Low Sperm Count?: A Comprehensive Guide to Understanding Low Sperm Count and How to Improve Sperm Health

It might surprise you to learn that low sperm count affects roughly 1 in 20 men - so if you’re looking for information on this topic you are not alone. The challenge of low sperm count is daunting to many couples, but the good news is that sperm health can be improved and low sperm count can be reversed if the cause is something you can stop.  Let’s take an in-depth look at the causes of low sperm count, its impact on fertility, and explore practical tips on how low sperm count can be improved over time and medical options for cases that require a higher intervention approach.    

What is Low Sperm Count?

Low sperm count, also known as oligospermia, is a condition characterized by having fewer sperm cells than normal in a man's semen. According to the World Health Organization (WHO), a normal sperm count is typically considered to be at least 15 million sperm per millilitre of semen. Anything below this threshold may be classified as a low sperm count, although the severity can vary.

How Low Sperm Count Affects Conception

Low sperm count can significantly affect the chances of conception because it reduces the number of sperm available to fertilize an egg. 

Here's how low sperm count affects conception:

• Reduced chance of fertilization: With fewer sperm available, the likelihood of one reaching and fertilizing the egg is diminished. Even if the sperm reaches the egg, the probability of successful fertilization decreases with a low sperm count.
• Increased time to conception: Couples may take longer to conceive because there are fewer sperm available to fertilize the egg, increasing the time it takes for successful fertilization to occur.
• Increased risk of infertility: Severe cases of low sperm count can lead to infertility, where conception becomes extremely difficult or impossible without medical intervention.
• Increased risk of miscarriage: Low sperm count can sometimes be associated with genetic abnormalities in the sperm. These abnormalities can increase the risk of miscarriage if fertilization occurs.
• Impact on treatment options: When couples seek fertility treatments such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or intrauterine insemination (IUI), a low sperm count may limit the treatment options available or require more intensive interventions.

Common Causes of Low Sperm Count

Understanding the underlying causes of low sperm count is crucial for developing effective treatment strategies. Several factors can contribute to this condition, including:

• Lifestyle Choices: Poor lifestyle habits such as smoking, excessive alcohol consumption, drug use, and obesity can negatively impact sperm production and quality.
• Environmental Factors: Exposure to environmental toxins, radiation, and certain chemicals (such as pesticides and heavy metals) can impair sperm production and function.
• Heat Exposure: Prolonged exposure of the testicles to high temperatures, such as from hot baths, saunas, or tight underwear, can reduce sperm production.
• Stress: Chronic stress may disrupt hormonal balance and interfere with sperm production.
• Medical Conditions: Certain medical conditions, such as infections, hormonal imbalances, genetic disorders, and structural abnormalities in the reproductive organs, can interfere with sperm production or transportation.
• Age: Advanced age can lead to a decline in sperm quantity and quality.
• Medications: Some medications, including certain antidepressants, chemotherapy drugs, and steroids, may affect sperm production.

Natural and Medical Options to Increase Sperm Count

If it is determined that low sperm count is a result of lifestyle choices, environmental factors, heat exposure or stress, the good news is that by making positive changes, sperm count is likely to improve in a relatively short period of time (~90 days).

• Maintain a Healthy Lifestyle and Limit Exposure to Environmental Toxins: Adopting a healthy diet, avoiding exposure to chemicals through food or environment, exercising regularly, maintaining a healthy weight, and avoiding tobacco, alcohol, and recreational drugs can help optimize sperm production and quality.
• Avoid Heat Exposure: Minimize exposure to high temperatures, such as avoiding hot baths, saunas, and tight-fitting underwear.
• Manage Stress: Engage in stress-reducing activities such as meditation, yoga, or hobbies to help alleviate stress and promote hormonal balance.
• Stay Active: Regular physical activity can help improve overall health, including reproductive health.

• Consider Supplements: Certain supplements, such as antioxidants like vitamin C, vitamin E, and coenzyme Q10, may help improve sperm count and quality. However, it's essential to consult with a healthcare provider before starting any new supplements.

There are also several medical treatments available to increase sperm count:  

Medications: Certain medications can help increase sperm production and improve sperm quality. These may include:

• Hormone treatments: If a hormonal imbalance is causing the low sperm count, hormone replacement therapy or medications such as clomiphene citrate or gonadotropins may be prescribed.
• Antibiotics: If an infection is causing low sperm count, antibiotics may be prescribed to treat the infection.
  

Surgery: In some cases, surgical interventions may be necessary to correct underlying issues affecting sperm production. These may include:

• Varicocele repair: Varicocele is a swelling of the veins that drain the testicle, and it can sometimes be surgically repaired to improve sperm count.
• Vasectomy reversal: For men who have undergone a vasectomy but wish to restore fertility, vasectomy reversal surgery can be an option.
• Testicular sperm extraction (TESE) or microdissection TESE: These procedures involve extracting sperm directly from the testicles for use in assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
  

Assisted reproductive techniques (ART): If other treatments are unsuccessful, or in cases of severe male infertility, assisted reproductive techniques such as intrauterine insemination (IUI), IVF, or ICSI may be used to achieve pregnancy. These techniques involve collecting sperm and combining it with a partner's egg in a laboratory setting before transferring the resulting embryo to the uterus.

It's important to note that low sperm count is just one factor that can affect fertility. Other factors, such as sperm motility (ability to move), sperm morphology (shape and size), and overall sperm health, also play crucial roles in fertility. Additionally, female fertility factors and overall health and lifestyle of both partners can influence the chances of conception. If a couple is struggling to conceive, it's advisable for both partners to undergo fertility testing to identify any potential issues and explore appropriate treatment options.

At Pollin, our fertility consultation, comprehensive diagnostic fertility testing and semen analysis is covered by OHIP.