Top 10 Frequently Asked Questions about Low Sperm Count

Most couples trying to conceive (TTC) experience a mixed range of emotions when they are not able to achieve their dream of having a baby easily. The intended parents may experience feelings of frustration, devastation, or even shame when they failed to conceive. Male infertility problems such as low sperm count is one of the reasons that reduce the chances of a successful pregnancy.

It is important for you to note that this is not a rare condition and many men around the world face similar problems. Let us look into the top 10 most commonly asked questions by many men out there when they find out that they are having problems with their sperm counts and general sperm health.

  1. What is low sperm count, and how to know if I am having this problem?

World Health Organization (WHO) declared that the average number of sperms should be around 15 million per milliliter (ml), or at least 39 million per ejaculate. If the semen analysis results show that you have 15 million sperm per milliliter, you have a normal, healthy sperm count. Anything below the average indicates that the sperm count is low. This problem is also known as Oligospermia. 

Generally, when your partner has trouble getting pregnant, the fertility doctor will recommend you and your partner to get infertility testing. The male infertility tests include semen analysis to check your overall sperm health, especially the sperm count. Doctors often conduct two or three separate sperm analyses to get a good idea of your sperm’s health. Follow the instructions given by the doctor to get the best semen sample for analysis. The semen sample obtained will then be analysed in the laboratory. If you have fewer than 15 million sperm per milliliter of semen, your sperm count is considered to be lower than the average sperm count (low sperm count).  Your fertility doctor will then suggest appropriate interventions to treat your condition.

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  1. Are there any obvious signs or symptoms that indicate decrease in sperm count?

There aren’t any definite signs or symptoms to indicate problems with sperm count. However, there are some problems that are commonly associated with male fertility that may cause issues with sperm count. Thus, you are encouraged to get a consultation from doctor if you observed the following signs:

–  A problem with maintaining an erection firm enough for sexual intercourse (erectile dysfunction).

– Pain, discomfort, or swelling in the testicle area

– History of prostate or sexual problems or male reproductive surgery.

  1. I was told that I have infections in the tubes that carry sperm. Does it affect my sperm count?

Some infections may interfere with sperm production. Inflammation of testicles or sexually transmitted infections (STI) such as HIV or Gonorrhea may cause a decrease in sperm count. Thus, it is advised to consult the doctor and do a semen analysis to check your sperm health if you are diagnosed with infections. There are many treatments available to treat the condition before it becomes worse and lowers your chances of having a baby later in life.

  1. Shall I do semen analysis if my brothers are diagnosed with Oligospermia? Is this condition inherited from our father?

There are chances that genetics could cause problems in sperm counts. Men can carry genetic disorders such as missing Y chromosome or the presence of extra chromosomes that may lead to a reduced sperm count. These disorders can be hereditary and thus it is best to inform your family history to your doctor or fertility specialist during the consultation.

  1. Can exposure to excessive heat affect sperm count?

Excessive heat around the genitals does have effects on sperm count. If you frequently use saunas and hot tubs or place your laptop on your lap while working, it can lower sperm quality and potentially reduce sperm count. It is because testicles work well when the body temperature is slightly below your body temperature. When there is too much heat around the area, it can negatively affect your sperm quality. The good news is that the effect is reversible and does not cause a permanent impact on the reduction in sperm count. Provided there are no other fertility problems that affect sperm health, the sperm quality should return to normal if the exposure to excessive heat is reduced for a few months. 

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  1. Can obesity or being overweight affect the sperm count?

Obesity or overweight men may have diminished quantity and quality of sperm. Studies suggested that weight gain may affect male fertility and lowers the chances of fatherhood. Overweight men are 11% more likely to produce low sperm count than their normal-weight peers. Meanwhile obese men are 42% more likely to have fewer sperm counts. Your overall health including weight is one of the important factors in conceiving healthy baby. Thus, if you plan to have a baby, it is advised to seek help, reduce weight and get in the best shape as possible.  

