Low sperm count

A low sperm count is considered as a concentration of less than 15 million sperm per ml of semen. It’s also called oligozoospermia or poor sperm quality.

By Wallace Health I Medically reviewed by Adrian Roberts.
Page last reviewed: October 2018 I Next review due: October 2021

What is a low sperm count?

A low sperm count can make it harder to conceive naturally. It’s the cause of infertility in one in five of couples who are struggling to conceive.

In many cases, the cause can be overcome and sperm count can be increased. For example, giving up smoking can increase your sperm count. If the cause can’t be addressed, then fertility treatment may be recommended to give you the best chance of pregnancy with your partner.

How to tell if you have low sperm count

If you and your partner haven’t been able to get pregnant over the past year through regular sex (every two to three days), then you should make an appointment with your GP – ideally together. Fertility problems can affect men and women and sometimes it’s both.

Talk to your doctor if you’re concerned about symptoms

You can book an appointment with a Spire private GP today.

Diagnosis and tests for low sperm count

If you’re a man concerned about your fertility, you should see your GP. They’ll discuss your medical, sexual and social history, such as:

  • How long you and your partner have been trying to get pregnant
  • Any previous children you have
  • Your occupation (to check for possible exposure to certain pesticides or solvents that can affect fertility)
  • Lifestyle factors that may influence fertility (for example smoking and drinking excessively)

A semen analysis is the initial fertility test for a suspected low sperm count. As well as your sperm count, it will also check:

  • Semen volume
  • pH (acidity)
  • Sperm motility, morphology and vitality (whether they can move properly, their shape and if they’re alive)

You may also need to provide a urine sample to test for chlamydia – a common sexually transmitted disease that can affect fertility.

Causes of low sperm count

The cause of your low sperm count isn’t always obvious. It can be due to:

  • Hormone imbalance, such as hypogonadism, where your body doesn’t produce enough testosterone
  • A genetic problem
  • A structural problem – including undescended testes, damaged or blocked sperm tubes or previous surgery to the testicles or hernia repairs
  • Current or previous infection, such as chlamydia or gonorrhoea
  • Medications, such as chemotherapy
  • Age – quality of sperm declines from 40 onwards

Lifestyle factors can also play a big part in reducing male fertility such as:

  • Smoking
  • Drinking too much alcohol
  • Being overweight
  • Stress

Common treatments for low sperm count

There are many options available to you to help you and your partner conceive.

Your doctor will advise you to keep trying to conceive with your partner naturally. Over eight in 10 couples will conceive naturally in the first year of regular, unprotected sex, rising to nine in 10 in the second year.

Help increase your chances by:

  • Having sex every two to three days
  • Moderating alcohol intake
  • Stopping smoking
  • Exercising regularly
  • Healthy eating
  • Lose any excess weight

Surgery can also help, for example to remove any blockages that are preventing sperm release.

If a low sperm count can’t be resolved, then you may want to consider fertility treatment. This can include:

  • IVF – eggs are removed from a woman’s womb, fertilised with your sperm and returned to her womb
  • Intracytoplasmic sperm injection (ICSI) ­– performed as part of IVF, where a single sperm is injected directly into the egg (helpful for very low or no sperm count)

If you have no semen at all which cannot be resolved, then you may wish to consider a semen donor.

Get in touch

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