Low sperm count

What is Low Sperm Count?
Low sperm count (Oligospermia) means the fluid (semen) you ejaculate contains fewer sperm than normal.

• Low Count: Fewer than 15 million sperm per milliliter of semen.
• Azoospermia: A complete absence of sperm in the semen.

Having a low sperm count decreases the odds that one of your sperm will fertilize your partner's egg. However, many men with a low sperm count are still able to father a child.

Symptoms

The main sign is the inability to conceive a child. However, underlying hormonal or genetic problems may cause other symptoms:

• Sexual Dysfunction: Low sex drive or Erectile Dysfunction (ED).
• Testicle Pain: Swelling, pain, or a lump in the testicle area.
• Hair Loss: Decreased facial or body hair (signaling a hormone abnormality).

⚠️ WHEN TO SEE A DOCTOR
See a doctor if you have been unable to conceive a child after one year of regular, unprotected sexual intercourse, or if you have a history of testicle/prostate surgery.

Causes

Sperm production is complex. It requires the testicles, hypothalamus, and pituitary glands to all work together.

1. Medical Causes

• Varicocele: A swelling of the veins that drain the testicle. This causes overheating and is the most common reversible cause of male infertility.
• Infection: STIs (Gonorrhea/Chlamydia) or inflammation (Prostatitis) can block sperm passage.
• Ejaculation Issues: "Retrograde ejaculation" occurs when semen enters the bladder instead of leaving the penis.
• Undescended Testicles: Testicles that didn't descend from the abdomen during fetal development.
• Hormone Imbalances: Low testosterone levels affecting production.
• Celiac Disease: Sensitivity to gluten can cause male infertility.

2. Environmental Causes

External factors can damage sperm production:

• Overheating: Frequent use of saunas, hot tubs, or sitting with a hot laptop on your lap can raise scrotal temperature and reduce sperm count.
• Chemicals: Exposure to pesticides, herbicides, painting materials, and lead.
• Radiation: X-rays can temporarily or permanently reduce sperm production.

3. Lifestyle Causes

• Drugs & Alcohol: Anabolic steroids shrink testicles. Alcohol lowers testosterone levels.
• Smoking: Smokers often have lower sperm counts than non-smokers.
• Weight: Obesity causes hormonal changes that reduce fertility.
• Stress: Severe emotional stress can interfere with the hormones needed to produce sperm.

Diagnosis: The Semen Analysis

The most important test is the Semen Analysis. Doctors examine a sample under a microscope to count sperm and check their movement (motility) and shape (morphology).

To ensure accuracy, you may need to:

• Abstain from ejaculating for 2 to 7 days before the test.
• Avoid lubricants.
• Provide a second sample 7 days later (as counts fluctuate).

Other Tests

• Scrotal Ultrasound: To check for Varicocele.
• Hormone Testing: Blood tests for pituitary and testicle hormones.
• Genetic Tests: To check for chromosomal defects (like Klinefelter's syndrome).

Treatment

Treatment depends on the cause. In rare cases where no sperm are present, a donor may be considered.

1. Medical & Surgical

• Surgery: Repairing a Varicocele or reversing a vasectomy.
• Treating Infections: Antibiotics for reproductive tract infections.
• Hormone Replacement: Medications to correct hormone levels (takes 3-6 months to see results).

2. Assisted Reproductive Technology (ART)

If natural conception is difficult, doctors can use ART:

• Sperm Retrieval: Surgically taking sperm directly from the testicle.
• IVF / ICSI: Injecting a single sperm directly into an egg to achieve fertilization.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.