Low Sperm Count, The Causes, & Possible Treatment

With over 40% of infertility caused by a male-factor, it’s time we find out the causes and treatment options to improve fertility.

Male infertility is caused by oligospermia (low sperm count), and other factors such as lifestyles, medical conditions, and environmental exposure.

Oligospermia, or low sperm count, is when there is a low concentration of sperm cells in the semen. A man with such semen quality hardly gets pregnant with his wife.

Classification of oligospermia (low sperm count)

Based on semen analysis, sperm counts can be grouped into five categories. They include

  • Azoospermia: When the sperm concentration is zero
  • Severe oligospermia: This is when sperm concentration is less than one million per millilitre.
  • Moderate oligozoospermia: Sperm concentration from 1 to 5 million/ml
  • Mild oligozoospermia: Concentrations from 5 to 20 million/ml
  • Normal sperm count: Above 20 million/ml. (1)

Note that sperm motility and morphology in each of the above categories may be normal, or abnormal (asthenozoospermia).

However, the most recent classification of sperm count by the World Health Organisation (WHO) placed sperm at 15 million/ml and above at the normal count.

oligospermia/low sperm count

Causes of low sperm count (oligospermia)

Several factors can cause a low sperm count, they include

Sexually transmitted diseases (STDs)

STDs like a staph infection and gonorrhoea can affect sperm production and quality if left untreated for too long.

Some may cause inflammation or even block the tubules that convey semen.

Untreated STDs can also cause watery sperm, affecting sperm morphology and motility.


Varicocele is the swelling of veins in the scrotum. It is common among infertile men affecting 1 in every three men.

A varicocele prevents blood drainage, causing blood to flow back from belly to the scrotum and thereby increasing the temperature of the testis, which affects sperm quality.

Anti-sperm antibodies

Antibodies are body soldiers that guard against antigens. Occasionally, the antibodies mistook the sperm cells as antigens and attacked them. Such a condition can affect sperm morphology and motility.

Chromosome disorder

Certain health conditions, such as Kallmann’s and Klinefelter’s syndrome decreased sperm concentration.

Klinefelter’s syndrome is when a man is born with two X and one Y chromosome, instead of one X and the Y chromosome.

This can affect the healthy development of a male reproductive organ and may cause infertility.

Hormonal imbalance

The pituitary gland, being the master’s gland, produces follicle-stimulating hormones (FSH) and luteinizing hormones (LH).

These reproductive hormones cause the testes to produce testosterone and sperm cells.

If there is an imbalance in any of the reproductive hormones, it will affect sperm production.

 Ejaculation problems

Retrograde ejaculation is when your sperm moves backwards into your bladder instead of getting out of your penis.

It occurs when the nerves and muscles in your bladder don’t close during orgasm.  Medications, surgery, and nervous system disorder may cause this problem.

Exposure to chemicals or toxins

Prolonged exposure to chemicals such as pesticides, heavy metals, herbicides, and radiations can cause infertility in men.

Drug abuse and smoking: The use of hard drugs like Indian hemp, cigarettes, hard drugs, and excess alcohol can gradually affect sperm quality.

Obesity: Being overweight sometimes affects sperm production because it lowers sperm production in your body.

Malnutrition: A balanced diet is a diet that contains all six classes of food. Constant eating of unbalanced food will gradually affect sperm production.

Overheating the testicles

High temperatures can affect sperm production, avoiding any action that may stress or increase the temperature around the testis. Examples include sitting on hot objects, wearing tight boxers, a constant placing of a laptop on your lap, etc.

Age: Sperm production usually decreases as you age. The probability of producing healthy sperm is always higher from your twenties and decreases as you reach the seventies.

Symptoms of oligospermia

The primary symptom of low sperm count is infertility. Other symptoms differ depending on the cause of the low sperm count.

Oligospermia treatments

The best treatment for oligospermia is prevention. As an adage says that prevention is always better than cure, preventing all the actions that cause a low sperm count remains the best option.

Some behaviours, such as having multiple sex partners, smoking, drug abuse, exposure to hazardous compounds, taking excessive alcohol and many others, should be stopped.

Complications like vas deference obstruction can be corrected with surgery.

  • Control your weight. Do regular exercises to maintain your structure.
  • For hormonal treatment, seek medical advice on how to balance your hormones to improve fertility.