What can you do about a low sperm count?

Low sperm counts can be the result of many things. Sometimes, something as simple as not eating well enough and having vitamin and mineral deficiencies can cause a low sperm count, which is also called oligospermia. Overheating of the scrotum can also cause a low sperm count. Before you start looking into fertility treatments like IVF, you should certainly discuss the causes of your low sperm count, and possible solutions. You never know – a simple vitamin and mineral supplement could make all your problems go away!

Conceiving naturally with oligospermia

The lower the sperm count, the less likely it will be that a man can get his partner pregnant naturally. The morphology and motility (the shape and speed)  of the sperm that the man does produce also matter. While fertility treatment – and invitro fertilization with ICSI, intracytoplasmic sperm injfection in particular – often offer the best chance for conception, exceptions definitely do exist! If you’re interested, a quick google search will show you lots of forums where women talk about how they got pregnant anyway, despite their partner’s oligospermia. Sometimes, this happens even while they are already preparing to have IVF!

Our conclusion? If you have already found out that you have – or your partner has – a low sperm count, through sperm analysis, you should certainly follow your doctor’s advice to try and increase it. If that doesn’t work, fertility treatments are a good option for you. But, natural pregnancy is not impossible, so you don’t have to stop trying to conceive naturally either.

Who is a candidate for ICSI?

ICSI is suitable for men who have a very low sperm count (oligospermia), or whose ejaculate contains a large number of sub-standard quality sperm, like sperm that does not move very well or has an abnormal shape – or in medical terms, a man whose sperm has motility and morphology problems. ICSI can also help men who have a vasectomy or other sperm delivery problem. In this case, sperm needs to be extracted directly from the testicle before it will be injected into the egg.

ICSI risks

Because ICSI is still a relatively new fertility treatment, the long-term risks are not very well understood yet. Research conducted to date shows that babies conceived with ICSI have normal motor and cognitive skills, but there are some other risks:

• Boys born as a result of ICSI have the potential to inherit their father’s infertility, according to medical speculation. Because the oldest boys born after ICSI are still in their teens, there is no reliable information about this possibility yet.
• A small percentage (4.2 percent according to one major study) of children born after ICSI have genetic and developmental defects. This is three times higher for the specific defects than it is for babies who were conceived naturally.
• You may have a slightly higher chance of having a miscarriage after undergoing IVF with ICSI, because it is possible that the sperm had chromosomal abnormalities not compatible with the embryo developing fully.
• A low sperm count can be caused by underlying genetic conditions, among which cystic fibrosis. If this is true in your specific case, the condition could be passed on. You may therefore wish to undergo genetic screening before opting to undergo ICSI treatment.

Men with lower sperm counts can absolutely have biological children – the odds have never been better in this age of fertility treatments. Depending on the exact sperm count, many men with oligospermia also get their partners pregnant naturally though. The odds go down as the sperm count decreases, but many men get their partner pregnant without even knowing they have a low sperm count, and others who are aware of their oligospermia still manage to conceive naturally too.

Oligospermia can sometimes be cured, too, if underlying conditions are discovered and treated. Simple lifestyle changes like quitting smoking and alcohol, and starting to eat more healthily, are enough for some men who previously had a low sperm count. In cases where treatment is not possible, and where a couple has not been able to get pregnant due to the man’s low sperm count (sometimes in combination with female fertility problems as well), there are a few different treatment options.

Where men have a slightly lower sperm count, the simplest assisted reproductive technique – intrauterine insemination – may give just the extra boost they need. In more extreme cases, there is IVF with ICSI. ICSI stands for Intracytoplasmic Sperm Injection. This means that a single sperm is isolated and injected directly into a single egg in a laboratory. This procedure differs from “normal” IVF where sperm fertilize previously extracted eggs spontaneously once a sperm sample is added to the petri dish with egg cells.

A low sperm count can be caused by many things, but there are few symptoms. In some cases, the solution is as simple as quitting smoking and living a more healthy life. Other men who have oligospermia suffer from underlying medical conditions that are not as easy to treat. Men who have had previous testicle or scrotum surgery and have been trying to conceive with no success should seek medical help earlier, for instance. Those with painful and swollen testicles, or those who are suffering from erectile dysfunction, also need medical care. But for many, a low sperm count has no symptoms, and the only indication is infertility – the inability to conceive a child after trying for more than a year.

Hormonal imbalances, tumors, antibodies that attack the man’s own sperm, an infection, or a varicocele are among medical causes of oligospermia. Environmental causes include smoking, exposure to pesticides, overheated testicles (due to clothing that fits too tightly, or hot baths), and heavy metal exposure. But even a vitamin deficiency, stress, or age can contribute to a low sperm count.

