Oligospermia (Low Sperm Count)

Overview

What is oligospermia (low sperm count)?

Oligospermia is a term that means you have a low sperm count. One medical definition is that you have fewer than 15 million sperm in 1 milliliter of semen. A typical sperm count is more than 15 million sperm per 1 milliliter of semen.

Besides being known as low sperm count, oligospermia is also called oligozoospermia. A severely low sperm count (fewer than 5 million sperm in 1 milliliter of semen) is also known as severe oligospermia.

What is the difference between oligospermia and azoospermia?

Oligospermia means that you do have a measurable amount of sperm in your semen, but the numbers are lower than the typical numbers. If you have azoospermia, it means there no sperm seen in your semen.

Having a low sperm count is a significant factor in infertility. You may be infertile if you’ve been trying to get pregnant (or get someone pregnant) for a year and haven’t yet done so. This means that for at least a year you’ve been having regular sex without using birth control methods.

How common is oligospermia?

Researchers aren’t sure how many people have oligospermia. The condition isn’t usually diagnosed unless a couple is trying to conceive and can’t. There are an estimated 180 million couples throughout the world who are dealing with infertility.

Infertility among people who have been assigned male at birth contributes to about half of the infertility issues overall. (Healthcare providers may call this male infertility or male-factor infertility.) This figure of about 50% includes situations where male factor infertility is the only factor and those more common situations where there are fertility factors in both partners.

Symptoms and Causes

What are the signs and symptoms of oligospermia?

The main sign or symptom of a low sperm count is the inability to conceive a baby with a partner after one year of unprotected sexual intercourse.

What causes a low sperm count?

There are a variety of things that could cause you to experience oligospermia or other sperm disorders. The list of causes include:

  • Diseases, including those related to genetics, infection, hormones and obstructions (blockages).
  • Environmental toxins.
  • Heat.
  • Drugs.

Diseases and conditions

Some of the diseases that can cause a low sperm count include:

Toxins

Toxins aren’t good for any part of your body, including sperm count. Some of the toxins that are present in the environment include heavy metals like arsenic, cadmium, lead and mercury.

Heat

Your testicles work best at a particular temperature, which is slightly lower than your body temperature. Heat-related situations that affect sperm production include:

  • Having undescended testicles. If the testicles are still up near the groin, they’re too hot.
  • Having varicocele. These twisted veins can be large and can increase the temperature of the testicles.
  • Spending a long time in hot tubs. This cause may be reversed – your sperm count could increase once you stop spending time in hot water.

Medications and drugs

Both prescribed medications and non-prescription substances can make your sperm count low. There are many categories of medications that can be involved. Some of these medications include:

  • Testosterone.
  • Methadone.
  • Nitrofurantoin.
  • Lamotrigine.
  • Clomipramine.
  • Paroxetine.
  • Prednisone.
  • Methotrexate.
  • Finasteride.
  • Sirolimus

There are many other medications that may affect sperm counts. Check with your healthcare provider or pharmacist if you think your medication may be causing problems. Don’t stop taking prescribed medications on your own without discussing with your healthcare provider.

Diagnosis and Tests

How is oligospermia diagnosed?

Your healthcare provider will take a medical history and do a physical examination. They may order other tests, including:

Management and Treatment

How is oligospermia treated?

Your provider’s treatment suggestions will depend on the cause of the oligospermia. You may increase your sperm count by stopping medications or behaviors that are contributing to low sperm levels.

Other causes may need other treatments. For instance:

  • You may need surgery to treat a varicocele or blocked sperm ducts.
  • Your provider may prescribe hormone supplements.
  • Your provider may prescribe antibiotics for infections.
  • Your provider may suggest counseling to deal with issues like erectile dysfunction or premature ejaculation.

There are cases when you won’t be able to increase your sperm count. If you’re trying to conceive, your provider might suggest other ways to assist in reproduction.

How should I take care of myself to make sure my sperm count is the best it can be?

If you have a low sperm count, there are certain things your healthcare provider may suggest that you do. These may include lifestyle changes, such as:

  • Reach and maintain a healthy weight by exercising and eating a healthy diet.
  • Stop smoking and using tobacco products.
  • Reduce the consumption of alcoholic beverages.
  • Stop the use of marijuana and/or other substances.

You may have heard about vitamin or mineral or herbal supplements that may help. Consult your healthcare provider before trying any of these remedies.

Prevention

How can I reduce my risk of having a low sperm count?

You can help yourself in all ways, including your sperm count, by adopting a healthy lifestyle in terms of sleep, exercise, diet and alcohol use.

Outlook / Prognosis

How long does oligospermia last?

How long a low sperm count lasts depends on the cause. You may be able to reverse the condition if the cause is something you can stop, like taking certain medications or keeping your testicles too warm.

You may not be able to change some causes of low sperm count, such as one that happens as a result of genetic issues.

Oligospermia isn’t a fatal condition and isn’t likely to interfere with work or school.

Living With

When should I see my healthcare provider about a low sperm count?

You probably won’t automatically know that you have a low sperm count. It’s not something that you can feel. The first sign is mostly when you can’t conceive when you’re trying. You’ll probably go to a healthcare provider at that time to see why you and your partner aren’t able to conceive. You’ll find out you have oligospermia because you’re tested.

Ask your provider:

  • What’s causing the low sperm count?
  • Are there things I can do to make my sperm count higher?
  • Is the low sperm count related to a serious condition?
  • Should I see another type of healthcare provider for additional help?

A note from Cleveland Clinic

The first sign that you have a low sperm count might come when you and your partner are trying to conceive. You may talk to your healthcare provider if you’ve been deliberately having unprotected sex for a year or even longer. A low sperm count may signal other illnesses, but it doesn’t mean you won’t be able to be a parent. Talk with your healthcare provider and answer all their questions honestly. Make sure you ask the questions you want to ask and are able to get the answers you need.

Last reviewed by a Cleveland Clinic medical professional on 02/04/2022.

References

  • Ding J, Shang X, Zhang Z, et al. FDA-approved medications that impair human spermatogenesis. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354694/) Oncotarget. 2017;8(6):10714-10725. Accessed 2/4/2022.
  • Ferlin A, Garolla A, Ghezzi M, et. Al. Sperm Count and Hypogonadism as Markers of General Male Health (https://www.sciencedirect.com/science/article/pii/S240545691930210X) , Eur Urol Focus. 2021;7(1): 205-213 issn 2405-4569. Accessed 2/4/2022.
  • Fode M, Sønksen J, Ohl DA. Disorders of the Male Reproductive Tract. In: Hammer GD, McPhee SJ. eds. Pathophysiology of Disease: An Introduction to Clinical Medicine, 8e. McGraw Hill; 2019. Accessed 2/4/2022.
  • Kuroda S, Usui K, Sanjo H, et al. Genetic disorders and male infertility. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7542010/) Reprod Med Biol. 2020;19(4):314-322. Accessed 2/4/2022.
  • Leslie SW, Siref LE, Soon-Sutton TL, et al. Male Infertility. (https://www.ncbi.nlm.nih.gov/books/NBK562258/) [Updated 2021 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Accessed 2/4/2022.
  • McLachlan, RI. Approach to the Patient With Oligozoospermia, (https://academic.oup.com/jcem/article/98/3/873/2536497) J. Clin. Endocrinol. Metab. 2013; 98(3):873-880. Accessed 2/4/2022.

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