Overview – What is it?
Low sperm count, also known as oligozoospermia, is when a man has less than 15 million sperm per millilitre of semen. Semen is the fluid ejaculated by a man during sex. The cause of a low sperm count can be due to lifestyle, medical and environmental factors, among other risk factors.
Some of the symptoms that can be caused by low sperm count include low sex drive, a decrease in facial or body hair and pain in the testicles. Low sperm count can be diagnosed through semen analysis, post-ejaculation urinalysis and hormone testing, among other tests.
Treatment for low sperm count can be through methods such as surgery, hormone treatments and assisted reproductive technology.
To prevent yourself from having a low sperm count, you should maintain a healthy body weight, not smoke and limit alcohol intake, among other preventive measures.
Causes – What causes it?
Production of sperm requires proper functioning of the testicles, the pituitary gland and the hypothalamus. The latter two are located in the brain and produce hormones that help in sperm production.
Low sperm count can be caused by the following:
- Medical causes: Some medical issues such as tumours in the male reproductive organs, undescended testicles, and hormonal imbalance, can cause low sperm count.
- Environmental causes: Environmental factors such as exposure to heavy metals, industrial chemicals and radiation, and overheating of the testicles due to elevated temperatures (which can be caused by wearing tight clothing and working on a laptop for long periods) can cause low sperm count.
- Lifestyle factors: Smoking, alcohol abuse, using drugs like steroids, being obese or overweight, prolonged and severe stress and some occupations linked with infertility such as being a truck driver, can cause low sperm count.
Other risk factors include:
- A previous vasectomy or major abdominal or pelvic surgery,
- A history of undescended testicles, and
- Previous cancer treatments like radiation therapy.
Symptoms – What do you feel?
The major sign of low sperm count is the inability to get your partner to conceive a child. Other symptoms to watch out for include:
- Pain, swelling or the presence of a lump in the testicle area,
- Problems with sexual function such as erectile dysfunction (difficulty maintaining an erection) and having a low sex drive, and
- Decrease in facial and body hair and other hormonal problems.
Diagnosis – How do you diagnose it?
The diagnosis can be done through the following:
- Physical exam: This is to examine the genitals for any abnormalities. The doctor will also find out your medical history; whether you have any inherited conditions or chronic health problems, any illnesses or injuries and whether you have gone through any surgeries.
- Semen analysis: This is done by analysing sperm under a microscope to determine how many sperms appear within squares on a grid pattern.
Other tests that may be done include:
- Hormone testing: To determine the level of hormones produced by the pituitary gland and testicles.
- Testicular biopsy: This is done by taking a tissue sample from the testicle to determine whether the sperm production is normal.
- Anti-sperm antibody test: This is a test used to check for antibodies that attack the sperm and affect their ability to function.
- Transrectal ultrasound: This test is done to check for blockages of the ejaculatory ducts and seminal vesicles.
- Specialized sperm function test: To check how well your sperm survives after ejaculation, how well they can penetrate an egg and whether there are any problems with the sperm attaching to the egg.
Treatment – How do you treat it?
The treatment options for low sperm count include:
- Surgery: This is done to correct some causes of low sperm count such as varicocele.
- Hormonal treatments: This could include hormone replacement or medications, especially in cases where the low sperm count is caused by high or low levels of certain hormones.
- Treating infections: This is the use of antibiotics to treat some infections of the reproductive tract. However, this may not always restore fertility.
- Assisted reproductive technology (ART): This involves obtaining sperm through surgical extraction or from a donor after which they are inserted into the female genital tract or used for IVF (in vitro fertilization).
Prevention – How do you prevent it?
Low sperm count can be prevented through:
- Maintaining a healthy body weight
- Eating a healthy diet
- Limiting alcohol intake
- Not smoking or using illegal drugs
- Managing stress
- Avoiding exposure to pesticides, heavy metals and other toxins
- Avoiding overheating the genital area