Low sperm count refers to few number of sperm in the semen which decreases a man’s chances of getting his partner pregnant. Low sperm count is medically termed oligospermia and signifies less than 15 million sperm in a milliliter of semen. A condition can also arise in which there is no sperm at all in the semen. This is known as azoospermia.
Diagnosis of low sperm count
Diagnosing low sperm count involves an elaborate history taking, physical examination and a number of investigations that the doctor may ask you to do. One of such investigations is semen analysis to detect any abnormality in your semen and sperm. The normal parameters the doctor will be looking out for are as follows and any deviation from the normal might explain why it’s been difficult to conceive.
- Ejaculate volume : > 1.5ml
- PH : > or = 7.2
- Viscosity : Normal
- Liquefaction : < 60 minutes
- Sperm count : > 39 million
- Sperm concentration : > 15 million per milliliter
- Total sperm motility : > 40%
- Progressive sperm motility : > 32%
- Morphology :
- Vitality : > 58%
- Agglutination : absent
- White blood cell : < 1 million per milliliter
These are the normal values as stipulated in the 5th edition of WHO laboratory manual for the examination and processing of human semen.
Depending on the outcome of the initial test, the doctor can also ask for other investigations to further confirm the diagnosis and identify the exact cause of low sperm count such as
- Scrotal ultrasound scan.
- Hormones test.
- Post-ejaculation urinalysis for retrograde ejaculation.
- Genetic testing for abnormal chromosome.
- Testicular biopsy.
- Anti-sperm antibody tests
- Trans-rectal ultrasound to check prostate and blockage of ejaculatory ducts and seminal vesicles.
How low sperm count can be treated
There are several things that can cause low sperm count. Treatment is focused based on the underlying cause of the condition. There are medical and surgical therapies available for some of the causes of low sperm count in addition to certain home remedies and lifestyle changes.
Infections of the male reproductive system can be treated with antibiotics and hormone therapy can be used to correct any hormone imbalance that is causing the low sperm count. Patients whose low sperm count is due to erectile dysfunction and premature ejaculation can be treated with medication and counselling.
Surgeries can be done to correct varicocele in the scrotum and also to open an obstructed vas deferens. A previous vasectomy though difficult, can be surgically reversed. There are surgical sperm retrieval techniques that can be used to directly retrieve sperm from the epididymis or testicles.
Some patients will also be adviced to opt for Assisted Reproductive Therapy (ART) or adoption in situations where medical or surgical interventions fail to correct the problem. The man and his partner will be counselled about this by the doctor.
Home remedies that can help a patient with low sperm count involves frequent sexual intercourse with his partner which is well timed when the woman is most fertile in her menstrual cycle. If sexual intercourse every day or so does not seem feasible, the patient is adviced to have frequent sex with his partner around when she is ovulating (which is midway in the menstrual cycle). The couple must also avoid the use of lubricants like K-Y jelly, lotions or saliva which impairs sperm movement and function.
Lifestyle changes that can help reduce the risks factors and prevent low sperm count in males include
- Stop smoking
- Reduce or completely stop drinking alcohol
- No illicit drugs like cocaine or marijuana
- Maintain a healthy weight
- Manage stress properly
- Avoid exposure to pesticides, heavy metals and other toxins.
- Avoid wearing very tight under pants or overheating the testicles through prolonged sitting, hot tubs, and laptops.
Patients with low sperm count can successfully father a child as they work and cooperate with their health specialist.
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