So you have low sperm count: What to do next

September 23, 2025

This article was reviewed by Lynn Marie Morski, MD, JD.

So, you’ve been told your swimmers are lacking a little bit. If you’re now wondering, Can a man recover from low sperm count?, the answer is most likely yes.

Sperm production is a delicate process influenced by everything from your morning coffee to the air you breathe. In many cases, low sperm count (oligospermia) can be improved with the right lifestyle changes, medical treatments, or reproductive assistance.

Here, we’ve broken down what causes low sperm count, how it affects fertility, and—most importantly—how to increase sperm count and boost your chances of conception.

What Causes Low Sperm Count?

The reason behind a low sperm count can vary from guy to guy. To address the issue, you first have to understand which factors may be involved. Let’s break down the usual suspects.

Medical Causes

Sometimes, your body just doesn’t play fair. Underlying medical issues are commonly at fault for low sperm count, including:

Hormone imbalances: Hormones are the backstage crew making sperm production possible, and if they’re out of sync, it can throw the whole operation into chaos. Low testosterone, high estrogen, or issues with the pituitary gland can all mess with sperm count.
Varicocele: This is a fancy name for swollen veins in the privates that overheat your temperature-sensitive sperm.
Infections: Medical villains like intimately transmitted infections, prostatitis (inflammation of the prostate), or even viruses can be at play.
Chronic conditions: Long-term health issues or certain autoimmune diseases, in which your body decides sperm are the enemy and launches an attack, may also lead to dips in sperm count.
Genetic disorders: Some men are born with conditions that affect sperm production, like Klinefelter syndrome, where an extra X chromosome messes with testosterone levels.
Previous cancer treatment: If you’ve undergone chemotherapy and/or radiation, these can take a serious toll on sperm production. It’s a brutal trade-off—saving your life but potentially reducing your fertility. That’s why sperm banking is a thing.

Bottom line? If something’s off inside your body, sperm count can take a hit. However, knowing is half the battle, and with the appropriate medical support, many of these issues can be addressed.

Environmental Factors

Ever feel like modern life is a constant game of “avoid the toxins,” whether you’re walking the city or loading up your grocery cart? Well, your sperm feel the same way.

From pollution to pesticides, the world is full of environmental factors that can mess with fertility. While it’s impossible to avoid every problematic substance, there are things you can do to help minimize excessive exposure.

Here are some of the heaviest hitters:

Chemical exposures: If your job involves heavy metals, pesticides, solvents, or industrial chemicals, your sperm could be taking the hit. Studies show that exposure to toxins like lead, cadmium, and endocrine disruptors like BPA (found in plastics) can lower sperm count. So, maybe think twice about microwaving your lunch in plastic containers.
Radiation: If you’ve had an excessive number of X-rays, had chemo, or worked around radiation, your sperm might be struggling.
Heat: Your privates are naturally designed to stay cooler than the rest of your body (hence why they hang out in the breeze), but modern habits aren’t helping. Long hours in hot tubs, saunas, heat waves, or even keeping your laptop on your lap can create a “sperm sauna” situation—hot, sweaty, and terrible for business.
Air pollution: Breathing in pollutants and endocrine-disrupting chemicals (EDCs) found in everything from car exhaust to plastics can lower sperm production.

Modern life is a battlefield for sperm, but having an awareness of what exposures may be affecting your swimmers can help you take steps to adjust.

Lifestyle Habits

What you do on a daily basis, from your diet to your sleep habits, can affect your sperm production—for better or for worse. The good news is that if you can identify some areas for improvement, this is one of the easiest things to fix.

