Low Sperm Count and Pregnancy

Male Infertility


Jul 21, 2021

Low sperm count refers to a condition when a man has less than 15 million sperm in one milliliter of the collected semen sample. Doctors also refer to this problem as oligozoospermia. The condition makes natural conceiving of the female partner challenging. However, studies conducted on low sperm count success stories proved that successful pregnancies still occur with low sperm count.  Besides low sperm count, a few men even have the problem of poor sperm quality. Luckily, there are many treatments available to deal with a low sperm count problem to help conceive your female partner.  

Low Sperm Count and Pregnancy

Low Sperm Count Symptoms 

Common low sperm count signs and symptoms include the following.

Inability to Become Father – Inability to become a father or make his partner pregnant is the prime symptom associated with low sperm count or poor quality of sperm in men. 

Underlying Health Issues – Underlying health issues include dilation of a testicular vein, hormonal imbalance, and inherited chromosomal abnormality. Additionally, there are several other conditions, which block the entry of sperm to the uterus and contact with the egg. Other than this, a decrease in facial or body hair also indicates low sperm count. 

Lack of Libido/Sex Drive – Lack of enough libido or low sex drive with erectile dysfunction indicates low sperm count. 

Issues in Testicle Area – In some cases, pregnancy failure or low sperm count takes place because of testicle area problems. These are the formation of lumps or swelling in the testicle area. 

What Causes Low Sperm Count in Men

Sperm production is a complicated procedure, and it involves the regular functioning of your testicles with pituitary and hypothalamus glands. The organs present in the human brain are responsible for producing hormones to activate sperm production. Once the testicles produce sperms, delicate tubes transport them until they combine with semen and ejaculate out from the penis. Hence, causes of low sperm count or low sperm production depend on problems with any of the systems mentioned here. Besides, a few men experience problems of sperm movement, sperm function, and abnormal sperm shape. Doctors have revealed the following common reasons for low sperm count in men-

Medical Treatment/Health Issues that cause Low Sperm Count


Varicocele refers to a swelling in the veins, which drain the men’s testicle. It is a common reversible problem related to male infertility, and it causes a reduction in sperm quality. 


A few infections may interfere with sperm health or sperm production and cause scarring to block sperm passage. These are epididymis inflammation, testicles’ inflammation, and some STIs, i.e., sexually transmitted infections, like HIV or gonorrhea. In most cases, doctors may prescribe medications to retrieve sperms easily. 

Ejaculatory Problems 

Retrograde ejaculation occurs whenever semen enters the urinary bladder at the time of orgasm rather than emerging from the penis’ tip. You may suffer from zero ejaculation or retrograde ejaculation because of diverse health conditions. These include surgery of the urethra, prostate or bladder, spinal injuries, and diabetes. Alpha-blockers and other medications may also cause ejaculatory issues. 

Cancer and Tumor 

Non-malignant tumors and cancers may affect the reproductive organs directly even though the glands continue to release reproduction hormones. Besides, chemotherapy, radiation, and surgery to treat tumors may even affect infertility in males.  

Hormone Imbalances 

The pituitary, hypothalamus, and testicles produce hormones, which are essential to produce sperm. Alternations in any or all of the hormones and any other system, like the adrenal gland or thyroid, may cause impairment in sperm production. 

Tubules Defects, which Transport Sperm 

There are different types of tubes available to carry sperm. However, blockage in the tubes may occur for various reasons, like infections in the past, accidental injury due to surgery, abnormal development or trauma, like cystic fibrosis, and inherited health conditions. 


Cancer medications, testosterone replacement therapy, antibiotic and antifungal medications, long-term anabolic steroids, ulcer medications, and other similar types of medications may impair the production of sperm and reduce fertility in males. 

Surgeries in the Past 

A few surgeries may prevent the ejaculation of sperm. These include inguinal hernia repairs, vasectomy, testicular or scrotal surgeries, prostate surgeries, abdominal surgeries, and many more. In most cases, surgeries reverse the mentioned blockages or retrieve the sperm directly from testicles. 

Lifestyle Causes of Low Sperm Count

Lifestyle causes related to low sperm count are-

  • Use of Drugs

Anabolic steroids taken for stimulation of muscle growth and strength may cause shrinking of your testicles and reduction in sperm production. The use of marijuana or cocaine may reduce the exact number and the quality of the sperm. 

  • Use of Alcohol 

Consumption of alcohol may cause low testosterone levels followed by a decrease in sperm production. 

  • Smoking Tobacco 

Men involved in smoking tobacco may have a relatively low sperm count. 

  • Emotional Stress 

If you have prolonged or severe emotional stress, it may interfere with the hormones responsible for producing sperms. 

