Understanding Low Sperm Count (Oligospermia)

A Comprehensive Guide for Patients

Endocrinology

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Last updated: Mar 24, 2025

What is Low Sperm Count?

Low sperm count, medically known as oligospermia, occurs when a man has fewer than 15 million sperm per milliliter of semen. This condition can make it more difficult to achieve pregnancy naturally.

Common Causes

  • Lifestyle factors:

    • Smoking and alcohol use
    • Excessive heat exposure
    • Certain medications
    • Obesity
  • Medical conditions:

    • Varicocele (enlarged testicular veins)
    • Hormonal imbalances
    • Genetic factors
    • Infections

Signs and Symptoms

  • No obvious symptoms
  • Difficulty conceiving is often the only sign
  • Possible signs of underlying conditions:
    • Sexual function problems
    • Pain or swelling in testicles
    • Decreased facial/body hair

Diagnosis

  1. Semen analysis
    • Measures sperm count
    • Evaluates sperm motility and morphology
  2. Physical examination
  3. Blood tests
  4. Genetic testing (when indicated)

Treatment Options

Lifestyle Changes

  • Quit smoking
  • Reduce alcohol intake
  • Maintain healthy weight
  • Avoid excessive heat

Medical Treatments

  • Surgery for varicocele
  • Hormone therapy
  • Medication adjustments
  • Treatment of underlying infections

Assisted Reproductive Technologies

  • Intrauterine insemination (IUI)
  • In vitro fertilization (IVF)
  • Intracytoplasmic sperm injection (ICSI)

Prevention

  • Maintain healthy lifestyle
  • Protect against STIs
  • Avoid harmful environmental exposures
  • Regular medical check-ups

When to See a Doctor

  • Unable to conceive after 1 year of trying
  • History of testicle problems
  • Previous cancer treatment
  • Sexual function difficulties

Outlook

Many cases of low sperm count are treatable. Success rates depend on the underlying cause and chosen treatment method. Early intervention typically improves outcomes.

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