Low sperm count - treatment options

What is low sperm count?

Low sperm count refers to the number of active sperm cells in a man's ejaculate. If the total sperm count is less than 15 million active sperm cells per millilitre, you are diagnosed with a low sperm count. A low sperm count makes it harder to conceive naturally, as active sperm cells are required to fertilize the egg, and the fewer there are, the harder it is to conceive.

Can I get pregnant with a low sperm count?

Yes, it is possible to get pregnant with a low sperm count. You can achieve pregnancy by improving your sperm count through these tips or using fertility treatments like IVF and ICSI to fulfil your dream of a child.

Symptoms of low sperm count

Often, there are no physical symptoms of low sperm count and it only becomes clear that the sperm count is low, if no pregnancy is achieved within the first year of trying. In some cases, physical symptoms are visible. The most common ones are:

• Experiencing problems with your sexual function like low sex drive or difficulty maintaining an erection
• Pain or swelling in the testicle area
• Decreased facial or body hair

Diagnosing low sperm count

It is difficult to diagnose low sperm count, as the most common symptom is having trouble conceiving and you only discover this after a period of having intercourse regularly. The only way to diagnose low sperm count is through a sperm analysis. Here is an overview of the different steps in a semen analysis:

• Step 1 - Book an appointment: Contact your doctor, a local sperm bank, or a fertility clinic to book an appointment.
• Step 2 - Create the sample: Once you arrive at the clinic or sperm bank, complete the documents handed to you and proceed to a small, private room to make the sperm sample.
• Step 3 - Receive the result: You will receive the result of the test via e-mail or telephone.

Other articles for men struggling with low sperm count

• Getting pregnant with erectile dysfunction
• Minimum sperm count for IVF treatment
• Low sperm motility

5 treatment options for men with low sperm count

During the last couple of decades, the progress in fertility treatment has made it possible for men with low sperm count to conceive with their sperm, as new fertility treatment options have emerged. In IVF and ICSI, fertilization happens outside the body in a laboratory, thus improving the chances of conception and making it relevant for men with a low sperm count. Below is a short description of each treatment method and how it may help you:

1. Keep trying

Natural conception can still be possible with a low sperm count, especially if the female partner has no infertility issues. A lot of things have to go right to create a pregnancy, meaning that men with low sperm count do have a chance of conceiving, it may just take a bit longer.

Sperm count can also vary depending on lifestyle, health, and other factors. You may be able to increase your sperm count by changing your lifestyle.

2. Fertility treatment

Another way to get pregnant with a low sperm count is to enter fertility treatment. For men struggling with low sperm count, there are two types of treatment, which are often recommended:

IVF treatment
In vitro fertilization (IVF treatment) makes it possible for men with low sperm count to conceive as healthy sperm cells are placed alongside the egg in a plastic container. The purpose of IVF treatment is to make it easy for the sperm cells to find and penetrate the egg, thus increasing the chances of conception. According to the NHS, the birth rate for IVF treatments was 23% in 2021.

ICSI treatment
If you struggle with a low sperm count, intracytoplasmic sperm injection (ICSI treatment) could be an option. The treatment is similar to IVF, but instead of placing the sperm cells alongside the egg, an embryologist uses a small needle to inject a single sperm cell into the egg. The injection creates the most optimal conditions for the sperm cell to fertilize the egg, and it is possible to create a pregnancy by only using a few healthy sperm cells. According to the NHS, the birth rate for ICSI treatments was 23% in 2021.

3. Lifestyle changes

One of the things men can do to help increase their sperm count is to change their lifestyle. Besides genetics and age, lifestyle is one of the most important factors for men’s sperm count. Whether you are trying to conceive naturally or about to enter fertility treatment, you can improve your chances of conception by focusing on a healthy and balanced lifestyle. Here are some lifestyle changes that may help increase your chances of getting pregnant:

• Exercise: Regular exercise can help increase sperm count and sperm quality in general. Moderate exercise is recommended, about 30 minutes each day.
• Diet: Being overweight or underweight can affect hormone levels and sperm production. By focusing on a healthy and balanced diet, you can maintain a healthy weight and BMI, thus improving your sperm count. Follow the link to read more on how to improve your sperm quality through food.
• Smoking: If you are about to enter fertility treatment or trying to conceive you should stop smoking.
• Limit alcohol consumption: Excessive alcohol consumption can lower testosterone levels and reduce sperm production, thus making it harder for you to conceive.
• Stress: Studies have shown a link between high levels of stress and a decrease in hormone production, which can affect sperm count negatively. Try to find ways to cope with the stress, such as exercise, meditation, or talking with a therapist.

While lifestyle changes can improve your sperm count, it is not always enough. Some men cannot produce healthy sperm cells because of genetics or surgery and are forced to search for other ways to conceive. If you have tried to increase your sperm count through lifestyle changes, but have not succeeded, we recommend that you contact a doctor to discuss your next step.

4. Surgery

There are different reasons for men with low or zero sperm count to consider surgery. If the ejaculate shows no active sperm cells, a sperm retrieval procedure is possible. Some men suffer from azoospermia, meaning that there are no sperm cells present in their ejaculation. If you are diagnosed with obstructive azoospermia, you may be able to produce healthy sperm cells, but an obstruction hinders the sperm cells journey from the testicles to the ejaculation. Some men diagnosed with obstructive azoospermia can conceive naturally if they receive a surgical sperm extraction (TESE), where a small incision is made into the testicle and any healthy sperm cells are extracted.

After the extraction, the sperm cells are most likely used in ICSI treatment, to increase the chances of fertilization. Surgical sperm extraction is only used in severe cases, where the level of active sperm cells is extremely low or completely absent in the ejaculate.

5. Alternative ways to become a father

If you have tried to conceive naturally or through fertility treatment and have not yet fulfilled your dream of being a father, there are other methods to follow. In the section below, you can read about two ways to become a father and the rewards you gain from choosing each method.

• Fertility treatment with donor sperm: By choosing a sperm donor, you maintain a genetic relation between your partner and your child, as well as potential siblings. Donor sperm can be used in almost all kinds of fertility treatments, depending on your partner’s fertility and the recommendation from your fertility clinic. You do not need to worry about your child’s well-being, as learnings from donor-conceived children have taught us that they are doing well.
• Adoption: It is also possible for you to become a father through adoption, which can be a rewarding and fulfilling experience. One of the risks of adoption is the amount of time you must wait before the adoption process is finished. Unlike fertility treatment with donor sperm, you cannot start immediately, you need to go through a verification process before you can begin.

If you are considering whether to use donor sperm for fertility treatment, feel free to contact our Customer Care Consultants that will answer any questions you might have.