A sperm count, as most people understand it, refers to the number of sperm present in one milliliter of sperm. As part of the conventional semen analysis (or sperm test), three major variables are measured (shape).

Motility is at least 50% and morphology is at least 15% for a normal sperm concentration of at least 20 million per mL However, sperm motility and seminal volume are the most essential elements in a semen analysis.

Swelling involves glans and distal shaft: (A) dorsal view and (B)... |  Download Scientific Diagram
swelling involves glans and distal shaft

Causes of low sperm count

Surgeries, Infections, Current and Past Health Issues
Mumps, sexually transmitted diseases such as Chlamydia, or urinary tract infections can leave scars that block the delicate tubes that transport sperm from the testes to the penis. Spinal cord injuries, diabetes, and certain surgeries can block the normal flow of sperm, and/or lead to retrograde (backward) ejaculation.


Genetic or Chronic Disease
While most genetic causes of low or the complete absence of sperm production are rare, many chronic conditions and/or medications used to treat them are common causes of male infertility. Conditions such as cancer of the testicle or prostate, diabetes, high blood pressure and peripheral vascular disease can cause a man to have a low sperm count.

Lifesaving cancer treatment either surgery, chemotherapy, or radiation therapy can destroy sperm cells, and greatly decrease a man’s sperm count. TFC offers fertility rescue prior to cancer treatment to proactively protect future fertility.

Structural Problems with the Penis or Testicles
Structural problems with the penis that can cause a man’s sperm count to plummet include Peyronie’s disease (in which plaque and/or scar tissue builds up in the penis), as well as problems with inflammation and scar tissue that can interfere with the normal ejaculatory process. A varicocele is present in up to 40 percent of men with fertility issues, and is a condition that can occasionally affect fertility. While most men with a varicocele will not need or benefit from surgery, the condition warrants a conversation with a fertility specialist.

Other potentially important structural issues include undescended testicles, sperm duct problems, and blockages in the tubes that transport sperm (vas deferens).

Hormonal Imbalances
Hormones drive the production of sperm, and sometimes the hormonal signals between the brain, pituitary and testicles can stall or cease altogether. A blood test can confirm whether all systems are functioning, or if an imbalance is causing a low sperm count.

Previous Vasectomy
Surgeries to reverse vasectomy can produce successful results to restore patency in the tubes that carry sperm. Side effects of the surgery, however, may lead a man to produce antibodies that can attack his own sperm.

Medications for Low T
Ask your fertility doctor about the medications that may lead to a low sperm count, including popular Low T therapies. Men who have used anabolic steroids for extended periods of time may experience a low sperm count as a result. In many cases, these side effects are temporary, and fertility is restored after simply stopping the medication.

Environmental and Lifestyle Factors
Certain habits and occupations put men at risk for fertility problems, and a lower sperm count can make it difficult to become a father. Embrace a healthful lifestyle and weight while trying to conceive, and you will increase your chances for success. The most common threats to a man’s fertility include:

  • Alcohol abuse
  • Anabolic steroids
  • Cigarette smoking
  • Exposure to toxic chemicals, heavy metals, pesticides, paint and solvents
  • Illegal drugs, including cocaine and marijuana
  • Obesity

In extreme cases, prolonged exposure to heat and long-distance cycling can also affect a man’s fertility and leave him with a low sperm count. In these cases, a change of habits may be the only necessary course of action.

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