Introduction
It is important to understand the basics of male fertility and semen analysis, commonly referred to as a “sperm count.” A sperm count measures the concentration of sperm per milliliter of semen. It also looks at other factors such as motility (the ability for the sperm to swim), morphology (the shape of the sperm) and finally volume.
Low sperm count can have an effect on a man’s fertility, as it reduces the chances of successfully conceiving with a partner. Having low sperm count does not necessarily mean that a person will be unable to father children, however their fertility may be lowered. Additionally, some lifestyle choices can exacerbate poor semen quality.
Some men may want to measure their own sperm counts, while others may choose to seek professional help. There are several options available for determining whether or not someone has low sperm count, from at-home tests to laboratory testing ordered by a healthcare provider. The following guide will provide an overview of some methods that people can use to measure their own semen quality and ascertain whether or not they have low sperm count:
Symptoms of Low Sperm Count
Low sperm count can be difficult to detect, as the symptoms may not be obvious. However, if you suspect that your sperm count is low, there are certain signs and symptoms that you should look out for. These can include difficulty in achieving or sustaining an erection, reduced libido, changes in seminal fluid, or even infertility.
Let’s take a look at the different signs of a low sperm count in detail:
Difficulty achieving pregnancy
When a couple is having difficulty conceiving, one of the first tests a doctor may order is a semen analysis. This test reveals whether or not there are enough sperm present to fertilize an egg and create a pregnancy. A low sperm count, called oligospermia, affects fertility by reducing the likelihood that an egg will be fertilized. Low sperm count is typically defined as less than 15 million sperm per millilitre or fewer than 39 million per sample.
In addition to difficulties conceiving, men with low sperm counts may experience other symptoms such as:
- A decrease in sex drive
- Changes in the size or shape of their genitals
- Difficulty maintaining an erection
- Painful urination or ejaculation
- Lumps in their scrotum region
- Testicular pain
- Infertility issues with past partners.
If you are experiencing difficulty achieving pregnancy and have any of these symptoms, it is important to speak with your doctor about getting tested for low sperm count. Problems with infertility should always be diagnosed and treated as soon as possible to ensure that treatment can be tailored to your individual needs.
Low sex drive
Low sex drive, which is also medically known as hypoactive sexual desire disorder (HSDD), is one of the most common symptoms of a low sperm count. A decreased desire to participate in sexual activities can be a sign of other medical issues such as anxiety, PTSD, depression, genetics or lifestyle habits such as smoking or excessive alcohol consumption. Additionally, men can experience low sex drive due to physical discomfort caused by an underlying medical condition such as erectile dysfunction (ED) or a hormonal imbalance like hypogonadism.
Other physical symptoms associated with low sperm count are testicular pain, diminished testicular size and swelling of the scrotum. Men who have difficulty attaining orgasm, who experience difficulty getting an erection or who have problems ejaculating may also be experiencing a low sperm count. Blood tests and semen analyses are often used to diagnose male infertility conditions like low sperm count and can help determine the cause for further treatment.
A health care provider may recommend reducing or eliminating certain lifestyle habits and medications that can reduce the quality or quantity of sperm produced. If these treatments do not resolve the issue then there are medical treatments available such as artificial insemination and fertility drugs that a doctor might recommend depending on the circumstances. A man seeking help with his fertility should consult with his doctor for an accurate diagnosis and appropriate treatment plan.
Erectile dysfunction
Erectile dysfunction is a common symptom of low sperm count and can present in different ways. In some cases, a man may be unable to get or keep an erection at all. In other cases, it might take longer than usual for an erection to occur and the man may not be able to maintain it for long.
Other potential symptoms of erectile dysfunction include:
- Difficulty achieving orgasm
- Reduced satisfaction from orgasms
- Decreased sexual desire when compared with pre-existing levels.
Additionally, a man with a low sperm count might have difficulty ejaculating during sexual activity.
Decreased semen volume
Men with a low sperm count may experience several symptoms, one of which is a decrease in semen volume. Healthy semen volumes range between 1.5 and 5.0 milliliters (mL) per ejaculation, but normal levels vary from person to person. A decrease in semen volume can therefore be an indicator of a lower-than-normal sperm count, or it can arise from other causes such as testicular injury or medical treatments such as chemotherapy.
In certain cases, men having difficulty conceiving may have a condition called oligospermia, which is associated with decreased semen volumes below 1.5 mL per ejaculation. This condition is sometimes accompanied by other symptoms such as low libido or erectile dysfunction, although these symptoms are not always present if you have oligospermia alone.
In addition to decreased semen volumes caused by medical conditions like oligospermia and medical treatments, sperm counts can also be influenced by lifestyle factors such as smoking cigarettes or using marijuana and alcohol excessively; other factors such as being overweight or obese; and problems related to the age at which men commence sexual activity. A man should talk to his doctor if he believes he has any of the associated symptoms of a lower-than-normal sperm count so that they can take steps towards addressing the issue as soon as possible before fertility problems become severe.
