Maybe your doctor just informed you that your sperm count is low, which may contribute to fertility issues. Or maybe you just have a sneaking suspicion that low sperm count is at the root of your fertility challenges. If so, you’re probably thinking: Why me? What does “low sperm count” even mean? How can I fix it?
The first thing to know is that you’re not alone. In fact, up to 50% of fertility problems can be attributed at least in part to male factor infertility. Still, depending on the cause of the low sperm count, there may be several avenues on which you can proceed.
What is low sperm count?
When you have a semen analysis, there are several parameters that are assessed. Two of the main aspects doctors look at are sperm concentration, or how many sperm there are in each milliliter of the sample provided (normal concentration is greater than 15 million sperm per milliliter), and sperm motility, or what percentage of the sperm in the sample is in motion (normal motility is greater than 40%). Low sperm count would be defined as a semen analysis with results less than these normal values.
What causes low sperm count?
A number of things can cause low sperm count, including certain cancer treatments, hormonal disorders, history of groin or testicle surgery, reproductive tract infections (including sexually transmitted infections) and certain medications such as chronic opioids and testosterone supplementation.
Varicocele is the most common surgically correctable cause of low sperm count and male factor infertility. This is characterized by dilated veins in the scrotum. The majority of men with low sperm count, however, may have no identifiable cause, as frustrating as that may be.
How can I treat low sperm count?
If you have been told you have low sperm count with associated fertility issues, it’s a good idea to chat with a urologist who specializes in male infertility. They can perform a thorough evaluation to assess for possible causes and potentially recommend medical or surgical treatments.
But don’t freak out. There are actually a few things you can try on your own to treat low sperm count while waiting for your appointment or the results of your workup:
Avoiding some stuff
Plain and simple, cigarette or e-cigarette usage has a negative effect on sperm counts; regular cannabis use (more than once per week) and excessive alcohol intake similarly are associated with low sperm count. Anabolic steroids or supplemental testosterone use can affect the hormones in the body that stimulate the testicles to make sperm and thus can cause low sperm counts.
Keeping tabs on your diet and exercise
Obesity is associated with low sperm count. There is data to suggest that weight loss in obese men may improve semen quality. And further, obese men tend to have hormonal abnormalities, which can improve with weight loss.
Moderate- or high-intensity physical activity (activities that force you to breathe somewhat harder or much harder than normal) has a positive effect on semen parameters. But interestingly, elite physical activity — when a person performs exhaustive endurance exercises — may negatively affect semen parameters.
Lastly, adherence to a healthy diet, notably the Mediterranean diet, can improve semen count. Increasing intake of fruits, vegetables, fiber-rich foods, fish, seafood, poultry and limiting full-fat dairy, cheese, red meat, soy and sugar-sweetened foods can improve sperm quality.
Thinking hard about supplements
There’s a lot of mixed information out there about supplements and male fertility. We know that oxidative stress (when cells that use oxygen to function produce toxic end products, known as reactive oxygen species or free radicals) can play a role in male subfertility. While many antioxidants and dietary supplements may reduce oxidative stress, the data on improving semen parameters is limited and occasionally contradictory.
Further, many supplements that claim to improve male fertility have limited or no scientific support. However, there is data that Coenzyme Q10, L-carnitine, Folic acid, Zinc, Vitamin C and Vitamin E may improve certain semen parameters. Just make sure that you chat with your doctor before taking any supplement used for male fertility management.
Unexplained low sperm count can be super hard to process. Still, some lifestyle modifications can have a positive effect on semen parameters. “Sperm health is a measure of overall health,” Dr. Sarah Vij, the Director of the Center for Male Fertility at Cleveland Clinic explains. “Anything you can do to improve your overall health, eating right, staying active, avoiding cigarette smoking and limiting alcohol, can improve your fertility.”
Summing it all up
When it comes to sperm count, there isn't always a definitive answer, and more research is needed to truly understand all that's involved. The good news is, there are promising low-risk strategies to improve sperm count. Good luck!
Dr. Darren Bryk is a urologist who specializes in male infertility. He currently works as a urologist for Urology Medical Specialists in South Florida. Dr. Bryk's clinical and academic interests include male factor infertility, erectile and ejaculatory dysfunction, Peyronie's disease, hypogonadism, male voiding dysfunction, prosthetic urology, urethral reconstruction and vasectomies. Dr. Bryk is diligent in truly connecting with every single one of his patients, which he believes is the best way to provide excellent care and achieve successful outcomes. Dr. Bryk works to provide comprehensive treatment strategies to his patients that include education on the issue, behavioral and mental health options, and medication and surgery if needed. He believe that the doctor-patient partnership is of utmost importance. Dr. Bryk has collaborated with Cofertility on social media platforms and is also a Medical Advisor for Beli, Inc. He also serves on the Medical Advisory Board for Stardust Jewish Fertility Foundation.
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