Abnormal sperm counts

An abnormal sperm count may refer to problems with the number of sperm (the concentration), the motility (the ability for sperm to progress forward) or the morphology (the appearance of the sperm’s head, tail and other defining features).

It is typically diagnosed through a semen analysis, which needs to be analysed by an accredited laboratory. 

There are several definitions that you may have read to describes abnormalities within a man’s semen analysis.

• Azoospermia – No sperm cells in semen
• Oligozoospermia – Low sperm count < 15 million/mL 
• Asthenozoospermia – poor sperm motility < 32% progressive motile spermatozoa 
• Teratozoospermia – sperm with abnormal morphology < 4% normal forms 
• Oligoasthenoteratozoospermia (OAT) – low number, low motility and abnormal morphology

The majority of semen is made up of nutrients and liquids and in fact only 0.2mls of the ejaculate will be sperm. A man would have no idea whether there is sperm in his ejaculate by its appearance or volume.

Causes of an abnormal sperm count

There are various factors that can contribute to abnormal sperm counts, including

• hormonal imbalances
• genetic factors
• infections
• varicoceles (enlarged veins within the scrotum)
• lifestyle factors (such as smoking, excessive alcohol consumption, drug use, and obesity)
• medications
• exposure to toxins, and radiation therapy or chemotherapy.

Impact on Fertility

Abnormal sperm counts can significantly affect fertility. Low sperm counts may reduce the chances of conception, while azoospermia makes natural conception impossible without medical intervention. However, it’s important to note that even with abnormal sperm counts, conception may still be possible through assisted reproductive technologies such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Treatment Options

Treatment options depend on the underlying cause of the abnormal sperm count. For some men, lifestyle changes such as quitting smoking, reducing alcohol intake, and maintaining a healthy weight may help improve sperm count. In cases where a specific medical condition is responsible, treating the underlying condition may improve sperm production. Other treatment options may include hormone therapy, surgery to correct anatomical issues like varicoceles, or assisted reproductive technologies mentioned earlier.

Prognosis

The prognosis for achieving pregnancy varies depending on the severity of the abnormal sperm count and the effectiveness of treatment – in addition to the female partners fertility. In some cases, lifestyle changes or medical interventions can successfully improve sperm count and lead to natural conception. 

Emotional Support

Dealing with infertility can be emotionally challenging for both partners. Pippa Sangster has a good understanding of this and links with counselling services to help couples cope with the emotional aspects of infertility and to explore available options for treatment and support.

Follow-Up

We will work closely with patients to try and improve abnormal counts. Follow-up visits and repeat semen analyses may be necessary to assess progress and make any necessary adjustments to treatment. However we understand the financial burden of infertility treatment and will try to keep repetitive tests to a minimum.

Overall, understanding the causes, impact, treatment options, prognosis, and emotional aspects of abnormal sperm counts can help couples navigate their fertility journey more effectively.