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Fertility issues can be a sensitive and challenging topic for many couples, with low sperm count, or oligospermia, being a significant concern for men. What exactly causes this condition that affects millions worldwide? Low sperm count, also known as oligospermia can be identified using semen analysis test, it is a condition in which a man has fewer sperm in his semen than normal. 15 million sperm per milliliter of semen is counted as the normal sperm count where a couple can get pregnant. Men with a sperm count lower than this may have difficulty conceiving, as a couple.

What are the Signs of Low Sperm Count?

Low sperm count signs can include difficulty achieving pregnancy, low sex drive, and changes in the shape or color of the testicles. However, many men with this problem do not experience any noticeable symptoms.

What are the Causes of Low Sperm Count?

Now that we know what is low sperm count and its signs, let’s understand the causes of low sperm count. These can be divided into medical causes, environmental causes and lifestyle causes. Understanding the underlying causes of low sperm count can help in finding the most appropriate treatment option.

Low sperm causes

Also Read: How to Read a Semen Analysis Report

1. Medical Causes:

The medical reasons behind less sperm count include:

  • Varicocele: A condition of enlargement or swelling testicular veins. It can cause the testicles to become too warm, which can affect sperm production.
  • Infection: Certain infections, such as sexually transmitted infections (STIs) and mumps, can damage the testicles and reduce sperm production.
  • Ejaculation problems: Certain conditions, such as retrograde ejaculation or premature ejaculation, can prevent semen from being ejaculated properly and reduce sperm count.
  • Antibodies that attack sperm: In some men, the body produces antibodies that attack and damage sperm, reducing sperm count.
  • Tumors: Tumors in the testicles or pituitary gland can affect sperm production.
  • Undescended testicles: Testicles that do not descend into the scrotum can be more susceptible to heat damage and may produce less sperm.
  • Hormone imbalances: Hormonal imbalances, such as low levels of testosterone, can affect sperm production.
  • Tubules defects that transport sperm: Certain defects in the tubules that transport sperm can reduce sperm count.
  • Chromosome defects: Certain genetic disorders, such as Klinefelter syndrome, can affect sperm production.
  • Celiac disease: An autoimmune disorder that affects the small intestine can lead to malabsorption of nutrients and can cause hormonal imbalances that can affect sperm production.
  • Certain medications: Some medications, such as testosterone replacement therapy and certain antidepressants, can affect sperm production.
  • Previous surgeries: Some surgeries, such as vasectomies or hernia repairs, can affect sperm production.

2. Environmental Causes:

Environmental causes of low sperm count include the following factors. It’s important to note that environmental factors can have a cumulative effect, meaning that exposure to multiple toxins or radiation over time can increase the risk of low sperm count. This highlights the importance of taking preventative measures to minimize exposure to such environmental toxins and to seek medical attention if you suspect that your low sperm count may be caused by an environmental factor. Now let’s study these factors….

  • Industrial chemicals: Exposure to certain industrial chemicals, such as pesticides, solvents, and heavy metals, can damage the genetic material in sperm and reduce sperm count.
  • Extensive metal exposure: Exposure to certain metals, such as lead, cadmium, and mercury, can affect sperm production and function.
  • Exposure to X-rays or radiation: Exposure to high levels of X-rays or radiation, such as from radiation therapy for cancer, can damage the cells that produce sperm and reduce sperm count.
  • Testicle overheating: The testicles need to be at a slightly lower temperature than the rest of the body to produce healthy sperm. Factors that can cause testicles to overheat include tight underwear, frequent use of saunas or hot tubs, and certain medical conditions such as varicocele.

Lifestyle Causes

3. Lifestyle Causes:

Lifestyle many times also can play a role in low sperm count.

  • Drug use: The use of certain recreational drugs, such as marijuana, cocaine, and anabolic steroids, can reduce sperm count and affect sperm function.
  • Alcohol use: Excessive alcohol consumption can negatively impact sperm production and function.
  • Occupation: Certain occupations, such as those that involve prolonged sitting or exposure to heat, chemicals or radiation, can increase the risk of low sperm count.
  • Smoking tobacco: Smoking cigarettes or using other tobacco products can decrease sperm count and affect sperm function.
  • Stress: Chronic stress can negatively impact hormones that are essential for sperm production and function.
  • Depression: Men with depression may have lower sperm count than those without depression.
  • Obesity: Obesity can lead to hormonal imbalances that can affect sperm production and function.
  • Issue in testing the sperm: In some cases, a low sperms may be due to a problem with the way the sperm is collected or tested.
  • Electronic Gadgets: Excessive use of laptops & mobile phones

How to Get Pregnant with Low Sperms?

For couples trying to conceive with low sperm counts, there are several treatment options available. These include trying to conceive naturally, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), donor insemination, and gonadotropin medications.

As soon as you spot low sperm count signs, it’s also important to consider lifestyle changes that can improve sperm count such as avoiding environmental toxins, maintaining a healthy diet, regular exercise, avoiding very hot water for bathing and quitting smoking if you smoke.

IVF Treatment

Low Sperm Count Treatment Options:

 The issue can be treated with a variety of methods, depending on the underlying cause and the couple’s specific circumstances.

  • Keep trying to conceive: For couples who are trying to conceive naturally, it’s important to keep trying even if the man has a low sperm count. In many cases, conception will eventually occur on its own.
  • In-vitro fertilization (IVF): IVF is a treatment in which a woman’s eggs are fertilized with a man’s sperm outside of the body, and the fertilized egg is then implanted into the woman’s uterus. A very effective treatment option for infertile couples.
  • Intracytoplasmic sperm injection (ICSI): ICSI is a variation of IVF in which a single sperm is injected directly into an egg, rather than allowing the sperm to fertilize the egg naturally. This can be an effective treatment option for men with very low sperm counts.
  • Donor insemination: In cases where the man’s sperm count is extremely low or there is a genetic disorder, donor insemination may be recommended. This involves using sperm from a sperm donor to fertilize the woman’s eggs.
  • Gonadotropins medication: In cases of hormonal imbalances that are causing low sperm count, gonadotropins medication may be prescribed. These medications are designed to stimulate the production of sperm.

Low Sperm Count Treatment Cost:

It’s important to note that the success rates of these treatment options may vary depending on the underlying cause of the low sperm count, the couple’s individual circumstances and that of the clinic/hospital in the region. Additionally, the cost of treatment, and medicine for low sperm count can vary and insurance coverage for these treatments may be limited. So it’s important to discuss all options with a qualified healthcare provider.


A. The answer to this question depends on the underlying cause of the low sperm count. In some cases, the condition may be reversible with treatment.

A. Masturbating does not cause low sperm count, but excessive masturbation can lead to temporary sperm depletion.

A. Medications such as gonadotropins, as per the underlying cause, may be prescribed to stimulate sperm production, while others may address underlying conditions such as hormonal imbalances. Consult a qualified healthcare provider for further guidance.

Dr. Shefali Jain

Dr. Shefali Jain is Gynecologist, Obstetrician & Infertility Specialist in Indore with more than 27 years of experience in the field of ART with highest success rate. She has received many awards for her exceptional work in the field of infertility. She has been an invited speaker to many national and international conferences.