  • Depression

Similar to stress, depression may cause a negative influence on the concentration of your sperm. 

  • Weight 

The overweight condition causes impairment infertility in many ways, including specific hormonal changes to reduce fertility in males. 

How do I know if I have a low sperm count?

Before you get the answer of zero sperm count, how to increase it, or anything similar, you must schedule your appointment with your doctor to undergo a low sperm count diagnosis. 

Medical History 

Before doctors start their diagnostic procedures, they discuss the medical history with men suffering from oligospermia or low sperm count. Accordingly, the doctor will collect the following information-

  • Any problem related to erectile dysfunction 
  • Number or frequency of your intercourse 
  • Whether you have undergone scrotal or testicular surgery in the past
  • Whether you have an infection in your urinary tract
  • If you have any illness in the past
  • Do you have any drug, smoke, or alcohol abuse?
  • List of medications you have taken in the past, which may affect your semen or sperm
  • List of medications you are taking which may reduce your motility or sperm count
 Physical Examination 

Under physical examination, we check the following-

  • Systemic illness 
  • Signs of hypoandrogenism
  • Symptoms of hypogonadism

Besides, physical examination identifies any structural abnormality present in various external sexual organs. Especially, physical examination is essential to determine the presence of cryptorchidism or varicocele. 

Semen Analysis and Sperm Analysis

Semen analysis and sperm analysis are the crucial techniques to test fertility in males, and doctors consider it the referral point. Doctors collect two different ejaculated semen samples from the male in a non-spermicidal condom or by the following masturbation. If the first sample comes abnormal, the doctor collects the semen samples after six weeks to get the best results. Men have to start absent from sexual intercourse for at least three days of their semen test so that the samples highlight the true constitution of semen. 

How Semen Analysis is Helpful for Patients 

Semen analysis helps in detecting the following issues-

Sperm Count Abnormalities 
  • Oligozoospermia, which indicates the presence of less than the minimum pregnancy requirement of 15 million sperm in one milliliter, like for instance, 2 million sperm count pregnancy 
  • Azoospermia, which refers to zero sperm or absence of sperm in the semen sample
Sperm Motility and Sperm Function Abnormalities 

Sperm lacking progressive forward motility of 25 microns in one second constitutes a minimum of 50 percent of the sample of sperm. When the sperm in a semen sample is poorly motile or persistently motile, fertilization does not occur, as the sperm fails to enter the uterine cavity by passing through the cervical mucus.  

Sperm Morphology Abnormalities 

According to the WHO classification, doctors have to classify sperms morphologically to give additional details to different parameters in determining the quality of the collected semen. 

  • Imaging Testing 

An imaging test in the form of scrotal ultrasonography excludes a varicocele or testicular tumor in men. Alternatively, doctors may perform transrectal ultrasonography to visualize the seminal and prostate vesicles whenever there is a low volume of semen. 

  • Hormone Testing 

The combination of hormone testing with the testing of FSH, i.e., follicle-stimulating hormone levels of semen, is recommendable to identify the insufficient production of sperm. High levels of FSH with a low level of testosterone indicate unresponsiveness of the testicles. In contrast, low FSH levels with low testosterone levels imply the deficiency of gonadotropin. FSH may remain normal in few mutations, but it will cause late maturation arrest. 

  • Genetic Testing 

Genetic testing is recommendable in men who suffer from low sperm count in severe form with the suspected congenital obstruction. The test is suitable for men with incomplete or primary testicle failure and congenital hypogonadism but has normal FSH and non-obstructive azoospermia and testicular volume. 

What are the Treatments of Low Sperm Count in Men?

Doctors recommend the following low sperm count treatments. 

Surgical Procedure 

If low sperm count takes place due to varicocele, a surgical procedure may correct it. Surgery is also recommendable to repair any obstructed vas deferens. 

Sperm Retrieval Techniques

Can a man with zero sperm count get a woman pregnant? The answer is yes; it is possible by adopting sperm retrieval techniques. In this method, doctors retrieve the sperm from the patient’s epididymis or testicles directly. The method is preferable when the patient has zero sperm for ejaculation. 

Treatment of Infections 

A few infections interfere with the production of sperm or overall sperm health. These infections may even cause scarring to block the sperm passage. In this situation, doctors recommend certain antibiotics to cure or treat reproductive tract infections and increase the production of sperm. In most cases, antibiotic medications retrieve the sperm easily, but some infections may cause permanent sperm damage. However, this treatment of low sperm count not necessarily restores the condition of fertility. 

Treatments to Cure Problems of Pregnancy in Men

If you have premature ejaculation or erectile dysfunction problems, doctors will prescribe certain medications to treat the problem of inability to conceive. 

