Low Sperm Count – Causes, Symptoms, Prevention, and Treatment

June 10, 2025

In India, 15–20% of couples experience fertility problems but men account for approximately 50% of cases. Medical experts identify low sperm count or oligospermia as a widespread yet seldom discussed infertility cause. Global research reports that sperm counts have decreased by more than 50% over the last forty years, which establishes serious reproductive health concerns worldwide.

Male infertility remains widely undiagnosed and poorly understood because some people incorrectly blame female factors, while others harbour stigma toward male infertility. Delayed medical diagnosis leads to both psychological consequences as well as relationship strain. So, keep reading to get detailed explanations about male infertility causes and symptoms, followed by treatment options and useful guidance for couples.

What is Low Sperm Count?

A low level of sperm occurs when a man's semen contains a smaller amount of male sperm cells than expected. Medical guidelines define a low count as fewer than 15 million sperm per millilitre of semen. In most severe cases, some men may have no sperm at all, which is known as azoospermia.

Even with a low sperm count, a man can still father a child, as it only takes one healthy sperm to fertilize an egg. While having fewer sperm may reduce the chances of conception, it doesn’t mean the man is infertile. With the right treatment and lifestyle changes, many men with low sperm counts can successfully conceive.

What Are The Common Symptoms of Low Sperm Count?

Most men don’t have any obvious symptoms of low sperm count unless they’re trying to conceive. Difficulty conceiving after a year of regular, unprotected sex is the main and often the only symptom.

However, other symptoms may vary depending on the reason and involve the following:

Low sex drive
Erectile dysfunction
Swelling or a painful, lumpy feeling in your testicles.
These may be signs of hormonal imbalances, such as decreased facial or body hair.

Consult your healthcare professional if you experience any of the above signs. The sooner you diagnose the problem, the sooner you can cure it.

What Causes Low Sperm Count in Men?

Low sperm count does not result from a single cause. Several factors, such as lifestyle, environmental factors, and certain medical conditions, can put you at risk of having a low number of sperm in the semen. The following table covers all of these factors:

Category	Cause	Explanation
Medical Causes	Varicocele	Swollen veins in the scrotum can reduce sperm production, but they can be treated with surgery.
	Infections	STIs or testicular infections can damage the organs that make sperm.
	Hormonal Imbalances	Problems in the brain or testicles can affect the hormones needed to make healthy sperm.
	Ejaculation Issues	Conditions like retrograde ejaculation send sperm into the bladder instead of out through the penis.
	Undescended Testicles	When testicles don’t move into the scrotum at birth, it can cause fertility problems later.
	Tumours or Past Surgeries	Growths or past operations in or near the testicles may affect sperm-making ability.
Environmental Causes	Chemical Exposure	Regular contact with harmful chemicals like pesticides or heavy metals can hurt sperm health.
	Radiation or X-rays	High exposure can damage the cells that produce sperm.
	Overheating the Testicles	Using hot tubs often, or placing laptops on the lap for long periods, may reduce sperm count.
Lifestyle Causes	Smoking, Alcohol, and Drugs	These substances, especially steroids and marijuana, can lower sperm count.
	Obesity	Too much body fat can upset hormone balance and reduce sperm production.
	Stress and Poor Sleep	Ongoing stress or not sleeping enough can affect the hormones that help create sperm.

It’s also important to differentiate between low sperm motility vs sperm count. How well sperm moves is known as Motility. Even if you have a normal count, poor motility can impact your chances of becoming pregnant.

How Do Doctors Determine Whether You Have A Low Sperm Count?

To diagnose low sperm count, a healthcare provider usually recommends a semen analysis. This test measures -

Total number of sperm
Motility (movement)
Morphology (shape)

Sperm count might fluctuate, so sometimes you need several samples over time to confirm the results.

Additional tests might include -

Genetic markers, as well as blood tests to check hormone levels
Blockages or abnormalities may be detected with ultrasounds.
If there is an issue suspected with sperm production, a testicular biopsy may be used.

How to Prevent Low Sperm Count and Improve Fertility?

Lifestyle changes often help boost sperm health, even though some conditions leading to low sperm count and male infertility cannot be avoided. Check out these proven ways to help protect and enhance your sperm health:

Do not smoke, take recreational drugs, or drink excessive amounts of alcohol
Maintain a healthy weight
Limit testicle heat exposure (avoiding hot tubs, tight underwear).
Exercise, meditate, or get counseling to manage stress.
Consume a diet consisting of foods that boost male fertility, such as:
- Walnuts and almonds
- Leafy greens like spinach
- Eggs (rich in vitamin E)
- Fruits like bananas and berries
- Fish that are oily (salmon, tuna, and herring) contain fatty acids like omega-3.

Antioxidants, vitamins (specifically C and E), zinc, and selenium in these foods will help increase sperm count, motility and quality.

What Treatment Options Are Suggested For Low Sperm Count?

Low sperm count may make it more difficult to become pregnant, but there are many treatment options. The appropriate treatment is based on the cause of the issue. These are the most common medical treatments for low sperm count:

Surgery

Some men have something called varicocele. This is when veins in the scrotum swell. Surgery can repair it. If the tubes that sperm travel through (the vas deferens) are clogged, surgery can open them up. If a man has already had a vasectomy, sometimes it can be reversed. If no sperm is in the semen, physicians can take sperm directly from the testicles with a minor surgery.

Treatment of Infections

Reproductive infections, such as those of the prostate or testicles, may hamper sperm formation. Physicians routinely use antibiotics for treatment. After recovery from an infection, sometimes the sperm count fails to achieve its original position completely. Though not all infections make men infertile, early treatment is a good idea.

Treatments in Sexual Health

Some men can experience issues such as erectile dysfunction or premature ejaculation. These do not allow sex and conception to be easy. Doctors can provide medication or refer them to counselling. Medication and counselling can enhance sexual performance and the probability of pregnancy.

Hormone Treatments

Hormones control how the body makes sperm. If hormone levels are too high or too low, it can affect fertility. Blood tests can check for this. If needed, hormone medicines can help fix the imbalance. This may improve sperm production in some men.

Lifestyle Changes

Physicians usually prescribe healthy lifestyles. These are quitting smoking, consuming less alcohol, exercising, and having a healthy diet. Refraining from steroid drugs and maintaining a healthy weight can also do the trick. Reducing stress and having adequate sleep are beneficial for endocrine balance.

Assisted Reproductive Technology (ART)

When other treatments do not succeed, couples may seek ART. These are:

Intrauterine Insemination (IUI): Doctors inject sperm directly into the uterus at the time of ovulation.
In Vitro Fertilization (IVF): Sperm and egg are combined in a laboratory and the embryo is implanted into the uterus.
Intracytoplasmic Sperm Injection (ICSI): One sperm is injected into an egg and then inserted into the uterus.

The doctors decide which method to use depending on the quality of sperm, test results and the couple's preference. Most men with low sperm count can still become fathers with proper guidance.