Low sperm count, also called as oligospermia, is the condition of having fewer than 15 million sperm per millilitre of semen. Although the exact cause for oligospermia is hard to determine, here are some of the top reasons for low sperm count in men.
Sperm problems account for 9% of all cases of infertility, reports the US CDC, and they are the additional factor in 35% of all infertility cases.
Health and lifestyle causes
- Drugs: Anabolic steroids that are used to pump your muscles may cause the testicles to shrink, leading to infertility. Chemotherapy, testosterone therapy, antifungal drugs, some antibiotics and anti-depressants, cocaine and marijuana can all lower sperm count.
- Alcohol: Alcohol abuse is linked to lower testosterone and thus lower sperm production
- Smoking & Tobacco use: Smoking can damage the DNA of the sperm, affecting both its quality and quantity.
- Obesity: Excessive weight in men can reduce fertility by lowering testosterone levels and raising the risk of erectile dysfunction.
- Stress: Stress causes hormonal changes that affect sperm production in men.
- Occupation: Jobs that involve prolonged hours of sitting or just any job causing excessive heat to the testicles in a direct or indirect manner can be detrimental to the sperm.
- Very frequent ejaculation: Men with overly active sex drive can have a lower sperm count due to excessive ejaculation (over 3 times a day)
- Heating of testicles: Anything bringing heat to the testicles—frequent saunas, hot tubs, tight clothing, even working with a laptop on your lap for long hours or anything that raises the temperature of the testicles can cause reduction of sperm numbers. It is usually reversible.
- Radiation or X-rays: High doses of radiation, especially as in cases of radiotherapy for cancer treatments, can damage the sperm.
- Chemicals: Herbicides, pesticides, painting materials, benzenes, toluene, and lead, on extended exposure cause reduction in sperm count.
- Varicocele: This is the enlargement of veins that drain the testicles, which results in poorer quality of the sperm. It is a reversible condition.
- Ejaculation problems: Surgery or some medical conditions such as diabetes, spinal injuries, etc. can cause retrograde ejaculation, in which the semen travels back and enters the bladder instead of being released from the body.
- If this is your case, the doctor may be able to extract sperm from your testicles using surgical sperm extraction (TESE)
- Reproductive system problems: The tubes that carry sperm could be blocked or damaged due to infection or injury, or in some cases, they might even be absent from birth.
- Hormonal imbalance: According to the Hormone Health Network, conditions such as a pituitary tumor or anything that lowers LH and FSH levels can disrupt spermatogenesis and result in lower sperm numbers.
- General health: Poor health, chronic illnesses and drug abuse may also decrease sperm production.
- Infection:Sexually transmitted diseases such as gonorrhea or HIV, and infectious diseases that cause inflammation of the epididymis (epididymitis) or testicles (orchitis) can block the sperm’s passage or damage the testicles.
I have low sperm count, what are my options?
If you can identify with any of the above reasons for low sperm count, your first step would be to see if the condition is reversible.
Otherwise, you can get tested for the quality of the sperm and opt for IVF with ICSI (intracytoplasmic sperm injection) to improve the chances of success.
If you need surgical sperm extraction—PESA, TESA, or TESE—consult with your doctor.