Hormone Medications and Hormone Replacement

Men who have infertility because of low or high levels of certain hormones may overcome the issue with hormone medications and hormone replacement. The treatment also helps your body to use hormones properly. 

Assisted Reproductive Technology 

Assisted Reproductive Technology comprises a group of treatments to obtain sperm through different methods. The technology is also used to insert the sperm into the female’s genital passage or use it for advanced treatments. 

Types of Assisted Reproductive Technology

Doctors may choose a particular type of Assisted Reproductive Technology based on the underlying condition of men. These include the following-

IVF Technology

IVF or in vitro fertilization is an innovative technology used for many years in the medical sector. The treatment procedure has a success rate between 15 percent and 25 percent in 1 cycle. Based on this, it has become a successful procedure for men with low sperm count and other problems, which thwart pregnancy. 

During the IVF cycle, your doctor will retrieve eggs from the female and fertilize with your sperm. The fertilized egg takes many days to grow in a small Petri dish to become an embryo. After this, your doctor will implant the embryo into the uterus of the woman. Depending on the condition of eggs, IVF can produce multiple numbers of embryos to enhance conceiving multiple babies. 

Infra Cytoplasmic Sperm Injection (ICSI)

ICSI, I.e., Infra cytoplasmic sperm injection procedure, remove eggs from the body of a woman. Later, a doctor injects one of the matured eggs with healthy sperm. Whenever any egg usually develops, the doctor transfers it back to the body of the woman. ICSI is the best low sperm count treatment as it can handle even the severe sperm issue in no time. For instance, any man with low sperm count or low sperm motility may go with this option. 

In some cases, men have normal morphology and sperm count but experience DNA damage. It reduces the fertility rate or increases the risk related to the early miscarriage of female partners. On the other side, with ICSI, your doctor may choose the healthiest sperm for implanting it in the partner’s egg. 

Intrauterine Insemination (IUI)

It is the procedure in which sperm is injected inside the woman’s uterus to implant. It reduces the travel time taken by sperm to reach the eggs. The sperm is first collected and filtered for it and then the best sperms out of them are chosen to inseminate. This increases the chances of a man to father his baby.

Intrafallopian Transfer

In the case of intrafallopian transfer, doctors will fertilize the egg into the fallopian tube of your female partner. Intrafallopian transfers are excellent options for all suffering from sperm count or sperm mobility problems. Doctors choose two different types of intrafallopian transfers, I.e., zygote intrafallopian transfer and gamete intrafallopian transfer. 

In the case of gamete intrafallopian transfer, the transfer of both eggs and sperm takes place inside the fallopian tube of patients to allow the sperm in fertilizing the egg. In contrast, intrafallopian zygote transfer allows fertilizing the eggs roves from a woman’s body in a lab setting. Later, the fertilized eggs are transferred into the woman’s body to form embryos. Here, embryos deposit inside the fallopian tube. 

Artificial Donor Sperm Insemination 

If your testicles fail to produce sperm, the only alternative is artificial insemination via sperm donation. It is the last one on the list of tips for getting pregnant with a low sperm count. There are many sperm banks, which store frozen sperm collected from different sperm donors. 


Couples may review donors’ profiles and select a suitable donor. However, sperm collected from any individual donor remains in quarantine for approximately six months before it becomes available for donation. During the six months, doctors check the sperm donor to ensure that he does not have HIV or any other infectious disease. 


Can low sperm count be cured?

Yes, your low sperm count problem is curable. Only, you have to undergo proper treatment based on the symptoms and underlying causes. Particularly, if you want to cure low sperm count, you must avoid drug usage and consumption of alcohol. 

What is a good sperm count for pregnancy?

Normal semen has between 40 million and 300 million sperms in one millimeter. However, if you have healthy sperm, 20 million sperm in one milliliter helps your partner conceives easily. In contrast, a sperm count below 20 million sperm in one milliliter indicates a low sperm count. 

How can I increase my chances of getting pregnant with a low sperm count?

You may increase your chance of getting pregnant with a low sperm count by following a few simple home remedies. These increase your frequency to perform sex, avoid lubricants, and be involved in intercourse when increasing fertilization possibility. 

What can a man do to help conceive?

Men can help conceive with simple tips, which are losing the extra fat, having healthy and nutritious foods, involving in physical activity regularly, and consuming multivitamins daily. Besides, it would help if you underwent proper treatment of your underlying health conditions. 

What time of day is sperm count highest?

Samples of healthy semen collected any time in the morning from 5 am to 7:30 am exhibiting a high concentration of sperm and higher sperm count. Sperm collected during early morning hours has a regular shape compared to the one collected during later hours.  


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