  1. I don’t smoke but I vape and drink alcohol occasionally. Can it still affect my sperm count?

Yes, vaping can still affect sperm count. You may assume vaping is a safer option, but they all share a similar type of effect. Be it smoke or vape, it contains nicotine which can significantly lower your sperm count, motility, and overall quality. Sperms are highly sensitive to oxidative stress. Smoking or vaping can lead to the body experiencing oxidative stress that can eventually cause damage to sperm quality.

On the other hand, the effects of alcohol consumption on sperm count are subject to the amount of alcohol consumed. Not everyone will be affected by the same amount of alcohol in the same way. However, consistent heavy drinking or binge drinking can negatively impact your sperm health. It may lower your testosterone level and causes poor sperm health. Hence, if you are intending to build a family, it is best to stop smoking or vaping, reduce alcohol consumption and practice a healthy lifestyle.

  1. Can taking testosterone injections for bodybuilding affect sperm count and fertility?

Some men are obsessed with bodybuilding and are willing to use testosterone injections to have a great body and physical appearance. However, be careful when you take these injections because they are unnatural testosterone. When you take them for an extended time, it will suppress the production of sperm and affect your sperm count. Prolonged suppression may cause difficulties in achieving pregnancy. 

  1. Can lifestyle changes help to increase my sperm count?

Lifestyle changes can affect sperm count positively. Practicing a healthy lifestyle such as exercising regularly and eating a balanced diet may boost your sperm production. Several studies suggested that regular exercise can increase sperm count. If you have low sperm count due to weight problems, you may focus on exercises targeting weight loss. Research shows that losing weight can positively affect sperm quality, quantity, and motility. It is also best to eat a balanced diet that includes antioxidants, vitamins A, C, E, zinc, and folic acid, to boost testosterone levels and help increase sperm quality.

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While a healthy lifestyle helps to maintain good sperm health, you must also consider other factors that contribute to male infertility that may require additional treatments or medications. Thus, if you and your partner are having trouble conceiving, it is best to talk to your fertility specialist to evaluate your condition and get proper consultations.  

  1. What are some common fertility treatments for men with less sperm count?

Treatments are advised according to the condition of both you and your partner. Intrauterine Insemination (IUI), In-vitro Fertilisation (IVF), or Intracytoplasmic Sperm Injection (ICSI) are among the common treatments suggested by fertility specialists. IUI involves an injection of sperm directly into the uterus of your female partner. If the treatment does not work, your specialist would suggest IVF with ICSI. IVF is a treatment that combines eggs with sperm outside of a woman’s body. Upon fertilisation, the fertility specialist will insert the fertilised egg/embryo into the womb to be formed as a baby. If your sperm count is severely low, then your specialist would recommend doing IVF together with ICSI. ICSI is an additional treatment where a single sperm is washed and injected into the egg with a tiny needle. A combination of ICSI and IVF allows the best sperm to be chosen for the treatment. Hence, getting a combined treatment increase the chances of a successful pregnancy.


Whether you’ve been trying for a baby or have yet to plan for a family, it’s important to take care of yourself and care for your sperm’s health. Male infertility can be one of the hardest challenges you may face. It can be devastating knowing that you have trouble conceiving. However, do not lose hope if you are diagnosed with male infertility problems. There are many available treatments and lifestyle shifts that you can practice to boost your sperm health. With the emerging technological development and advancements in today’s world, a couple can conceive even with fertility problems such as low sperm count. Thus, if you need help or support, do not hesitate to consult a doctor to get a suitable treatment as soon as you can. In treating fertility, earlier consultation and treatment is always better.

Learn more about male infertility here: Male Fertility

You are sure to have many questions. In addressing infertility, the sooner you have them answered, the better. Do list them down and call 03-80699333 (TMC Fertility & Women’s Specialist Centre, Puchong) or +6-03-62871000 (Thomson Hospital, Kota Damansara) or email ask@drnavdeepfertility.com to make an appointment to consult with Dr Navdeep.