Male Infertility and Low Sperm Count: Causes, Diagnosis and Treatment
Understanding Male Infertility
When a couple has difficulty conceiving, the cause lies with male factors in a substantial proportion of cases — either alone or alongside a female factor. Male infertility usually comes down to problems with sperm count, movement (motility), or shape (morphology), though in some men, no sperm is found in the ejaculate at all, a condition called azoospermia.
Common Causes
- Varicocele — enlarged veins in the scrotum that raise testicular temperature and impair sperm production
- Hormonal imbalances affecting testosterone and related hormones
- Lifestyle factors: smoking, excess alcohol, obesity, and prolonged heat exposure
- Genetic conditions affecting sperm production
- Prior infections, surgery, or injury affecting the reproductive tract
Signs That May Point to a Problem
Male infertility often has no obvious symptoms and is discovered only when a couple struggles to conceive. Some men may notice testicular swelling, pain, or a visible varicocele, or have a history of undescended testis or previous surgery in the area — all worth mentioning during evaluation.
How It's Diagnosed
A semen analysis is the starting point, assessing sperm count, motility and morphology. Depending on the findings, further tests may include hormone blood work, a scrotal ultrasound to check for a varicocele, and genetic testing when sperm count is very low or absent.
Treatment Options
Treatment depends on the underlying cause. Lifestyle changes and, where relevant, hormonal medication can improve mild cases. A varicocele affecting fertility can be corrected surgically through microsurgical varicocelectomy. For men with azoospermia, sperm retrieval techniques such as TESA (testicular sperm aspiration) or Micro-TESE (microsurgical testicular sperm extraction) can retrieve sperm directly from the testicle for use in assisted reproduction, even when none is found in the ejaculate.
Lifestyle Factors That Support Fertility
- Maintaining a healthy weight
- Avoiding smoking and limiting alcohol
- Managing heat exposure (prolonged hot baths, laptop use on the lap, tight underwear)
- Managing chronic conditions like diabetes
When to Consult Dr. Raju R
If you and your partner have been trying to conceive without success, a semen analysis is a straightforward first step. Dr. Raju R evaluates and treats male infertility — including varicocelectomy and advanced sperm retrieval techniques like Micro-TESE — at Genesiss Multi-Speciality Hospital, Bangalore.
Consult Dr. Raju R at Genesiss Multi-Speciality Hospital, Bangalore.
Book AppointmentRelated Conditions
Related Treatments
Frequently Asked Questions
A count below about 15 million sperm per millilitre of semen is generally classified as low (oligospermia). A complete semen analysis also looks at sperm movement and shape, not just count, since all three affect fertility.
It depends on the cause. Some causes — like a hormonal imbalance, infection, or varicocele — are treatable and can meaningfully improve sperm count. Others, especially certain genetic causes, may need assisted reproduction techniques such as sperm retrieval rather than a count that improves on its own.
Low sperm count (oligospermia) means sperm are present but fewer than normal. Azoospermia means no sperm are detected in the semen at all — the underlying causes and treatment approach differ, so the specific diagnosis matters.
Not always. A varicocele is treated when it’s judged to be significantly affecting sperm count or quality, or causing symptoms — not every varicocele needs surgical repair, so this is decided based on the full fertility evaluation.
Yes, for many men. Reducing alcohol and smoking, maintaining a healthy weight, avoiding excessive heat exposure to the testicles, and managing stress can meaningfully support sperm quality, though they don’t replace treatment for an underlying medical cause.
Related Articles
Male Infertility After 35 or 40: Does Male Age Affect Sperm Quality & Pregnancy?
Fertility decline is usually discussed as a female issue — but male age affects sperm quality too, gradually and in ways worth knowing about.
Abnormal Sperm Morphology: Can Pregnancy Happen With Poor-Shaped Sperm?
An "abnormal morphology" result sounds alarming — but the strict criteria used mean even fertile men have mostly abnormal-shaped sperm. Here’s the real picture.
Poor Sperm Motility: Causes, Treatment & How to Improve Sperm Movement
Sperm count isn’t the whole picture — how well sperm move matters just as much. Here’s what causes poor motility and what actually helps.