Fertility Answers - Helping Build Families

What is Causing My Low Sperm Count?

Sperm count is one of the most revealing indicators of a man’s fertility health.

Low sperm count is an indicator of male infertility
Sperms and woman ovum zygote. Conceiving a child concept.

Up to 40% of infertility issues can be linked back to the male partner. When this happens, the culprit is most often sperm count, or not having enough sperm cells.

Sperm count represents the number of sperm present in one milliliter (mL) of semen. During a semen analysis, we measure three primary factors: sperm concentration (count), sperm motility (or the percent of sperm that are actively swimming), and sperm morphology (shape). While motility and morphology are important, the primary focus for fertility health is typically on how many sperm a man has.

Male fertility is in large part a numbers game – the more sperm you have, the better the chances. Fertility experts define a normal sperm count to be at least 20 million per mL. After ejaculation, a sperm cell must be vital enough to swim from the vagina, through the cervix and uterus, and then up through a fallopian tube to fertilize the egg. This is not an easy journey and few of the many millions of sperm make it all the way there. 

Possible causes of low sperm count

There can be many causes for your low sperm count:

  • Environmental and lifestyle factors – Your habits and even your occupation can put you at risk for low sperm count. Lifestyle choices such as obesity, alcohol abuse, cigarette smoking, drugs including marijuana and cocaine are some. You occupation may expose you to toxic chemicals such as heavy metals, pesticides, paint and solvents. Additionally, long exposure to high heat or long-distance cycling have been shown to lower sperm count.
  • Testosterone replacement medication and anabolic steroid supplements – Popular low-T therapies and steroid supplements, while they can make you feel better and increase muscle mass, can actually wreck havoc on your sperm count.
  • Surgeries, infections, health issues – Infections, such as mumps, chlamydia, or urinary tract infections, can leave scar tissue that can block the tubes transporting sperm. Additionally, spinal cord injuries, diabetes, and other surgeries can block normal sperm flow or lead to backward, or retrograde, ejaculation.
  • Genetic and chronic disease – Genetic diseases, such as cystic fibrosis, though rare, can cause low or the complete absence of sperm. Conditions such as testicular cancer, prostate cancer, diabetes, high blood pressure and peripheral vascular disease can also cause low sperm count. And many of the medications and treatments used to treat these diseases can destroy sperm cells. This includes chemotherapy and radiation. Ask our male fertility specialists about fertility preservation that can freeze your sperm before treatment begins.
  • Structural problems of the penis or testicles – Structural problems include Peyronie’s disease (in which scar tissue builds up in the penis), as well as problems with inflammation and scar tissue that can interfere with the normal ejaculatory process. A varicocele, or enlargement of the veins in the scrotum, is a condition that can occasionally affect fertility. Other potentially important structural issues include undescended testicles, sperm duct problems, and blockages in the tubes that transport sperm (vas deferens).
  • Vasectomy reversal side-effects – A vasectomy reversal attempts to reconnect the tubes that sperm travel through. Sometimes, though, scar tissue from surgery can lead to low sperm count even after reversal.

Ways to improve your sperm count

The good news for men with many of the above low sperm count issues is that it is often reversible. Unlike women who are born with a finite number of eggs, a man’s body is always producing new sperm. Changes in your diet, lifestyle, or medications can often lead to improved sperm counts in just a few months time.

Your doctor may also recommend anti-estrogens or gonadotropin therapies, which are hormones that can boost fertility. Additionally, several natural supplements and vitamins can be beneficial to promote normal sperm health. These include Vitamin E, Vitamin C, Co-Enzyme Q, Omega-3 and zinc. You can also find fertility specific supplements, such as FertilAid for Men, that can help boost sperm health. Since it takes up to 3 months to produce mature sperm, it’s important to take any medications or supplements for at least 2-3 months prior to seeing the maximal benefit.

Contact our male fertility specialists today.


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