The treatment of oligospermia is of course dependent on the underlying cause. In many cases, it is possible to solve the problem and boost sperm count. When this is not possible, Intrauterine insemination, or in more severe cases IVF in combination with Intracystoplasmic Sperm Injection, may enable a man with a low sperm count to have a child.

For men, a range of environmental exposures are often associated with reduced sperm concentration, more common known as low sperm count,  and is also often associated with  sperm quality. It is logical:  if a man has sub-optimal in either quantity or quality, he is less likely to conceive, and will, on average, take longer to conceive, should they manage to successfully conceive at all.

Infertility among men is ont the rise: 50 years ago males were twice as fertile as they are today.

Perhaps this is in conncetion with environmental chemicals and toxins are found in many environments, and that wasn’t so present in our enviroment 50 years ago. These chemicals are most commonly found at dangerous concentrations in occupational environments, such as chemicals used in agricultural and manufacturing sector workplaces.

Other environmental factors which have evidence of an association with male infertility, include heat, radiation, chemicals and trauma – besides the environmental factors mentioned above.

Heat exposeure is often a problem because sperm production in humans and other mammals is dependent on the temperature of the testicles, and the increased testicular temperature may affect both the quality and quantity of sperm produced. Some men take hot baths, but some only sit for long hours: long periods of sitting can increase testicular heat, as the testicles are insulated by the thighs whilst a man is seated.

Another study showed that comparing oven operators to other, non-heat exposed workers in a ceramic factory reported that significantly greater proportions of oven operators were childless; for example 7.6% of oven operators compared to 1.1% who don’t work in that industry, and they also reported difficulty conceiving (23% of oven operators compared to 12% of men not in that industry). After the analysis the semen of the oven operators contained significantly less motile sperm (7% motile) than that of the other workers in the ceramic factory (who had 28% motile sperm).

IUI is also not effective for couples facing severe endometriosis, severe male factor infertility or if a woman has damaged or blocked tubes.  Female age has a lot to do with the success of IUI and is also not very beneficial for a woman with a significantly reduced ovarian reserve.  Intrauterine insemination and low sperm count is unlikely to work which is why it is generally done as a last option if other methods have failed to result in conception.

IUI is most commonly used for handling problems related to unexplained infertility and can be beneficial for ovulation related and mild male factor infertility issues.  Other factors can influence whether or not IUI insemination is successful and can depend on:

• Female age
• Number and quality of sperm
• Cause of infertility
• Duration of infertility
• Type of ovarian stimulation used

Success rates are higher in women under 35 years old and over the age of 40, these rates drop significantly.  Couples using IUI due to unexplained infertility have varying degrees of success and the chances of conceiving are approximately 8% within the first month.

Intrauterine insemination and low sperm count studies have shown the procedure can be relatively successful. However, when sperm count is less than 5 million the chances for conceiving and pregnancy are substantially lowered.  In cases like this, IUI is generally done in conjunction with ICSI which involves directly injecting sperm into the egg.

Sperm counts are not going to give a perfect indication of success rates, but after consulting with a fertility specialist a couple can get a better idea of what to expect.  With help from a fertility specialist and sometimes using IUI, a couple can become pregnant and welcome a baby into the world.

This only leads to conclusion that more and more men will be infertile and the only way they will be able to impregnate their partner is through the help of artificial insemination. They will be forced to resort to medical, surgical reproductive treatment if they want their partners to conceive.

In the last 30 years we have witnessed huge development in the field of reproductive technology, the revolution came with IVF aka in vitro fertilization, and with ICSCI, intra-cytoplasmic sperm injection. Both technologies surpass natural conception and both are very complex. More than millions babies worldwide have been conceived by these new techniques.

Both IVF and ICSI are suggested when couple is dealing with low sperm count, and in cases when low sperm count can’t be improved by surgery or otherwise.

The most recent technologies have used robotics and microsurgical assisted techniques to improve sperm counts. This helps a couple to conceive in a more natural way and it avoids the use of IVF and ICSCI in cases of low sperm count or other cases when male infertility factor is involved.

With the advance in microsurgery and robot assisted microsurgery, the chance of sperm reappearance rate can be as high as 80% while without the use of revolutionary techniques the chance of sperm reappearance is very low – as low as 5%.

In cases of low sperm production because of enlarged veins surrounding the testes (varicocele), surgery promised up to 60% success rate.