Causes of Low Sperm Count
Low sperm count, also known as oligospermia, is the production of fewer sperm cells than normal. There are a number of potential causes for this condition, ranging from medical problems to lifestyle choices. Understanding the potential causes of low sperm count can help you determine if you’re at risk, and can guide you in making changes to improve your fertility.
Let’s take a closer look at the causes of low sperm count:
Exposure to toxins
Exposure to toxins can significantly decrease your sperm count. Such toxins could include heat, pesticides and other chemicals, radiation and smoking. In fact, multiple studies have demonstrated that smoking tobacco has an adverse effect on both sperm motility (movement) and morphology (shape). Counts among smokers are typically lower than those in non-smokers.
The presence of a type of environmental chemical called ‘endocrine disruptors’ has also been documented. These chemicals, which can also be found in certain foods, can mimic the effects of hormones such as oestrogen, leading to lower male fertility. Some research suggests that exposure to heavy metals like cadmium and lead may also reduce sperm counts in men.
Certain medications and recreational drugs have the potential to reduce fertility levels in males through their action on hormonal balance. Several drugs can cause poor sperm quality or even pyospermia (an increased number of pus cells contaminating the semen). These include marijuana, cocaine and anabolic steroids as well as alcohol or drug abuse during pregnancy. It is important that any potential problems with infertility be promptly addressed before conception takes place by visiting a doctor for advice beforehand.
Hormonal imbalance
Hormonal imbalance is one of the most common causes behind suboptimal sperm count. A hormonal imbalance can mean a reduction in the production of reproductive hormones, such as testosterone and other male sex hormones like LH (luteinizing hormone). Consequently, it may lead to inactive or dead spermatocytes, resulting in decreased sperm count.
Hormones also play a major role in triggering the production of spermatocyte cells and their movement through seminiferous tubules—the tube-like structure inside testicles which produce sperm. Imbalanced hormones may suppress the sperm-producing process and impair sperms’ motility (or movement). Sperm motility is essential for fertilization and conception. If motility drops significantly, it could hinder the sperm’s ability to reach and penetrate the egg.
Hormonal imbalances can be triggered by a number of factors, including:
- Excessive weight gain or loss
- Stress
- Multiple endocrine disorders – such as pituitary adenoma or homonal dysfunctions like hypogonadism – and
- Physiological issues such as cystic fibrosis that cause genetic abnormalities.
Treating imbalances typically consists of lifestyle changes combined with hormone replacement therapy (HRT), medications or supplements prescribed by an endocrinologist or reproductive specialist. It may also involve minor surgeries to remove certain tumours or fibroids from testicles that might be interfering with hormone production.
Genetic factors
Genetic factors can play a role in causing low sperm count. Hereditary conditions such as Klinefelter syndrome, cystic fibrosis, and some genetic abnormalities may lead to low sperm count in men. These conditions may decrease the amount of normal sperm produced, or cause a complete lack of sperm production. In some cases, surgery to correct these genetic abnormalities can improve the chances for normal fertility.
Additionally, male twins have been found to have significantly lower semen concentrations than non-twin brothers. This suggests that there could be a genetic component to a man’s fertility potential.
Medications
Certain medications can affect a man’s sperm count. Medications such as cimetidine and spironolactone, which are used to treat conditions such as high blood pressure, prostate cancer, and urinary tract infections, have been linked to low sperm count. Antifungal drugs like fluconazole and ketoconazole can also disrupt spermatogenesis. Other drugs that have the potential to lower sperm count include opioids, which are commonly prescribed for pain relief. Heavy or chronic use of these medications can lead to a decrease in testosterone or interfere with sperm production, resulting in lower sperm counts.
Men should speak with their doctor if they suspect that their medications may be contributing to low sperm counts.
Diagnosis
In order to diagnose whether or not your sperm count is low, your doctor will need to conduct a semen analysis. This analysis will measure the number, motility and shape of your sperm, as well as any other possible signs of low sperm count.
Your doctor will do this test by collecting a semen sample and then running tests on it to determine your sperm count and other indicators. Afterward, your doctor can tell you if your sperm count is low and what the best course of treatment is.
Semen analysis
Semen analysis, also known as a sperm count test, is the most accurate way to determine if a man has low sperm count. It is done by collecting a semen sample from the man and sending it to a laboratory for evaluation. The semen sample is examined under a microscope to look for the number of sperm present, their motility (ability to move), and morphology (shape).
In general, a normal semen analysis result shows:
- Sperm concentration of greater than 15 million sperm per milliliter or 15 million total per ejaculate
- Total motile count of more than 40 million per ejaculate
- Percentage of motile sperm that is greater than 50%
- Forward progression of at least 4 cm/hour
- At least 30% normal shaped sperm cells
If any of these values fall below the stated criteria, then the sample can be considered abnormal and the man may have a low sperm count. Further tests may be needed in order to investigate any underlying causes or treatment options available. In some cases, lifestyle changes such as reducing stress, exercising regularly and improving nutrition may help increase sperm production and improve fertility potential.
