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Low Sperm Counts

Targeted treatment can help men overcome the causes of low sperm counts

A man has several numbers that serve as indicators of good health: cholesterol, blood pressure and weight/BMI to name a few. When you see a TFC male fertility specialist, you will also add one more: sperm count.

What most people refer to as a sperm count is actually a sperm concentration, as it represents the number of sperm present in one milliliter (mL) of semen. A standard semen analysis (or sperm test) actually measures three primary factors: sperm concentration, sperm motility (or the percent of sperm that are actively swimming), and sperm morphology (shape).

A normal sperm concentration is at least 20 million per mL, whereas normal motility is at least 50% and normal morphology is at least 15%. While there are many other important factors involved in a semen analysis – such as seminal volume, the presence or absence of white blood cells, and the quality of sperm movement (to name a few), most lay people focus on sperm concentration.

If a semen analysis reveals a low sperm count, we will perform additional testing to ascertain the cause.

Some cases may warrant a referral to a urologist who specializes in male fertility, and we work with the best ones in Central Texas. It may encourage you to know that through our collaborative approach, TFC can successfully treat nearly all cases of male factor infertility. Some cases can be treated with minor lifestyle changes, while others may require medication, surgery or laboratory assistance in the form of either intrauterine insemination (IUI) or in vitro fertilization (IVF). Regardless, there is an excellent prognosis for nearly all men who pursue treatment.

Causes of low sperm count

Surgeries, Infections, Current and Past Health Issues
Mumps, sexually transmitted diseases such as Chlamydia, or urinary tract infections can leave scars that block the delicate tubes that transport sperm from the testes to the penis. Spinal cord injuries, diabetes, and certain surgeries can block the normal flow of sperm, and/or lead to retrograde (backward) ejaculation.

Genetic or Chronic Disease
While most genetic causes of low or the complete absence of sperm production are rare, many chronic conditions and/or medications used to treat them are common causes of male infertility. Conditions such as cancer of the testicle or prostate, diabetes, high blood pressure and peripheral vascular disease can cause a man to have a low sperm count.

Lifesaving cancer treatment either surgery, chemotherapy, or radiation therapy can destroy sperm cells, and greatly decrease a man’s sperm count. TFC offers fertility rescue prior to cancer treatment to proactively protect future fertility.

Structural Problems with the Penis or Testicles
Structural problems with the penis that can cause a man’s sperm count to plummet include Peyronie’s disease (in which plaque and/or 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 is present in up to 40 percent of men with fertility issues, and is a condition that can occasionally affect fertility. While most men with a varicocele will not need or benefit from surgery, the condition warrants a conversation with a fertility specialist.

Other potentially important structural issues include undescended testicles, sperm duct problems, and blockages in the tubes that transport sperm (vas deferens).

Hormonal Imbalances
Hormones drive the production of sperm, and sometimes the hormonal signals between the brain, pituitary and testicles can stall or cease altogether. A blood test can confirm whether all systems are functioning, or if an imbalance is causing a low sperm count.

Previous Vasectomy
Surgeries to reverse vasectomy can produce successful results to restore patency in the tubes that carry sperm. Side effects of the surgery, however, may lead a man to produce antibodies that can attack his own sperm.

Medications for Low T
Ask your fertility doctor about the medications that may lead to a low sperm count, including popular Low T therapies. Men who have used anabolic steroids for extended periods of time may experience a low sperm count as a result. In many cases, these side effects are temporary, and fertility is restored after simply stopping the medication.

Environmental and Lifestyle Factors
Certain habits and occupations put men at risk for fertility problems, and a lower sperm count can make it difficult to become a father. Embrace a healthful lifestyle and weight while trying to conceive, and you will increase your chances for success. The most common threats to a man’s fertility include:

  • Alcohol abuse
  • Anabolic steroids
  • Cigarette smoking
  • Exposure to toxic chemicals, heavy metals, pesticides, paint and solvents
  • Illegal drugs, including cocaine and marijuana
  • Obesity

In extreme cases, prolonged exposure to heat and long-distance cycling can also affect a man’s fertility and leave him with a low sperm count. In these cases, a change of habits may be the only necessary course of action.

Your Texas Fertility Center physician expertly helps men overcome a low sperm count. Treatments from lifestyle changes to minimally invasive artificial insemination can produce excellent results. For men with an extremely low sperm count, TFC may recommend sperm injection ICSI in an IVF cycle.

If you have tried to get pregnant for more than a year, or six months if the female partner is over 35, ask us about a male fertility assessment and semen analysis. We can easily assess data on sperm health, and recommend a results-driven course of action.

Contact our male fertility specialists today.

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