Low Sperm Count - Symptoms and Causes

Overview

A low sperm count occurs when there are fewer than 15 million sperm per milliliter of semen. Doctors call this condition oligospermia. When no sperm is present at all, the condition is known as azoospermia.

Semen is the fluid released from the penis during orgasm. Normally, this fluid contains millions of sperm cells. When sperm count drops below normal levels, it becomes harder for couples to achieve pregnancy naturally.

Men with low sperm counts may face challenges when trying to conceive with their partners. The fewer sperm present, the lower the chances that one will successfully fertilize an egg.

However, treatment options exist to help increase fertility chances for couples facing this issue.

Signs of Low Sperm Count

The main sign of a low sperm count is difficulty getting pregnant despite trying for some time. Many people with this condition don’t notice any other obvious symptoms.

Sometimes a low sperm count happens because of another health issue. In these cases, you might also experience:

Sexual function problems – including reduced interest in sex or difficulty getting or maintaining erections firm enough for intercourse.
Discomfort or abnormalities – such as pain, swelling, or lumps in the testicle area.
Hormone-related changes – like reduced facial or body hair growth.

When to Visit a Healthcare Provider

If you and your partner have been trying to conceive for a year without success while having regular unprotected sex, it’s time to seek medical advice. This situation meets the definition of infertility and deserves professional attention.

Consider seeing a doctor sooner if you experience:

Problems with erections, ejaculation, sexual desire, or other sexual functions
Pain, discomfort, or any unusual lumps in the testicle region
Previous issues affecting your testicles, prostate, or sexual health
Past surgical procedures on your groin, testicles, penis, or scrotum

Early evaluation can help identify potential causes and treatment options.

Why Low Sperm Count Happens

Low sperm count can result from several health issues. A varicocele is a common problem where veins in the testicle swell, which may change testicle temperature and reduce sperm numbers and quality. Sometimes surgery can fix this issue.

Infections affect sperm health too. Sexually transmitted infections like gonorrhea or HIV can lower fertility. Swelling in the testicles or epididymis (the coiled tube behind each testicle) from viral, bacterial, or fungal infections may also cause problems.

While most infections heal without lasting damage, some can permanently harm the testicles.

Ejaculation Problems

Retrograde ejaculation – when semen enters the bladder instead of exiting through the penis
Complete lack of ejaculation
Can be caused by diabetes, spinal injuries, or certain surgeries
Some blood pressure medications may affect ejaculation

Tumors, whether cancerous or not, can directly impact reproductive organs or the glands that control hormone production. Cancer treatments like surgery, radiation, or chemotherapy can also harm sperm production.

Undescended testicles, a condition where one or both testicles don’t drop into the scrotum before birth, often leads to fertility problems in adulthood.

Hormone imbalances significantly affect sperm production. The brain’s hypothalamus, pituitary gland, and testicles all produce hormones needed for making sperm. Changes in thyroid or adrenal hormone levels can also impact sperm count.

Blockages in the tubes that carry sperm can occur from injuries, past infections, or conditions like cystic fibrosis. These blockages might happen anywhere from inside the testicle to the tubes that drain it.

Genetic Factors

Some inherited conditions can cause reproductive organs to develop abnormally:

Klinefelter syndrome
Cystic fibrosis
Kallmann syndrome
Kartagener’s syndrome

Certain medications for arthritis, depression, anxiety, digestive issues, infections, high blood pressure, and cancer can reduce sperm production.

Previous surgeries like vasectomy, hernia repairs, or prostate operations might prevent sperm from appearing in semen, though sometimes these can be reversed.

Environmental Factors

The environment around us can harm sperm production and function in several ways:

Long-term exposure to industrial chemicals, particularly insecticides, pesticides, and organic solvents, may contribute to lower sperm counts. Contact with lead and other heavy metals can also cause fertility problems.

Radiation and X-rays can temporarily or permanently decrease sperm production. With high radiation doses, sperm counts might remain below normal for life. After moderate exposure, it may take years for sperm production to return to typical levels.

Heat exposure to the scrotum is another concern. The testicles normally stay slightly cooler than body temperature for optimal sperm production. Too much heat can reduce both sperm count and function.

Environmental Factor	Potential Impact
Industrial chemicals	May lower sperm count over time
Heavy metals	Can cause infertility
Radiation	Temporary or permanent reduction in sperm
Excess heat	Affects sperm count and function

Lifestyle and Health Factors

Many everyday choices and health conditions can affect sperm production.

Taking anabolic steroids to build muscle can significantly reduce sperm production. Cocaine and marijuana use might also lower sperm count and quality. Heavy or regular alcohol consumption can decrease testosterone levels and impair sperm production.

Tobacco smoking is linked to lower sperm counts compared to nonsmokers. The chemicals in cigarettes can damage sperm DNA and reduce fertility.

Long-term emotional stress, including worry about fertility issues, may worsen semen quality. The body’s stress response can interfere with the hormones needed for sperm production.

Body weight matters, too. Obesity can directly impact sperm or cause hormone changes that reduce fertility. Extra body fat can convert testosterone to estrogen, creating a hormone imbalance that affects sperm production.

Testing issues sometimes make sperm counts appear lower than they really are. This can happen if:

A sample is collected too soon after the last ejaculation
Testing occurs shortly after illness or stress
The sample doesn’t contain all the semen released
Collection technique isn’t proper

For accurate results, doctors typically analyze multiple samples over time rather than relying on a single test.

Impact of Lifestyle Factors on Sperm Health:

Drug use can reduce quantity and quality.
Alcohol lowers testosterone and sperm production.
Smoking decreases sperm count.
Stress affects overall semen quality.
Obesity disrupts hormone balance.

Risk Factors

Several factors can increase the risk of low sperm count in men. These include:

Lifestyle Choices

Tobacco smoking
Alcohol consumption
Use of certain illegal drugs

Health Conditions

Excess body weight
High stress levels
Past or current infections
Testicular trauma or injury
Inherited fertility disorders
Tumors and chronic illnesses
History of undescended testicles

Medical Treatments

Radiation therapy for cancer
Certain medications
Surgical procedures, including vasectomy and major abdominal or pelvic surgeries

Environmental Factors

Exposure to various toxins

These risk factors affect sperm production in different ways. Some directly damage sperm cells, while others interfere with hormone production needed for healthy sperm development.

Complications

When facing fertility issues due to low sperm count, couples often encounter several challenges. These may include:

Undergoing surgery to address underlying medical conditions
Participating in costly fertility treatments like IVF
Managing emotional strain from fertility struggles

The journey toward pregnancy can become financially demanding, particularly when advanced reproductive technologies are needed. Many couples also experience significant psychological pressure during this process, which can affect their relationship and personal well-being.

Prevention

Protecting your fertility involves avoiding certain factors that harm sperm count and quality. Here are important steps to consider:

Lifestyle Choices To Maintain:

Avoid smoking completely
Reduce alcohol consumption or abstain entirely
Stay away from illegal drugs
Maintain a healthy body weight
Manage stress effectively

Additional Protective Measures:

Consult with healthcare providers about medications that might impact sperm
Avoid excessive heat exposure to the genital area
Minimize contact with environmental toxins like pesticides and heavy metals

These simple changes can help preserve reproductive health and improve chances of conception when desired.