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Low Sperm Count (oligospermia/oligozoospermia)

Low sperm count (oligopermia) is characterized by having a lower than normal sperm count during ejaculation. Anything lower than 15 million sperm per milliliter of semen (15 mil/ml) is considered low. This condition usually has no symptoms and can be diagnosed with a semen analysis. While perhaps uncomfortable, this test simply requires ejaculation into for a cup for a complete analysis.[1]

Treatment for Low Sperm Count

There are a few, “natural” ways to increase your sperm count – however, it is important to note that most of these remain weakly proven scientifically.

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  • Exercise – Especially for overweight or obese men (according to the BMI scale), exercising for an hour a few times a week can increase sperm count.[3]

  • Smoking – by quitting smoking, sperm count can increase and sperm quality can stop deteriorating.[4]

  • Anti-oxidant rich diet – Foods that contain vitamins such as C, E, Coenzyme Q10, L-camitine, or selenium can help increase sperm count.[5]

  • Avoid exposure to environmental toxins – pollution and toxic chemical exposure can have an effect on sperm count.[6] However, this point is still up for debate as other studies say there is not enough data to support this point.[77]

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If nothing works naturally, there are a few ways to try to increase sperm count with medication:

  • Clomid – scientifically called “clomiphene citrate”, this drug can help increase sperm count by increasing gonadotropin secretion. This method of treatment has been used for years and has been proven to help in some cases.[8][9]

  • Gonadotropins (such as Gonal-F or Bravelle) – This hormone is available via injection. Your doctor may prescribe this if Clomid was unsuccessful. However, several studies have shown a similar effect with normal results on outcomes.[10][11]

Causes of Low Sperm Count

While it is difficult to exactly pinpoint the cause of low sperm count, there are a few associated problems:

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  • Genetic factors

  • Hormone imbalance

  • Varicoceles

  • Excessive alcohol or drug consumption

  • Overheated testicles

  • Chemotherapy[2]

If these drugs do not work, your doctor may recommend more in-depth infertility treatment. Unfortunately, intrauterine insemination (IUI) is not recommended due to the washing process involved.

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In vitro fertilization (IVF) is a process in which eggs are removed from a woman’s eggs, fertilized with a man’s sperm in a laboratory, then returned to the woman’s uterus to grow. In severely low sperm count cases, intracytoplasmic sperm injection (ICSI) will be needed. This is an additional part of IVF in which an embryologist injects one sperm into each egg to fertilize, rather than fertilizing naturally. For more information on IVF or ICSI, please visit the respective pages in the menu above.

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In extreme cases of low sperm count or cases where IVF has failed, donor sperm may be recommended as the next course of action. This is where another man’s donated sperm is used (either via at home insemination, IUI or IVF) to fertilize the woman’s eggs. For more information on donor sperm, please visit the “Donor sperm” page in the menu above.

[1] Mayo Clinic Staff. 2017. “Low Sperm Count.” Mayo Clinic. 2017. https://www.mayoclinic.org/diseases-conditions/low-sperm-count/symptoms-causes/syc-20374585.​

[2] NHS. 2017. “Low Sperm Count.” NHS Choices. 2017. https://www.nhs.uk/conditions/low-sperm-count/.

[3] Rosety, Miguel Ángel; Díaz, Antonio; Rosety, Jesús María; Pery, M.a Teresa; Brenes-Martín, Francisco; Bernardi, Marco; García, Natalia; Rosety-Rodríguez, Manuel; Ordóñez, Francisco Javier; Rosety, Ignacio. 2017. Exercise Improved Semen Quality and Reproductive Hormone Levels in Sedentary Obese Adults. Nutrición Hospitalaria [Spanish]. Vol. 34. Jarpyo Editores. http://www.redalyc.org/html/3092/309251456014/.

[4] Sharma, Reecha, Avi Harlev, Ashok Agarwal, and Sandro C. Esteves. 2016. “Cigarette Smoking and Semen Quality: A New Meta-Analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen.” European Urology 70 (4). Elsevier: 635–45. https://doi.org/10.1016/J.EURURO.2016.04.010.

[5] Barazani, Yagil, Benjamin Farrel Katz, Harris Mark Nagler, and Doron Sol Stember. 2014. “Lifestyle, Environment, and Male Reproductive Health.” The Urologic Clinics of North America 41 (1). Elsevier: 55–66. https://doi.org/10.1016/j.ucl.2013.08.017.

[6] Ibid.

[7] Sharpe, Richard M. 2010. “Environmental/Lifestyle Effects on Spermatogenesis.” Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 365 (1546). The Royal Society: 1697–1712. https://doi.org/10.1098/rstb.2009.0206.

[8] Homonnai, Zwi T., Haim Yavetz, Leah Yogev, Ronit Rotem, and Gedalia F. Paz. 1988. “Clomiphene Citrate Treatment in Oligozoospermia: Comparison between Two Regimens of Low-Dose Treatment.” Fertility and Sterility 50 (5). Elsevier: 801–4. https://doi.org/10.1016/S0015-0282(16)60319-9.

[9] Rönnberg, L. 1980. “The Effect of Clomiphene Citrate on Different Sperm Parameters and Serum Hormone Levels in Preselected Infertile Men: A Controlled Double-Blind Cross-Over Study.” International Journal of Andrology 3 (1–6). Wiley/Blackwell (10.1111): 479–86. https://doi.org/10.1111/j.1365-2605.1980.tb00136.x.

[10] MROUEH, ADNAN, BERNARD LYTTON, and NATHAN KASE. 1967. “Effects of Human Chorionic Gonadotropin and Human Menopausal Gonadotropin (Pergonal) in Males with Oligospermia.” The Journal of Clinical Endocrinology & Metabolism 27 (1). Oxford University Press: 53–60. https://doi.org/10.1210/jcem-27-1-53.

[11] KNUTH, ULRICH A., WERNER HÖNIGL, MONIKA BALS-PRATSCH, GUNTER SCHLEICHER, and EBERHARD NIESCHLAG. 1987. “Treatment of Severe Oligospermia with Human Chorionic Gonadotropin/Human Menopausal Gonadotropin: A Placebo-Controlled, Double Blind Trial.” The Journal of Clinical Endocrinology & Metabolism 65 (6). Oxford University Press: 1081–87. https://doi.org/10.1210/jcem-65-6-1081.

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