aLife Singapore | Low Sperm Count
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07 Apr Low Sperm Count

According to WHO guidelines, minimum sperm values of normal sperm are:

Volume: 2 ml
Concentration: 20 million/ml
Motility: 50%
Normal morphology: 30%

If the concentration of the sperm is low, it is called oligozoospermia.
If the sperms are not moving actively it is called asthenozoospermia.
If the sperms are having abnormal shape and size, it is called teratozoospermia.

Causes of Low Sperm Count

  • There is a large fluctuation of sperm values depending on the duration of abstinence, the conditions of sperm collection (e.g. use of condom, spermicide and vaginal lubricants), and possibly the time of the day.
  • Sauna, hot baths and tight underwear reduce the sperm count.
  • Drugs, alcohol and cigarette smoking affect sperm concentration and motility.
  • Infection of testis and prostate gland: Tuberculosis, mumps, sexually transmitted diseases like Chlamydia, gonorrhoea.
  • Varicocoele: These are abnormal veins that surround the testis and raise the temperature of the scrotum. They are present in 20-30 % of infertile patients.
  • Testicular growths.
  • Hernia or testis operation.
  • Patients on radiotherapy or chemotherapy treatment can have low or zero sperm count.
  • Genetic reasons: some males are born with small and undeveloped testis.
  • Hormonal reasons: Some males have abnormal hormone production from the brain, causing small testis and low sperm count. However, these are not common.
  • Patients with long standing diseases of liver and kidney may have low sperm count.
  • Unexplained causes: This accounts for 30-50 % of patients.

Treatment

Low sperm count is a complex problem. Lifestyle habits such as smoking, excessive drinking and drug abuse should be corrected. Sexually transmitted diseases should be treated. Sauna, hot baths, and exposure to hot environment or toxic chemicals (e.g. pesticides) should be avoided. Wearing loose underwear and trousers as well as taking cold showers may help to improve sperm quality. De-stressing program helps. Psychological support and counselling can reduce stress.

As no specific cause can be found in many patients, treatment is usually not very satisfactory except in a small number of patients with pituitary (a small gland at the base of the brain) hormonal deficiency. Vitamins such as B complex, C and E have been used to trace elements such as Zinc and Selenium. Male hormones (testosterone) have been used empirically with occasional success. Removal of the varicocoeles helps in improving the quality of the sperm. Assisted reproductive techniques using insemination into the womb (IUI), test-tube baby (IVF, ICSI) have been used with some success.

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