The most common cause of male infertility is a low sperm count. Other factors that affect infertility are linked to low-quality sperm and low sperm mobility.
Other men may have no sperm at all; however, the majority of male infertility cases are caused by low sperm count.
If you and your partner are experiencing problems with fertility, your doctor will usually schedule a semen analysis to determine your sperm count. It doesn’t matter how healthy your sperm are; if there aren’t enough of them it may be impossible for conception to occur.
There are a number of health issues and medical causes for the low count. It’s important that you work closely with your doctor to decide what factors are causing your infertility.
Testicular Failure Leads to Low Sperm Count
For some men, the sperm-producing area of their testicles doesn’t make enough mature sperm. This can happen at any point in sperm production for a few different reasons.
Sometimes the testicle does not have the cells that are necessary for the division to occur so that they can become sperm. Other times sperm development is interrupted.
Still, another reason is that there is not enough sperm to move through the ducts and on into the fluid that is ejaculated. Some of the causes of testicular failure include hormone issues, genetic abnormalities, or varicoceles.
Varicocele and Low Sperm Count
Varicoceles are swollen and enlarged varicose veins that are found in the scrotum. About 15 per cent of all men have a varicocele however in most cases this does not lead to low sperm count.
These enlarged veins have an effect on how the testicles release the sperm. If fertility is affected by varicoceles, surgery can be used to correct the condition.
Most of the time surgery will be successful and you’ll go on to conceive naturally. If surgery is not successful you may opt for IUI (intrauterine insemination) to get pregnant.
In IUI the sperm will be injected right into the uterus so that ejaculation doesn’t have to take place in the vaginal canal.
Drugs can Affect Your Sperm Count
Some medications are the cause of low sperm count. If you and your partner are having difficulty getting pregnant, your doctor will take a close look at any drugs that you’re taking.
Some common drugs that can affect your sperm count include the following:
- Sulfasalazine: Used for IBD (inflammatory bowel disease).
- Ketoconazole: An anti-fungal medication.
- Cimetidine: Prescribed for acid reflux and ulcers.
- Antibiotics: This includes Erythromycin, Gentamicin, and Nitrofuran.
- Allopurinol: Used for gout.
- Methotrexate: Prescribed for arthritis, psoriasis, and some cancers.
Many couples who are experiencing fertility problems will see an infertility specialist rather than their own family doctor.
It’s important that you let the specialist know all the medications that you’re taking. If it’s suspected that any of these medications may be causing a low count you may be given an alternative drug that won’t affect your fertility.
Low Sperm Count and Retrograde Ejaculation
Another cause of low sperm count is retrograde ejaculation. This condition occurs when sperm isn’t ejaculated out of the penis but instead flows back into the bladder during orgasm.
You may have an adequate sperm count, however, the problem is that the sperm isn’t able to reach the egg. For some men, retrograde ejaculation is a side effect of some medications that have been prescribed.
This condition may also be a symptom of a more serious problem such as multiple sclerosis or diabetes and so should not go undiagnosed.
Low Sperm Count and Oligospermia
Low sperm count is also known as oligospermia. If there are no sperm present at all the condition is known as azoospermia, although this condition is much less common and affects less than 1 per cent of all men.
You’ll be diagnosed with a low sperm count if the amount of sperm drops below 20 million in one milliliter of semen. Normal sperm count is anywhere from 20 million to 120 million.
Treatment for low count will depend on the cause but for some men the success rate of boosting their sperm count can be quite disheartening.
If treatment for low count is not successful, you and your partner may have to consider ART (assisted reproductive technology) in order to have a child.
ICSI for Low Sperm Count
If your sperm count is too low for conception to happen, one procedure that is revolutionizing male infertility treatment is ICSI (intracytoplasmic sperm injection).
Even if you have only a handful of sperm ICSI may be used along with IVF (in vitro fertilization) to allow for conception. What ICSI does is work with even the smallest amount of sperm.
Sperm is retrieved from the testicles using a procedure called TESE (testicular semen extraction). Sperm is removed and then used in an IVF cycle to fertilize the eggs.
Using ICSI and IVF together has a 70 per cent success rate of allowing men to become a genetic father to their child.