Hormone testing
Hormone testing is often the first step to diagnosing a low sperm count. Your doctor will likely order a semen analysis and hormone level test, as well as further tests if necessary. During the hormone testing, your doctor will check your testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), as well as other hormones. These hormones are key in determining whether or not you have an underlying medical condition that may be causing your low sperm count or if it is caused by lifestyle factors or medications.
Once these tests are completed, your doctor can then provide you with a proper diagnosis and treatment plan to help improve or restore your fertility. Treatment options may include:
- Medicines to increase testosterone levels
- Vitamins and supplements to increase sperm count
- Diet changes and lifestyle changes to reduce stress levels which can help improve sperm health and motility
- Surgery if necessary
- Assisted reproductive techniques may be recommended for successful conception if desired.
Genetic testing
Genetic testing can help detect certain genetic abnormalities that can cause a low sperm count. For example, changes to genes produced by any of the enzymes involved in spermatogenesis may cause a low sperm count which can be detected through gene sequencing. This can help to identify any underlying abnormalities that could be preventing optimal sperm production.
Genetic testing is typically done through a series of blood tests which analyze the DNA for any potential mutations that could be causing infertility issues in men. Genetic testing is not foolproof and some changes are present which are not associated with increased risk of infertility, so it may not always provide a definitive answer on its own. Other medical tests may also need to be performed to gain an overall understanding of the patient’s infertility issues before treatment or lifestyle changes can be recommended.
Treatment
Low sperm count can be treated with a combination of medications and lifestyle changes. Treatment may involve testosterone replacement therapy or medications that can help promote the production of healthy sperm. Additionally, lifestyle changes, such as quitting smoking, reducing alcohol intake and exercise can all help improve sperm quality and quantity.
Let’s look at some of the treatment options in more detail:
Lifestyle changes
If a sperm count is deemed to be low, or if male infertility has been diagnosed, the first line of treatment may involve making lifestyle changes. This can be beneficial in improving the health of reproductive organs and thus help increase a man’s sperm count.
Steps to help improve a low sperm count include:
- Losing weight: Excess body fat can lead to lower testosterone levels, which can have an adverse effect on sperm count.
- Improving diet: Eating more foods high in essential vitamins and minerals such as zinc, selenium and vitamin C may help improve overall fertility health.
- Limiting alcohol intake: Overconsumption of alcohol has been linked with reduced fertility in both males and females.
- Reducing stress levels: Stress can interfere with healthy sperm production. Using relaxation techniques such as mindfulness or yoga may be useful in reducing stress levels and improving overall fertility health.
- Giving up smoking: Smoking damage’s overall health, including reproductive organs. Quitting smoking is one of the best ways to ensure optimal fertility.
- Avoiding certain recreational drugs: Illicit drug use has been linked with lower sperm counts for men and poorer egg quality for women; avoiding recreational drugs altogether is generally advised for those looking to conceive.
Dietary changes
Making some dietary and lifestyle changes can be helpful when trying to address a low sperm count. Certain foods, including hot peppers, onion, garlic, and other cruciferous vegetables like cauliflower and broccoli, can reduce sperm counts by about 25-30%. Therefore, it is best for men with low sperm count to reduce or eliminate these foods from their diet.
In addition, processed sugars and trans fats should also be avoided as they can inhibit the production of hormones involved in regulating sperm production. Eating more healthy foods such as whole grains, lean meats and dairy products may aid in improving fertility. It is also recommended that men with a low sperm count try incorporating more zinc-rich foods such as oysters, beef, peanuts and wheat germ into their diets.
Other lifestyle changes that can help improve fertility include:
- Avoiding tight-fitting clothing to ensure testicular health.
- Reducing stress levels through exercise or relaxation techniques like yoga or meditation.
- Minimizing alcohol consumption.
- Quitting smoking if necessary.
- Exercising to increase blood circulation which may provide further assistance in addressing a low sperm count problem.
It is important to talk with a doctor before beginning any dietary or lifestyle changes when trying to address fertility issues.
Medications
If lower than normal sperm count has been diagnosed, the doctor may recommend medications to help improve the condition. One of the most common medications prescribed are hormone treatments such as human chorionic gonadotropin (HCG). HCG helps to increase testosterone production and thereby increase sperm count. Other types of hormone therapy may also be recommended, depending on individual circumstances.
Sometimes, certain antibiotics may also be prescribed to treat infections that could be affecting sperm production and reduce count.
In some cases, a man may need to take a combination of drugs, such as HCG and clomiphene citrate (CC), which acts like estrogen but helps produce more testosterone and may increase sperm production. It is important for patients to follow their doctor’s instructions carefully when taking any medications related to lowered sperm counts as dosing is very important for their effectiveness in increasing sperm concentration.
Conclusion
In conclusion, it is very important to understand if your sperm count falls below the normal range. This can be indicative of a wide variety of conditions that can affect fertility and male health. If you suspect that low sperm count may be affecting your fertility, it is recommended to visit a doctor for evaluation.
With the help of a trained medical professional, you will be able to determine the cause and proper course of treatment. In addition to seeking professional help, it is also important to make lifestyle changes such as:
- Decreasing stress levels
- Avoiding unhealthy habits like smoking and alcohol consumption
in order to maintain optimal reproductive health.