A low sperm count, also called oligozospermia, is where a man has fewer than 15 million sperm per millilitre of semen.

Having a low sperm count can make it more difficult to conceive naturally, although successful pregnancies can still occur.

Problems with sperm, including a low sperm count and problems with sperm quality, are quite common. They're a factor in around one in three couples who are struggling to get pregnant.

There are treatments available on the NHS or privately that can help you become a dad if you have a low sperm count.

CAUSES OF LOW SPERM COUNT.

In many cases, it's not obvious what causes a low sperm count.

Sometimes problems with sperm count and quality are associated with:

a hormone imbalance, such as hypogonadism (reduced hormone production)
a genetic problem such as Klinefelter syndrome
having had undescended testicles as a baby
a structural problem – for example, the tubes that carry sperm being damaged and blocked by illness or injury, or being absent from birth
a genital infection such as chlamydia, gonorrhoea or prostatitis (infection of the prostate gland)
varicoceles (enlarged veins in the testicles)
previous surgery to the testicles or hernia repairs
the testicles becoming overheated
excessive alcohol consumption, smoking and using drugs such as marijuana or cocaine
certain medications, including testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), some antibiotics and some antidepressants

TREATMENT FOR LOW SPERM COUNT.

If you or your partner has been diagnosed with a low sperm count, there are several options available.
Keep trying

Your doctor may initially suggest trying to conceive naturally for a little longer. Many couples conceive within the second year of trying.

You can help maximise your chances of conceiving by:

having sex every two or three days
moderating your alcohol consumption and stopping smoking
staying in good shape, exercising regularly and having a healthy, balanced diet

In vitro fertilisation (IVF) may be an option if you have a slightly low sperm count and you've been trying to conceive naturally with your partner for at least two years.

During IVF, an egg is removed from the woman's ovaries and fertilised with sperm in a laboratory. The fertilised egg is then returned to the woman's womb to grow and develop.

Intracytoplasmic sperm injection (ICSI) is a type of IVF technique, in which a single sperm is injected directly into an egg to fertilise it. The fertilised egg is then transferred to the woman's womb.

ICSI may be offered if you've been trying to conceive naturally with your partner for at least two years and you have either:

few or no sperm in your semen
poor quality sperm

Before having ICSI, you and your partner will need to have an assessment to ensure the treatment is appropriate.

This will involve questions about your medical and sexual history, and screening tests to check for infections or genetic problems that could affect your baby and the chances of ICSI working.

The Human Fertilisation & Embryo Authority (HFEA) has more information about ICSI.
Donor insemination

Donor insemination means using sperm donated by another man.

You may wish to consider using donor insemination as an alternative to ICSI, particularly if the man has a genetic disorder that could be passed on to any children. It can be used as part of IVF if necessary.

If you're considering donor insemination, you should be offered counselling as a couple about the implications for you and your children.

Read more about what you need to know about using a sperm donor.
Gonadotrophin medication

If you have very low levels of gonadotrophin hormones (which stimulate the production of sperm), you should be offered treatment with gonadotrophin medication to improve your fertility.

But if no cause has been found for your abnormal sperm count, you will not be offered hormone-based medicines as they are not known to improve fertility in these cases.