Low sperm count: main causes, prevention measures and solutions

A low sperm count means that the fluid (semen) you ejaculate during an orgasm contains less sperm than normal. A low sperm count is also called oligospermia. A complete absence of sperm is called azoospermia.

Your sperm count is considered lower than normal if you have less than 15 million sperm per milliliter of semen. A low sperm count decreases the chances that one of your sperm will fertilize your partner’s egg, resulting in pregnancy. However, many men who have a low sperm count are still able to conceive a child.

Symptoms of a lack of sperm

The main sign of a low sperm count is the inability to conceive a child. There may be no other obvious signs or symptoms. In some men, an underlying problem such as an inherited chromosomal abnormality, hormonal imbalance, enlarged testicular veins, or something that blocks the passage of sperm can cause signs and symptoms.

Some of the symptoms of a low sperm count include:

sexual function problems

For example, low libido or difficulty maintaining an erection (erectile dysfunction)

Pain, swelling, or lump in the area of ​​the testicles

Decrease in facial or body hair or other signs of a chromosomal or hormonal abnormality

When to consult a doctor

See a doctor if you have not been able to conceive a child after a year of regular, unprotected sex or sooner if you have any of the following

– Erection or ejaculation problems, low libido or other sexual function problems
– Pain, discomfort, lump or swelling in the area of ​​the testicles
– A history of testicular, prostate or sexual problems
– ne operation of the groin, testicles, penis or scrotum

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Causes of a lack of spermatozoa

Sperm production is a complex process that requires normal functioning of the testicles as well as the hypothalamus and pituitary gland. Two brain organs that produce hormones that trigger sperm production. Once the sperm are produced in the testicles, fine tubes carry them until they mix with semen and are ejaculated out of the penis. Problems with these systems can affect sperm production.

There may also be problems with the shape (morphology), movement (motility) or abnormal function of the sperm.

However, often the cause of low sperm count is not identified.

Medical causes

A low sperm count can be caused by a number of health conditions and medical treatments. Here are a few :

– Varicocele

A varicocele is a swelling of the veins that drain the testicle. It is the most common reversible cause of male infertility. Although the exact reason why varicoceles cause infertility is unknown, it could be related to abnormal temperature regulation of the testicles. Varicoceles lead to a decrease in the quality of sperm.

– Infection

Some infections can interfere with sperm production or health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles and certain sexually transmitted infections, including gonorrhea or HIV. Although some infections can lead to permanent testicular damage, most often it is still possible to collect sperm.

– Ejaculation problems

Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of exiting the tip of the penis. Various health conditions can cause retrograde ejaculation or lack of ejaculation, including diabetes, spinal injuries, and operations on the bladder, prostate, or urethra.

Certain medications can also cause problems with ejaculation, such as blood pressure medications called alpha-blockers. Some ejaculatory problems can be reversed, while others are permanent. In most cases of permanent ejaculation problems, sperm can still be collected directly from the testicles.

– Antibodies that attack sperm

Antisperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to destroy them.

– Tumors

Cancers and non-malignant tumors can affect the male reproductive organs directly, through glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Surgery, radiation therapy, or chemotherapy to treat tumors can also affect male fertility.

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– Undescended testicles

During fetal development, one or both testicles may not descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men with this condition.

– Hormonal imbalances

The hypothalamus, pituitary and testicles produce the hormones needed to create sperm. Alterations in these hormones, as well as other systems such as the thyroid and adrenal glands, can impair sperm production.

– Defects in the tubules that transport sperm

Many different tubes carry sperm. They can be blocked for a variety of reasons, including accidental injury from surgery, previous infections, trauma, or abnormal development, as in the case of cystic fibrosis or other similar inherited diseases.

The blockage can occur at any level, including in the testicle, in the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts, or in the urethra.

– Celiac disease

A digestive disorder caused by gluten sensitivity, celiac disease can lead to male infertility. Fertility may improve after adopting a gluten-free diet.

– Certain medications

Testosterone replacement therapy, long-term use of anabolic steroids, anticancer drugs (chemotherapy), certain antifungal and antibiotic drugs, certain ulcer medications, and other medications can impair sperm production and decrease male fertility.

– Previous surgeries

Certain surgeries can prevent you from having sperm in the ejaculate, including vasectomy, inguinal hernia repair, scrotal or testicular surgery, prostate surgery, and major abdominal surgery for cancer of the stomach. testicles or rectum. In most cases, surgery can be performed either to reverse these blockages or to harvest sperm directly from the epididymis and testicles.

Environmental causes

Sperm production or function may be affected by overexposure to certain environmental elements, including

– Industrial chemicals

Prolonged exposure to benzene, toluene, xylene, herbicides, pesticides, organic solvents, paint materials, and lead can contribute to lower sperm count.

– Exposure to heavy metals

Exposure to lead or other heavy metals can also cause infertility.

– Radiation or X-rays

Radiation exposure can reduce sperm production. It sometimes takes several years for sperm production to return to normal. With high doses of radiation, sperm production can be permanently reduced.

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– Overheating of the testicles

Although studies are limited and inconclusive, frequent use of saunas or hot tubs can temporarily lower sperm count.

Sitting for long periods of time, wearing tight clothes, or working on a laptop for long periods of time can also increase scrotal temperature and slightly reduce sperm production.

Health, lifestyle and other causes

Other causes of low sperm count include

– Drug use

Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Using cocaine or marijuana can also reduce your sperm count and quality.

– The alcohol

Drinking alcohol can lower testosterone levels and lead to decreased sperm production.

– Occupancy

Certain occupations may be linked to a risk of infertility, including welding or those associated with prolonged sitting, such as driving a car or truck. However, the data supporting these associations have yet to be clarified.

– Smoking

Men who smoke may have lower sperm counts than men who don’t smoke.

– Emotional stress

Severe or prolonged emotional stress, including fertility-related stress, can interfere with the hormones needed to produce sperm.

– Depression

Depression can have negative effects on sperm concentration.

– Weight

Obesity can impair fertility in several ways. Notably by having a direct impact on sperm and causing hormonal changes that reduce male fertility.


To protect your fertility, avoid known factors that can affect sperm count and quality. For example, known factors that can affect sperm count and quality should be avoided:

No smoking
Limit or abstain from drinking alcohol
Avoid illegal drugs
Talk to your doctor about medications that can affect sperm count
Maintain a healthy weight
Avoid the heat
To manage stress
Avoid exposure to pesticides, heavy metals and other toxins


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