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21 Sep 2020

Treatment options for low sperm count

Vicken Sahakian

Vicken Sahakian

M.D.

Intended parents around the world experience a wide range of emotions when attempting to start a family, only to be repeatedly met with negative pregnancy tests. Most people experience feelings of heartbreak, frustration, and even shame. 


However, it’s important that those facing infertility to realize that they are not alone. Although many people are reluctant to share their struggles with infertility, this is a condition that affects millions of Americans. 

Fortunately, there are many fertility treatment options that can make pregnancy a possibility. Male infertility treatment addresses these challenges, from low sperm count to poor sperm motility. 

Treating Low Sperm Count in Men

If you have a low sperm count, the semen you ejaculate during an orgasm contains fewer sperm than normal. Your sperm count is considered “lower than normal” if you have fewer than 15 million sperm per milliliter of semen. 

Low sperm count means your sperm are less likely to fertilize your partner’s egg, resulting in pregnancy. However, this does not mean you cannot father a child -- there are many possible treatments for men considering parenthood. 

A number of factors can lower sperm count, from smoking and drinking alcohol to certain medications or long-term illness. However, there are different steps men can take in an attempt to increase sperm count before considering the treatments below. 

Prevent  low  sperm  count  by  avoiding harmful  activities  and  agents

While having a low sperm count may be resulting from health or lifestyle choices. To prevent this, it’s recommended that men trying to increase sperm count and health follow these guidelines: 

  • Abstain from drugs and smoking
  • Limit or abstain from alcohol
  • Talk to your doctor about medications that can impact sperm count
  • Maintain a healthy weight
  • Limit exposure to high-stress environments
  • Avoid pesticides, heavy metals and other toxins
  • Avoid heat (jacuzzis, saunas, hot tubs)

Pregnancy with low sperm count may require treatment

Successful conception is dependent on a variety of factors. In short, a healthy sperm must travel to a mature egg and fertilize it. If a male has low sperm count, there are far fewer sperms able to attempt that journey, so the odds of pregnancy decrease significantly.

Depending on the cause of infertility in the male, a specific treatment is necessary. Unfortunately, most treatments of men with severely depressed sperm counts or motility are not very successful, except for IVF with Intracytoplasmic Sperm Injection (ICSI). Some of the treatments available include the following:

  1. IVF with ICSI: IVF, or in vitro fertilization, is one of the most popular forms of fertility treatment. This multi-step procedure stimulates ovulation so that mature eggs can be collected from the female partner (or an egg donor).  Those eggs are fertilized in a lab and the healthiest embryo(s) are then transferred into the woman’s uterus.
    IVF has a high rate of success, but by combining IVF with ICSI, or intracytoplasmic sperm injection, we can increase the success rate even further for men with low sperm count.
    ICSI involves collecting a sperm sample and cleansing it to isolate the strongest, healthiest sperm. Then a single sperm is collected and injected directly into the egg for fertilization. IVF with ICSI is often the best treatment option for men with low sperm count.
  2. Hormonal treatment: If a male patient has low levels of the pituitary hormones that stimulate sperm production, we may attempt hormonal treatment before considering more invasive options (such as IVF with ICSI).
    Similar to female hormonal treatment, this involves the use of injectable hormones. By providing males with hormones such as Pergonal or Humagon, we may be able to increase sperm count so that patients can conceive naturally.
  3. Antibiotic treatment: In rare cases, low sperm count is a transient condition that is the result of an infection. Some infections interfere with sperm production or sperm health which can cause scarring that blocks the passage of sperm.
    If your clinic diagnoses this as the cause of low sperm count, your clinician can offer antibiotic treatment to eliminate the infection and increase sperm production. Although some infections can result in permanent damage, sperm can usually still be retrieved. 
  4. Surgery: It is rare to treat low sperm count with surgery. However, if the male patient needs to repair a blockage in sperm transport, surgical treatment is an option for male patients with low sperm count.
  5. Artificial donor sperm insemination: if the testicles are unable to produce sperm, the only remaining alternative is sperm donation. There are many sperm banks that store frozen sperm from sperm donors.
    A couple can review profiles of such donors and pick a suitable donor to their liking. The sperm from these individuals is quarantined for over 6 months before it is available for donation and during this period of time the donors are repeatedly checked for infectious diseases such as HIV.

When low sperm count treatments are ineffective

For some men, low sperm count and motility aren’t addressed by the above steps. If this happens, don’t worry -- there are other fertility options available, and your clinic will work with you to successfully conceive and start a family. 

The first step to treating infertility is finding out what is likely causing it. If you have been unsuccessful in your attempts to conceive, it is time to work with a fertility clinic near you. 

Our experienced team of doctors at Pacific Fertility Center of Los Angeles are ready to help you start your family. Contact us at your earliest convenience to learn more about our comprehensive fertility services, including diagnostic testing and treatment.

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