Many reasons for a lower than normal sperm count
Infertility is an equal opportunity medical condition. This means there is a 40 to 50% chance that prospective dads who seek our help will have an infertility problem, with low sperm production being one of the main culprits.
Getting this diagnosis can be very shocking for men. After all, they probably have been producing what they think are normal and plentiful ejaculations. They may not realize that abundant semen does not indicate a normal sperm count.
The sperm production journey
First, let’s look at how sperm is made. It takes approximately 72 days for men to produce a new sperm supply. The production process begins in the brain with the pituitary gland. It releases hormones that jumpstart the development of sperm and testosterone inside the testicles, which are protected within the cool confines of the scrotum. Sperm continues to mature as they move through the seminiferous tubes of the testes to the prostate gland, where sperm mixes with seminal fluid to create semen.
What is a low sperm count?
According to the World Health Organization (WHO), a man with fewer than 15 million sperm per milliliter of semen is considered to have oligospermia or low sperm concentration. If his ejaculate is absent of sperm, he has azoospermia.
Depending on the cause of their sperm shortage, many men with low sperm counts can conceive on their own or with minimal assistance and lifestyle changes. After all, it only takes one sperm to fertilize an egg. However, low sperm counts can be predictive of a medical problem or genetic condition and may warrant further evaluation.
Azoospermic men, who comprise approximately five percent of infertile males, will need medical intervention to achieve a pregnancy.
Why do some men have low sperm counts?
So how and why does sperm production go awry? The reasons are varied and complex and include the following medical, environmental and lifestyle reasons.
- A varicocele, which is a collection of varicose veins in the scrotum that can interfere with blood flow, and inhibit temperature control of the testicles.
- Antisperm antibodies that mistake a man’s own sperm for foreign bodies and attempt to eradicate them.
- Infections, including sexually transmitted diseases
- Cancers and nonmalignant tumors, as well as medical conditions like diabetes and hypertension
- Undescended testicles, a congenital condition
- Chromosomal defects
- Blockage of the tubes that transport sperm
- Prior surgeries, such as vasectomies and prostate surgeries
- Some scientists are crediting overexposure to toxic industrial chemicals, metals, x-rays, and radiation to an increase in male fertility.
- Steroid drugs, marijuana or cocaine
- Excessive alcohol or tobacco
- Being overweight
- Exposing testicles to heat or friction (saunas and bike riding)
Diagnosis and treatment
Generally speaking, a semen analysis that evaluates sperm count, as well as movement and shape, is the main diagnostic tool for male fertility. A thorough medical examination is helpful in pinpointing lifestyle or occupational hazards to sperm health. Because sperm production is continually occurring, men can make positive changes that can potentially improve their sperm numbers after two to three months.
When treatment is needed, we recommend intrauterine insemination and/or in vitro fertilization with intracytoplasmic sperm injection (ICSI), depending on the extent of the male fertility problem or other infertility diagnoses.
Though no man likes to hear that he has a low sperm count, there are many reasons for low sperm production as well as treatment options. Low sperm does not necessarily mean ‘no’ sperm and only one sperm is needed to make a baby.