuming alcohol.
• Avoid the use of illicit substances.
• Consult with your physician regarding medications that may impact sperm count.
• Sustain a healthful weight.
• Steer clear of humidity.
• Overcome anxiety.
• Prevent exposure to contaminants, heavy metals, and pesticides.