Dear doctor, my husband has a low sperm count. Can we still have children?

25 July 2017

Q: My husband has been told that he has a low sperm count. Can we still have children?

A: Generally speaking, the answer is yes you can have children. If sperm count was found to be low, semen analysis should be repeated after 2-3 months of the first test. Your partner should start taking tablets containing anti-oxidants, such as Wellman tablet once a day.

You have to complete the basic investigations including testing your ovarian reserve (number and quality of eggs) which involves running a blood test to check the level of your hormones. Also, ovulation has to be tested by doing a blood test seven days before starting your period. Ideally, you should have X-ray and dye test done to check your Fallopian tubes.

Some couples do achieve natural pregnancy despite the low sperm count depending on the degree of abnormality of sperm parameters, including percentage of sperm motility and normal looking sperm.

However, if sperm count is low on two occasions, and you have been trying for at least six months, this indicates that a treatment called ICSI (Intra-Cytoplasmic Sperm Injection) is required. ICSI means that you will have a course of injections to stimulate your ovaries. You will have ultrasound scans and blood tests done during the course of injections to monitor the response of the ovaries. Then your eggs will be collected through the vagina and fertilised outside your body to generate embryos (fertilised eggs). Egg collection is done under intravenous sedation, meaning that you will not feel pain or remember the procedure. Thereafter, you will have the embryo/s transferred inside your womb. Embryo transfer is similar to a smear test.

Some men may have no sperm in the ejaculate. Usually, sperm can be retrieved surgically from the testis and the tubes transporting sperm from the testis into the ejaculate (semen). This requires a minor surgical procedure when sperm can be retrieved and frozen. The frozen sperm can then be used for ICSI treatment.

Mr Ehab Kelada is a Fertility Consultant practising at Spire Portsmouth Hospital.


The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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