Oligospermia (low sperm count)

What is oligospermia?

Oligospermia (also known as oligozoospermia or low sperm count) is a common condition that contributes to male infertility or male-factor infertility, making natural conception challenging. According to the World Health Organization (WHO), an average sperm count is at least 15 million per milliliter of semen. Anything below this is classified as oligozoospermia. The severity can range from mild oligospermia to moderate oligospermia or severe oligospermia.

Oligospermia (low sperm count)_ Tower Urology

Who is affected by oligospermia?

Oligospermia can affect men of any age. However, many men only realize they have this condition around the age at which they try to start a family. Often, having a low number of sperm produces no noticeable symptoms. This means that most men will only learn of their condition after undergoing semen analysis as part of a fertility evaluation.

Oligospermia is also frequently seen in men with underlying hormonal disorders, testicular conditions, or lifestyle habits that impact spermatogenesis. In some cases, hypogonadism, a condition where the body produces low testosterone and other reproductive hormones, can play a role in poor sperm production.

Men with cystic fibrosis, an inherited condition that affects the reproductive system, may also experience azoospermia (no sperm in the semen) or severe oligospermia due to the congenital absence of the vas deferens—the tubes that transport sperm. Other men may develop retrograde ejaculation, where semen is directed into the bladder instead of being expelled during ejaculation, reducing sperm concentration in the semen.

What causes low sperm count?

The causes of oligospermia can be various medical, hormonal, and environmental factors.

Medical causes

Medical causes are often due to structural abnormalities or medical conditions that affect sperm production, including:

Varicoceles, or enlarged veins in the scrotal sac, raise the testicular temperature and impair spermatogenesis.
Undescended testicles occur when the testes fail to move into the scrotum properly during fetal development.
Blockages in the reproductive tract, such as obstructions in the vas deferens or epididymis, prevent sperm from mixing with semen.
Sexually transmitted infections (STIs), such as chlamydia or gonorrhea, can lead to inflammation and scarring of the reproductive tract.
Ejaculatory disorders, including retrograde ejaculation, which affects sperm delivery.
Hormonal imbalances, including hypogonadism, where low testosterone and FSH levels impair sperm production.

Genetic and hormonal factors

Certain genetic conditions, such as Klinefelter syndrome, impact spermatogenesis by affecting chromosome structure and hormone regulation. Additionally, disorders of the pituitary gland, which regulates hormone levels, can lead to testosterone deficiencies that negatively impact sperm count.

Lifestyle and environmental causes

Sperm production is susceptible to lifestyle and environmental factors, including:

Smoking, excessive alcohol consumption, and drug use all of which can lower sperm concentration and motility.
Obesity contributes to hormonal imbalances and poor testicular function.
High temperatures from frequent hot tub use or tight underwear can impair spermatogenesis.
Exposure to toxins, such as pesticides, heavy metals, and radiation, has been linked to reduced sperm quality.

Symptoms of oligospermia

Most men with oligospermia do not experience any noticeable symptoms. Difficulty conceiving despite regular, unprotected sexual intercourse tends to be the most common sign. Still, other men may experience symptoms related to oligospermia that are also caused by an underlying condition. Examples include a low sex drive or erectile dysfunction, which may indicate an underlying hormonal issue. Pain, swelling, or lumps in the testicles could indicate varicoceles, tumors, or infections.

Because oligospermia can sometimes be associated with other reproductive conditions, it’s essential to undergo a comprehensive evaluation to determine the root cause. A semen analysis is the only way to confirm it.

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How is oligospermia diagnosed?

At Tower Urology, we consider multiple factors to determine the underlying cause of oligospermia or fertility issues.

First, we take the time to create a detailed medical history. We assess your risk factors, including prior infections, surgeries, and genetic conditions. Then, a thorough physical examination evaluates the testicles, scrotum, and reproductive structures for abnormalities.

The primary diagnostic test is a semen analysis, which measures sperm concentration, motility, and morphology to assess the quality of the semen. But additional testing may include:

Hormonal evaluations to check testosterone, FSH, LH, and prolactin levels, which regulate sperm production.
Scrotal ultrasound to detect varicoceles, tumors, or blockages.
Genetic testing to screen for chromosomal abnormalities.
Testicular biopsy to assess spermatogenesis in cases of severe oligospermia or azoospermia.