The main advantage of revolutionary robot assisted microsurgery is that natural conception is possible without the agony of going through multiple IVF or ICSCI cycles. In conclusion, these recent revolutionary discoveries in robotics have enabled male partners to conceive in a more natural way.

Males produce relatively low numbers of sperm that is capable of swimming fast enough and are capable of penetrating healthy female egg.

It is surprising to know but as many as 20% of young males between the age of 18 and 25 produce abnormally low sperm count. And even the sperm they produce does not meet the strict standards of World health organization’s rules. In fact only about 10% of their sperm would actually meet these standards. Interesting, don’t you think?

Scientists say males suffer an abnormally high incidence of reproductive problems, including congenital defects and undescended testes to cancer and impotency. Therefore it is no surprise that as much as 1 in 7 couples are found to suffer from infertility problems with male factor infertility to be the most common cause.  

20 years ago was the first time Danish scientists alerted the world Western men are suffering from an infertility crisis.  For an illustrative example, before the 1940s sperm count was well above 100m sperm cells per ml, while now days sperm count in young men is below 20m sperm cells per ml, which is defined  as abnormal.

Fertility experts began to talk about a new phenomenon that was affecting males, also known as collection of disorders known as testicular dysgenesis syndrome. They soon began to  ask themselves what was causing that disorder,  suspecting  lifestyle and environment.

They discovered that the problem begins in the womb – practically it was not the lifestyle of men that is the problem, but the problem is in their mothers.

For example, women that were exposed during pregnancy or while their sons were infants to high levels of toxic dioxins. Mothers who ate beef during pregnancy and a diet rich in potentially damaging chemicals called polycyclic aromatic hydrocarbons (PAHs), had sons with relatively low sperm counts, while if men were eating beef when adult, the consequences were not so dramatic.  Additionally mothers who smoke also have a dramatic impact on son’s fertility and may reduce sperm counts for up to 40 %.

Who needs secondary infertility treatment? If both partners are under the age of 35 and otherwise healthy, medical advice is usually to try to get pregnant for a year before seeking treatment. After the age of 35, doctors usually advise patients to come in for treatment after six months. And at any age, medical treatment is needed for couples when either party has a history of Chlamydia, the male partner has a low sperm count, or the female partner has had pelvic inflammatory disease or painful menstruation.

Why should it be difficult to conceive a second child? Sometimes there is a change in the health of the male partner. Men’s fertility is diminished by exposure to solvents, industrial chemicals, pesticides, and herbicides, often enough to cause low sperm counts.

If there has been no change in the health of the man, the most common cause of secondary infertility in women is uterine fibroids, also known as leiomyomas. These are tough growths in the uterus that are fueled by the release of the hormone estrogen.

The reason they often appear after pregnancy is that pregnancy releases enormous amounts of estrogen. After the baby is born, these growths can block the fallopian tubes so the egg cannot emerge from the ovaries, or they may block the cervix so sperm cannot enter the womb.

Fibroids can grow so large that a woman looks pregnant, making feeling guilty about infertility even more painful. There may be palpable lumps in the abdomen. Most of the time, however, there are no symptoms at all. Fibroids can only be identified by a pelvic exam and/or ultrasound.

When the primary issue in secondary infertility is uterine fibroids, care has to be taken to avoid scarring. Pelvic adhesions caused by scar tissue left by the surgery to remove the fibroids can also cause secondary infertility. In most cases, however, women are able to conceive and carry a child to term about 3 months after treatment for the fibroids.

If a couple has been trying for more than a year to conceive and have not had any luck, it is probably time to consult with a fertility specialist.  A semen analysis and sperm testing can be performed to diagnose a man is experiencing infertility issues.  A semen analysis is done in many parts and tests various aspects about the sperm, but should be done at least two times within a period of two or three months.

A semen analysis can also be used to check the sperm count a male has, which can determine what type of treatment would work best.  If there are still many sperm in the semen, a male and female may still become pregnant naturally, but if not, there are fertility treatments which could help them conceive a baby.  When trying to conceive, it is important that a couple uses every test possible in order to determine what can be done to alleviate or treat the underlying issues causing male infertility.

There are several different factors which could influence semen analysis and sperm testing results.  A man could have a low sperm count if he has testicular damage, has had radiation treatment for cancer or has been exposed to certain drugs.  A man with an estrogen influx could also experience a lower sperm count, but the condition can be treated.

When trying to conceive, a couple will both have to undergo rigorous testing in order to determine which individual is experiencing fertility impairment.  After careful consideration and medical testing, a couple can figure out what to do about male-related infertility and go on to successful treatment and soon welcome a baby of their own.