Not Enough Sperm For Pregnancy

Oligospermia, or reduced sperm count, is when a man has fewer than 15 million sperm present in 1mL of semen. When sperm count is low, pregnancy is more difficult to achieve. Depending on the underlying cause, men may require surgery, medication, or assisted reproductive technology (ART) to successfully conceive a pregnancy.


Diagnosing oligospermia

In most cases, a man will not be made aware of a diagnosis of oligospermia until attempts at conception have been unsuccessful for some time. Fertility testing for both partners is typically recommended after a year of trying to conceive without getting pregnant. For men, a simple semen analysis can be ordered. This test evaluates sperm concentration, morphology, and movement. Semen volume and vitality, or the percent of live sperm in the sample, are also examined. Based on the test results, the doctor will inform the patient if a diagnosis of oligospermia is warranted and whether the stage is mild, moderate, or severe.

Causes of reduced sperm count

There are many causes of oligospermia. In some cases, hormonal imbalances, such as an underactive thyroid, are the problem. Other individuals may have an obstruction that prohibits sperm from reaching the egg. Trauma or injury, certain medications, environmental toxins, and ejaculation problems can also lead to a diagnosis of reduced sperm count. The recommended treatment will depend on the underlying cause of oligospermia. Here are 3 solutions for improving pregnancy rates with low sperm count.

1. Surgery for varicocele

A common cause of sperm blockage is a varicocele, an enlargement of the veins within the scrotum that occurs when blood pools in the veins rather than circulating out. Varicoceles are often asymptomatic and have no known cause, but can make pregnancy more difficult. An estimated 10-20% of men with a varicocele have difficulty getting a female partner pregnant. The good news is that surgery can quickly correct this problem by cutting the affected veins and sealing off the ends. With blood flowing freely again, fertility is improved.

2. Medications can help

If the underlying issue is related to a hormonal imbalance, medication can be prescribed to correct the issue. Estrogen receptor blockers, for example, can stimulate the hypothalamus and pituitary gland in the brain, causing the release of follicle stimulating hormone (FSH) and luteinizing hormone (LH), which can increase sperm production. If low sperm count is caused by an infection, such as gonorrhea, medications can also help. In some cases, antibiotics can clear up the infection, restoring fertility to optimal levels.

3. Consider ART

If the cause of oligospermia is unknown or difficult to correct, the patient’s best option may be ART. With the use of procedures like intrauterine insemination (IUI) and in vitro fertilization (IVF), pregnancy is possible. With IUI, sperm is cleaned and concentrated and inserted directly into the uterus at the optimal time in the cycle, increasing the chances of success. IVF takes science a step further and selects the best sperm and egg to combine in a lab. The resulting embryo is then transferred into the uterus in hopes of impanation.

A single sperm

Although a diagnosis of oligospermia can be disheartening, a single sperm is needed to achieve a pregnancy. In some cases, surgery or medication can correct the underlying issue, restoring fertility to normal levels. In other situations, ART procedures such as IUI and IVF can be used to achieve pregnancy for men with low sperm counts. Options are available to have a baby.

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