Oligospermia, or low sperm count, is one of the most common causes of male infertility. According to the WHO, a normal sperm concentration is considered to be 16 million sperm per millilitre or higher. When counts fall below this, a man is diagnosed with oligospermia – graded as mild, moderate, or severe depending on the concentration.
Grades of Oligospermia
- Mild: 10–16 million sperm/ml
- Moderate: 5–10 million sperm/ml
- Severe: less than 5 million sperm/ml
- Cryptozoospermia: sperm found only after centrifugation
Common Causes
- Varicocele – the most common correctable cause
- Hormonal imbalances involving testosterone, FSH, LH, or prolactin
- Genetic conditions such as Klinefelter syndrome or Y-chromosome microdeletions
- Infections, previous surgeries, or undescended testes
- Exposure to heat, radiation, chemotherapy, or environmental toxins
- Lifestyle factors: smoking, alcohol, obesity, anabolic steroid use
- Chronic illnesses like diabetes or thyroid disorders
- Idiopathic – no identifiable cause in 30–40% of men
Diagnosis
Evaluation starts with a detailed history, physical examination, and at least two semen analyses performed 2–3 weeks apart. Further tests may include hormone profile (FSH, LH, testosterone, prolactin, TSH), scrotal ultrasound, genetic testing, and sperm DNA fragmentation assessment.
Treatment Options
Treatment depends on the underlying cause and severity:
- Lifestyle changes: Weight loss, smoking cessation, stress reduction, and balanced nutrition.
- Medications: Clomiphene, hCG, or gonadotropins to correct hormonal imbalances. Antioxidants to reduce oxidative stress.
- Surgery: Varicocele repair, correction of obstructions, or treatment of infections.
- Assisted reproduction: IUI for mild cases; IVF with ICSI for moderate to severe oligospermia. For very low counts, even a single sperm is sufficient for ICSI.
Prognosis
With the right combination of lifestyle changes, medical therapy, and assisted reproductive technology, most couples with oligospermia can achieve pregnancy. Even men with very severe oligospermia can father biological children through ICSI.
If you have been diagnosed with a low sperm count, consult a reproductive medicine specialist for a thorough evaluation and a treatment plan tailored to your specific situation.