Sperm count can be defined as the average total number of sperm present in one sample of semen and is considered a crucial factor for male fertility. Having a low sperm count, also known as oligospermia and in the complete absence of sperm is called azoospermia occurs when sperm count is lower than 10 million per ml, based on current World Health Organization guidelines. Low sperm count reduces the chances of sperm fertilizing the egg resulting in infertility. A man’s fertility typically centers on the quantity and quality of his sperm. However, a good number of men who suffer from this condition still go on to have healthy children. Anything that influences testosterone levels can have a significant impact on sperm number and quality.

Symptoms Of Low Sperm Count

The main symptom of low sperm count is a man’s inability to impregnate a woman. In most cases, there might be no obvious signs or symptoms. Other common symptoms include the following:

Causes of Low Sperm Count

Varicocele

A varicocele is an unusual enlargement of the veins that drain the testicle and it is the most common reversible cause of infertility in men. Varicocele generally results in the reduction of sperm quality and although the cause of this condition is not thoroughly understood, it is closely associated with abnormal testicular temperature regulation.

Infection

Certain infections, particularly sexually transmittable infections like; chlamydia and gonorrhoea can interfere with sperm production and sperm health, causing scarring that blocks the passage of sperm. Other infections include; inflammation of the prostate, inflamed testicles due to mumps and infections of the urinary tract or reproductive organs. Although most infections may cause permanent testicular damage, in most cases, however, sperm can still be retrieved.

Ejaculation problems

Retrograde Release occurs when sperm goes into the bladder during ejaculation rather than come out of the tip of the penis. Several health conditions can cause retrograde Release such as; diabetes, spinal injuries, and surgery of the bladder, prostate or urethra. In extreme case, some men with spinal cord injuries cannot release sperm at all although they continuously produce sperm.
Certain medications such as blood pressure medications are known as alpha blockers might also trigger ejaculatory problems. A good number of ejaculatory problems are treatable, while others are permanent. In most cases of permanent ejaculation problems, sperm can still be retrieved directly from the testicles.

Tumours

Cancers and nonmalignant tumours are capable of affecting the male reproductive organs directly or can affect the glands such as the pituitary glands that release hormones related to reproduction. Surgery, radiation or chemotherapy which can be used to treat tumours can also affect male fertility.

Undescended testicles

If during fetal development one or both testicles sometimes fail to descend from the abdomen into the sac that normally contains the testicles, i.e. the scrotum. It would likely lead to decreased fertility in men with this condition.

Hormone imbalances

The hypothalamus, pituitary and testicles produce hormones that are essential in producing sperm. Changes in these hormones, as well as from other systems such as the thyroid and adrenal, may interfere with sperm production.

Sperm duct defects

The tubes that carry sperm can be damaged by illness or injury. Some men are born with a blockage in the part of the testicle that stores sperm or a blockage of one of the tubes that carry sperm out of the testicles. Blockages can also occur in the epididymis, in the vas deferens, near the ejaculatory or in the urethrae. Other causes of blockages include; inadvertent injury from surgery, prior infections, trauma or abnormal development. Equally, men with cystic fibrosis and some other inherited conditions may be born without sperm ducts altogether.

Chromosome defects

Inherited disorders such as Klinefelter’s syndrome, a state in which a male is born with two X chromosomes and one Y chromosome instead of one X and one Y causes abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis, Kallmann’s syndrome, Young’s syndrome, and Kartagener syndrome.

Certain medications

There are medications that can impair sperm production and decrease male fertility such as; chemotherapy, testosterone replacement therapy, long-term anabolic steroid use, certain antifungal medications and some ulcer medications.

Environmental Causes
Overexposure to certain environmental elements can affect sperm production or function. Specific causes include:

  •  Industrial chemicals: Long-term exposure to benzenes, toluene, xylene, herbicides, pesticides, organic solvents, painting materials and other heavy metals may contribute to low sperm counts.
  • Radiation or X-rays: Continuous direct contact with radiation can decrease sperm production and it could take several years for sperm production to return to normal. With prolonged high doses of radiation, sperm production can be permanently lowered. Also, several reports show keeping mobile phones in the pocket, close to the upper thigh, can deter sperm production resulting low sperm count and morphology.
  • Overheating the testicles: Sitting for long periods, regular usage of saunas and hot tubs close-fitting clothing or using a laptop on your lap for a prolonged period can likely to increase the temperature in the scrotum, thereby reducing sperm production. Choose underwear that gives room for easy circulation and avoids wearing tight underwear.

Also, activities such as cycling for long periods at a time, driving for long distances can cause overheating of the testicles.

Health, lifestyle and other causes
Other causes of low sperm count include:

  • Illegal drug use: Anabolic steroids taken to enhance muscle strength and growth can cause the testicles to shrink and sperm production to decrease. The use of cocaine or marijuana can temporarily reduce the quantity and quality of your sperm.
  • Alcohol use: Excessive consumption of alcohol can lower testosterone levels and hinder sperm production. It significantly lowers the quantity of sperm which could result in infertility.
  • Tobacco smoking: Smoking cigarettes can significantly lower sperm production in men who smoke compared to men who do not. Regular smoking of cigarettes do not only deteriorate overall health over time but it is harmful to the male reproductive organs.
  • Emotional stress: Severe emotional stress, including stress about being infertile, has been shown to interfere with certain hormones needed to produce sperm.
  • Weight: Obesity can trigger hormonal changes that reduce male fertility. Layers of fat that surround the testicles can become overheated and heat is bad for sperm health.
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