Does having a low sperm count mean that you can’t have a baby? In this blog for Men’s Health Week 2024 (10-16 June) we’re talking all about this common male infertility issue and what you can do about it. As the week’s theme is health checks we’re discussing how to get a sperm test and to encourage more men to seek help if they’re worried about infertility.
The opening chapter of my book, “How to Have a Healthy Baby” provides more insight into male fertility, issues contributing to lowered sperm count and poor quality, as well as recommendations to help boost your fertility naturally.
A low sperm count is called oligozoospermia, which means that there are fewer sperm in your semen. According to World Health Organisation guidelines[1], a low sperm count is anything below 15 million sperm per ml of semen, or less than 39 million sperm in your ejaculate.
Sperm issues are much more common than you might think. Around 1 in 6 couples have difficulty conceiving[2], with male infertility the cause in up to 50% of cases[3]. Other common problems with sperm that can cause male infertility include poor sperm motility, abnormally shaped sperm, and producing no sperm at all, which is called azoospermia.
Research has shown that the average sperm count has halved worldwide over the past 50 years[4] and is continuing to decline – and scientists believe that lifestyle and environmental factors are to blame. Obesity, alcohol, smoking, and recreational drug use, along with exposure to certain chemicals and toxins, are all associated with male infertility[5].
No – a low sperm count does not mean you can’t have a baby. It might just take longer for you to conceive, or you may need help through fertility treatment, depending on your diagnosis.
A low sperm count – along with many other common sperm problems – is a treatable cause of infertility, and even with a low sperm count, many men still manage to conceive naturally[6]. Although your sperm count is important, it does not solely determine your ability to have a baby. Many factors affect your chances of pregnancy where sperm is concerned, such as how well your sperm moves (motility) and if it is shaped normally (morphology).
However, if sperm count is low, there’s a reason and that reason should be addressed – whether it be lifestyle, diet, environmental toxins or other factors as these will also impact the reproductive quality of your sperm. The goal is to have optimally healthy sperm to increase chances of conceiving a healthy baby.
Many men do not realise they have a sperm problem until they start trying for a baby. If your female partner is under 35 and you have been having regular, unprotected sex for over a year and have not conceived, it’s a good idea for both of you to see your GP or a Fertility Specialist for fertility testing. If your female partner is 35 or over we recommend seeking help and testing after 6 months of trying. For men this involves a sperm check, also called a semen analysis.
If you are advised to have a semen analysis to check your sperm count, it is nothing to worry about. A semen analysis is a simple, non-invasive test where your semen sample is analysed under the microscope in a laboratory. Ideally 2 or 3 days of abstinence is ideal prior to providing the sample. It assesses your sperm count and other key fertility factors, including:
Sperm motility: For natural conception to occur, the sperm must be able to ‘swim’ to the egg. Your sperm are checked to see how well they are moving and if they are showing forward movement.
Sperm morphology: The shape of your sperm matters too, as poor shape can make it harder for the sperm to move correctly and penetrate the egg for fertilisation. Sperm morphology examines the size and shape of the sperm head and tail.
Semen volume: This is how much semen you produce when you ejaculate. It can vary from around 1.5ml to more, depending on the last time you ejaculated and other everyday causes. If your analysis shows a low volume – known as hypospermia – you may need to repeat your semen analysis to check that this is not a consistent issue, as that may indicate a blockage. It is important to stress that the sperm makes up a very small fraction of the sperm volume, the majority is from the secretions from the seminal vesicles and the prostate.
Living a healthier lifestyle is one of the easiest ways you can try to improve your sperm count and sperm health when you’re trying for a baby. As new sperm is made every three months, lifestyle changes you make now can have a positive impact in a matter of weeks. Avoiding excessive heat to the testes and regular ejaculations can help with healthy sperm production.
The best ways you can help to improve your sperm count include:
Eating a healthy diet Studies[7] have shown that a diet rich in fish, fruit, and vegetables – such as the Mediterranean diet – is positively associated with sperm quality. However, a diet rich in processed foods and sugar has a negative impact on sperm quality. Lowering your BMI Several studies show that obesity is bad news for sperm health[8] – with overweight men at significantly increased risk of having a low sperm count compared to men with a normal weight range. Reducing alcohol intake and quitting smoking Alcohol and smoking both negatively affect sperm in several ways, according to studies[9]. Smoking, in particular, can reduce sperm count, semen volume, and sperm motility.
Get your copy of “How to Have a Healthy Baby” today – order on Amazon.
Sources – Article courtesy Adora Fertility Clinics
World Health Organization reference values for human semen characteristics: https://pubmed.ncbi.nlm.nih.gov/19934213/ WHO: 1 in 6 people globally affected by infertility: https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility Male Infertility: https://pubmed.ncbi.nlm.nih.gov/37709866/ Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries: https://academic.oup.com/humupd/article/29/2/157/6824414 Environmental and Occupational Exposures Associated with Male Infertility: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265198/ Spontaneous pregnancy in couples waiting for artificial insemination donor because of severe male infertility: https://pubmed.ncbi.nlm.nih.gov/9119099/ How Food Choices Impact on Male Fertility: https://link.springer.com/article/10.1007/s13668-023-00503-x Obesity and Increased Risk for Oligozoospermia and Azoospermia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5151180/ Association between socio-psycho-behavioural factors and male semen quality: systematic review and meta-analyses: https://www.fertstert.org/article/S0015-0282(10)00984-2/fulltext
