Oligospermia (Low Sperm Count): Causes & Treatment

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You may not know you have a low sperm count until you’re trying to have a baby and aren’t succeeding. Healthcare providers will diagnose oligospermia by collecting a semen sample and evaluating it in a lab. There are different causes for oligospermia, and treatment exists for many of them.

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Care at Cleveland ClinicMale Infertility TreatmentFind A Doctor and SpecialistsMake an AppointmentContentsArrow DownWhat Is Oligospermia?Symptoms and CausesDiagnosis and TestsManagement and TreatmentOutlook / PrognosisAdditional Common QuestionsContentsArrow DownWhat Is Oligospermia?Symptoms and CausesDiagnosis and TestsManagement and TreatmentOutlook / PrognosisAdditional Common Questions

What Is Oligospermia?

Oligospermia (AH-li-go-SPER-me-uh) is the medical term for a low sperm count. A typical sperm count ranges from 15 million to over 200 million sperm per 1 milliliter of semen. If you have oligospermia, you have fewer than 15 million sperm in 1 milliliter of semen.

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A low sperm count can cause male infertility. Having a low sperm count doesn’t mean your partner can’t get pregnant. But it can take longer or be more challenging.

Another name for oligospermia is oligozoospermia (AH-li-go-zo-SPER-me-uh). You may also hear healthcare providers use the term, “severe oligospermia.” That means you have fewer than 5 million sperm in 1 milliliter of semen.

Symptoms and Causes

What are signs of low sperm count?

In most cases, you probably won’t realize you have oligospermia because it doesn’t usually have any signs. The main symptom of a low sperm count is the inability to conceive with a partner after one year of repeated sexual intercourse without birth control.

Some males may have low sperm count signs that relate to the cause. These may include:

• Decreased body hair and facial hair
• Erectile dysfunction
• Low sex drive (libido)
• Swelling, pain or a noticeable lump on your testicle

Oligospermia causes

Many different situations may cause you to experience oligospermia or other sperm disorders. These may include:

• Certain conditions
• Environmental toxins
• Heat
• Lifestyle factors
• Medications and drugs

Diseases and conditions

Some diseases and conditions that can cause oligospermia include:

• Bacterial and viral infections, including urinary tract infections (UTIs) and sexually transmitted infections (STIs) like gonorrhea and HIV
• Blockages in your reproductive system that stop sperm from leaving your body
• Conditions that affect your hormones, like hypogonadism
• Genetic disorders, such as Klinefelter syndrome and cystic fibrosis

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Environmental toxins

Environmental toxins can affect any part of your body, including your sperm. These may include:

• Heavy metals like arsenic, cadmium, lead and mercury
• Industrial chemicals like insecticides and pesticides

Heat

Your testicles work best at a particular temperature, which is slightly lower than your body temperature. Heat-related situations that can affect your sperm production include:

• Undescended testicles, which get too hot if they’re up near your groin
• Swollen veins in your scrotum (varicoceles)
• Spending a long time in very hot environments, like a hot tub

Lifestyle factors

Lifestyle factors that may contribute to oligospermia include:

• Drinking a lot of alcohol over long periods
• Having a body mass index (BMI) greater than 25 (having overweight/obesity)
• Smoking or using other tobacco products
• Stress
• Using certain recreational drugs, such as marijuana and cocaine

Medications and drugs

Many categories of prescribed medications and nonprescription substances can cause a low sperm count. These may include:

• Clomipramine (Anafranil®)
• Finasteride (Proscar®)
• Lamotrigine (Lamictal®, Subvenite®)
• Methadone (Dolophine®, Methadose®)
• Methotrexate (Rheumatrex®, Trexall®)
• Nitrofurantoin (Macrobid®, Macrodantin®, Urotoin®)
• Paroxetine (Paxil®, Pexeva®)
• Prednisone (Deltasone®, Predone®, Sterapred®)
• Sirolimus (Rapamune®)
• Testosterone

There are many other medications that may affect your sperm count. Check with a healthcare provider if you think your medications may be causing oligospermia. Don’t stop taking prescribed medications without first discussing it with a provider.

What is the main cause of oligospermia?

Varicoceles are one of the most common causes of oligospermia. About 4 out of 10 males with low sperm counts have a swollen vein in their scrotums.

How to lower your risk

If you have oligospermia or are at risk of a lower sperm count, a healthcare provider may suggest lifestyle changes such as:

• Cutting back on drinking alcohol
• Maintaining a weight that’s healthy for you through regular physical activity and healthy eating patterns
• Quitting marijuana, cocaine and other substances
• Quitting smoking

Diagnosis and Tests

How doctors diagnose oligospermia

Healthcare providers will review your medical history and perform a physical exam. If they think you have a low sperm count, they’ll recommend a semen analysis. They may also recommend other tests to help determine oligospermia’s cause, including:

• Genetic testing
• Imaging tests of your reproductive organs, including transrectal and testicular ultrasounds
• Tests of your endocrine system to measure your hormone levels
• Urinalysis

Management and Treatment

Can oligospermia be corrected?

It depends on the cause. In some cases, you may increase your sperm count by stopping medications or behaviors that contribute to low sperm levels.

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Other causes may need treatments. Treatments may include:

• Antibiotics
• Counseling to treat issues like erectile dysfunction
• Hormone supplements
• Surgery to treat an enlarged scrotal vein or blockage

There are cases when you won’t be able to increase your sperm count. If you’re trying to have a biological child, a healthcare provider may suggest other options, like in vitro fertilization (IVF).

Can vitamins increase my sperm count?

Malnutrition may affect your sperm health and contribute to a low sperm count. Vitamins, minerals or herbal supplements may help, including:

• Coenzyme Q10
• L-carnitine
• Vitamin C

Talk to a healthcare provider before you try any of these remedies.

When should I see my healthcare provider?

If you and your partner can’t get pregnant, reach out to a healthcare provider for testing.

If a provider diagnoses you with oligospermia, you may wish to ask the following questions:

• What’s causing my low sperm count?
• Is there anything I can do to make my sperm count higher?
• Is a serious condition causing oligospermia?
• Should I see another provider for additional help, such as a urologist?

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Outlook / Prognosis

What can I expect if I have oligospermia?

Each oligospermia cause has a different prognosis. But many causes are treatable. If a healthcare provider diagnoses you with oligospermia, you’ll work together to determine the cause and your treatment options.

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Is pregnancy possible with oligospermia?

It depends on the cause and whether it’s treatable. Pregnancy may still be possible through unprotected sexual intercourse. You can also explore assisted reproductive techniques, like IVF. A healthcare provider can explain treatment options and family planning with you.

Additional Common Questions

What drink can increase sperm?

Juices that contain 100% juice — no added sugar — have lots of vitamins and minerals that help promote sperm health and may increase your sperm count. These include:

• Citrus fruits, including oranges, grapefruits, lemons and limes
• Goji berries
• Pomegranates
• Tomatoes

What is the difference between oligospermia and azoospermia?

Oligospermia means that you have a measurable amount of sperm in your semen. But the numbers are lower than expected. If you have azoospermia, it means there are no sperm in your semen.

A note from Cleveland Clinic

You likely won’t know that you have oligospermia until you’re trying to conceive. It’s not something you can feel or tell without lab testing. But you may begin to wonder if you and your partner can’t conceive after a year of regular unprotected sexual intercourse.

A low sperm count doesn’t affect your quality as a person, and it doesn’t mean you can’t be a parent. Many causes are reversible, and assisted reproductive technologies can also help you achieve pregnancy. If you have any questions, healthcare providers are here to help.

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Last reviewed on 02/27/2025.

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References

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