Treatment options for oligospermia

The proper treatment for low sperm count depends on the underlying cause. In cases where lifestyle changes contribute, improving diet, exercising, quitting smoking, and reducing stress can enhance sperm quality and concentration over time.

Hormonal imbalances can be treated with hormone treatments such as testosterone replacement therapy (TRT) or medications that stimulate pituitary function, which can help regulate spermatogenesis. If varicoceles are present, a microsurgical varicocele repair can be performed to restore normal blood flow and enhance fertility outcomes.

Men with obstructive oligospermia may also benefit from surgical procedures to remove blockages in the vas deferens, allowing sperm to be present in the semen. If infections are causing sperm abnormalities, targeted antibiotic treatments may be prescribed.

For couples struggling to conceive, assisted reproductive techniques (ART) such as intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), or in vitro fertilization (IVF) can significantly increase the chances of pregnancy. In cases of severe oligospermia, a testicular biopsy or sperm retrieval techniques may be necessary to extract viable sperm for insemination.

How long does recovery take?

Recovery time varies depending on the treatment. Men who make lifestyle modifications often experience improvements in sperm concentration and motility within three to six months. Hormone treatments require ongoing monitoring, with results typically observed within a few months. Surgical procedures, such as varicocele repair, have high success rates, with significant improvements in sperm quality observed within six months.

Why choose Tower Urology for oligospermia treatment?

At Tower Urology, we take a personalized, evidence-based approach to male infertility. All our professionals at Tower Urology are committed to giving you expert care. We take the time to understand you so we can personalize your treatment plan to your specific needs.

Tower Urology specializes in diagnosing and treating male fertility concerns, including oligospermia, with advanced diagnostic tools and personalized treatment options. Whether caused by hormonal imbalances, genetic disorders, infections, or lifestyle factors, we offer comprehensive solutions to improve sperm quality, concentration, and motility—helping men optimize their fertility potential.

We invite you to establish care with Tower Urology.

Call us or request your appointment online:

(855) 246-2700

Request your appointment online

Tower Urology is conveniently located for patients throughout Southern California and the Los Angeles, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Burbank, Glendale, and Downtown Los Angeles.

Oligospermia FAQs

Can masturbation cause low sperm count?

Masturbation does not cause low sperm count (oligozoospermia). However, frequent ejaculation may temporarily lower sperm concentration. The body continuously produces sperm, so occasional masturbation has no long-term effect. Sperm count typically returns to normal after a short period of abstinence.

Can a man recover from low sperm count?

Yes, low sperm count can often improve with lifestyle changes, medications, or treatment of underlying conditions. Reducing stress, quitting smoking, and maintaining a healthy diet may help. In severe cases, fertility treatments like IVF or IUI may be necessary.

Does weed or nicotine lower sperm count?

Both marijuana (weed) and nicotine can lower sperm count. Marijuana affects sperm production by disrupting testosterone and sperm motility. Nicotine reduces sperm quality and damages DNA. Quitting or reducing use can help improve fertility.

Sources

Male Infertility
https://www.ncbi.nlm.nih.gov/books/NBK562258/#:~:text=Oligozoospermia%3A%20Sperm%20concentration%20%3C15%20million,if%20%3C5%20million%2FmL.

World Health Organization reference values for human semen characteristics
https://academic.oup.com/humupd/article-abstract/16/3/231/639175?redirectedFrom=fulltext

Nonsurgical Management of Oligozoospermia
https://pmc.ncbi.nlm.nih.gov/articles/PMC7566408

Approach to the patient with oligozoospermia
https://pubmed.ncbi.nlm.nih.gov/23472228

Cannabis and Male Fertility: A Systematic Review
https://pmc.ncbi.nlm.nih.gov/articles/PMC7385722

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Dr Josephson has a magic hand. after protate surgery usually most of the patients get leaks but mine was perfect. He is very intelligent, helpful, patient, and polite. I recommend him to all my friends and family

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A family member was struggling with testicular pain for years and had concerns about fertility. I am so grateful that we were referred to Dr. Houman. He is very thoughtful and knowledgeable and has great bedside manner. He diagnosed a varicocele and recommended microsurgical varicocelectomy and we are so happy with the results. I highly recommend Dr. Houman.

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