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Main article: Low Sperm Count Overview
Updated: 19-October-2024
Treatment of Low Sperm Count
Once a diagnosis has been made, your Doctor will recommend one (or a combination) of the following treatment options for low sperm count:
- Expectant management
- Lifestyle
- Supplements
- Environment
- Surgery
- Medication
- Assisted Reproductive Technology
Expectant Management
Expectant management means watchful waiting. This can be an option for males diagnosed with mild oligozoospermia, especially if:
- the male patient is young and has been trying to conceive less than 12 months.
- the female partner is also young and not diagnosed with any female infertility factors.
In fact, studies show a significant number of men diagnosed with low sperm count, after only 12 months of unprotected intercourse, manage to conceive naturally in the next 12 months, by trying at least every 1-2 days during the woman’s fertile window.
Source: Keihani S, et al. (2017); Barak S and Baker HWG, (2016); Tur-Kaspa I, et al. (1994)
Moreover, a shorter abstinence period of 1 to 2 days is actually helpful to some men with low sperm count. Studies show that ejaculatory abstinence beyond 24 hours significantly decreases sperm count in males diagnosed with oligospermia. Although this is only likely to be true for men with elevated oxidative stress levels.
Experts also recommend men with low sperm count to avoid lubricants, including saliva, where possible during intercourse as this can impair sperm movement and function.
Lifestyle
Although there is limited evidence that lifestyle changes can directly improve male fertility, according to derivable evidence experts suggest that the following lifestyle changes can maximise the chances of conceiving:
- Quitting smoking
- Limiting alcohol consumption
- Lose excess weight
- Regular exercise to stay in good shape
- Adequate and timely sleep
- Consuming a healthy and balanced diet
Quitting smoking is particularly effective for heavy smokers (≥ 20 cigarettes/day) with significant increases in semen volume (+17%), sperm concentration (+23%) and sperm count (+45%) reported after just 3 months.
Source: Kulaksiz D, et al. (2022)
For males who cannot quit smoking entirely, melatonin supplementation may be a valid option, according to a controlled rat study.
Source: Venditti M, et al. (2021)
Losing weight may also help improve sperm concentration and total sperm count in some cases. Studies show overweight men (BMI>30) who manage to lose weight (9+kg) by consuming an energy restricted diet for 3 months will slowly improve their testosterone levels (10+%) and possibly even sperm count in the following 9 months post-diet. Unfortunately both studies did not feature men with low sperm count so these results may or may not be relevant. Animal studies suggest lipid deposition in the testes is a contributing factor to obesity-related male hypogonadism.
Source: Yu C, et al. (2019); Moran L J, et al. (2016); Morgan D H, et al. (2014); Håkonsen L B, et al. (2011)
Similarly, exercise can also improve testosterone levels and thus sperm quality. However, exercise should only be done in moderation where possible to minimise the effect of higher oxidant levels (caused by increased consumption of oxygen from the skeletal muscles) on the natural balance of oxidants and antioxidants in the body. In a controlled rat study, low-intensity exercise significantly decreased the percentage of abnormal sperm, compared to high-intensity exercise (17.4 vs 25.1%). This finding is supported by human trials, which found 30 mins of endurance running at 70% intensity per week significantly increased testosterone levels more than other regular forms of exercise (endurance interval running, resistance training, explosive training, speed-endurance 50m, speed-endurance 150m). An earlier study also revealed this type of exercise (specifically jogging and walking) is more effective than dieting on testosterone levels in obese men.