Consider these lifestyle habits:

Risky substances: Smoking, alcohol, and recreational drugs might as well be known as the “Big Three” of sperm destruction. Smoking introduces toxins that damage sperm DNA. Too much alcohol messes with testosterone levels. And drugs like marijuana and steroids? They can tank your sperm count—fast.
Nutrition: If you’re living off ultra-processed and nutrient-deficient fast food, your sperm are probably running on empty. They thrive on antioxidants, omega-3s, zinc, selenium, and vitamins like C, D, and E. Think of sperm like athletes who need proper fuel to perform.
Stress and sleep: Chronic stress ramps up cortisol, which can suppress testosterone. And if you’re pulling all-nighters or consistently running on five hours of sleep, your body doesn’t have the time to regulate hormones and repair itself properly. Sperm production takes time—think of it like farming, not fast food.
Physical activity: Being sedentary can lead to lower testosterone, while excess fat (especially around the midsection) can increase estrogen levels—bad news for sperm. But don’t go overboard—extreme exercise (like marathon training or steroid-fueled bodybuilding) can also hurt sperm production. Balance is key.

If you want to boost your count, swap the bad habits for good ones—quit smoking, limit alcohol, clean up your diet, get some sleep, and maybe don’t spend all day sitting.

Low Sperm Count Signs and Symptoms

Unlike a bad haircut or an embarrassing text sent to the wrong person, low sperm count doesn’t always come with obvious signs. Most men don’t realize there’s an issue until they start trying (and struggling) to conceive.

But if you know what to look for, your body might be dropping some hints that your sperm production isn’t quite at peak performance.

Here are some possible signs:

Trouble getting pregnant: If you and your partner have been trying for a baby for a year (or six months if she’s over 35) with no luck, low sperm count might be part of the problem. Sure, there are many factors at play in fertility, but if she’s been given the all-clear, it might be time to check on your end.
Low drive: If your interest has dwindled, it could be a sign of low testosterone, which is directly linked to sperm production. Less energy and less drive may unfortunately mean fewer sperm.
Intimacy issues: Speaking of testosterone, if your privates isn’t standing at attention like it used to, it could be a sign of a hormonal imbalance. While ED has many causes—stress, heart health, and even too much time doom scrolling—it can also be linked to low sperm production and lower sperm volume.
Scrotal symptoms: If your boys are aching, swollen, or just feel different, pay attention. A condition called varicocele (swollen veins in the scrotum) is one of the leading causes of low sperm count. It’s like having varicose veins, but in a very inconvenient place. It can mess with blood flow and overheat your privates, which is bad news for sperm.
Reduced facial hair: If you’ve noticed your beard isn’t filling in like it used to, or your body hair is thinning out, it could indicate a hormonal imbalance. Testosterone is responsible for all those manly features—deep voice, muscles, body hair—so when levels are low, you might see changes in appearance along with sperm count.
Testicular changes: Size might not always matter, but in this case, it could be a sign of testicular atrophy (shrinking privates) or hypogonadism, which is sometimes linked to low sperm production. If your privates feel softer or smaller than usual, it could be due to hormonal imbalances, past infections, or even excessive steroid use. Your privates are the sperm factory—if they’re not in top shape, production may be down.

Of course, not every guy with a low sperm count has noticeable symptoms. You could feel perfectly fine, have a healthy drive, and still have sperm levels that are lower than expected.

That’s why if you’re trying to conceive and nothing is happening, getting a semen analysis is the best way to know for sure what’s going on under the hood—which we’ll talk about more below.

How Low Sperm Count Affects Male Fertility

Let’s revisit the birds and bees for a minute. To make a baby, you need a healthy egg and a healthy sperm, and the two need to meet up and mingle.

When conceiving, sperm are like contestants in a brutal survival game—only the strongest make it through the female reproductive tract all the way to the finish line (the egg).

But what happens when there aren’t enough players on the field? That’s where low sperm count comes in, making conception trickier. In fact, low sperm count causing male infertility is very common.

A healthy couple with normal fertility has about a 30 percent chance of conceiving in their first month, but this drops to a five percent chance after a year of consistency. With low sperm count, those odds drop significantly, meaning it could take much longer to get pregnant.

It’s a Numbers Game

If you have fewer sperm in your semen, the odds of one of them successfully reaching and fertilizing an egg drops significantly.

A normal sperm count, per World Health Organization guidelines, is around 15 million or more per milliliter (mL) of semen. However, studies show that anything below 40 million/mL, and your chances of natural conception start to dip. It doesn’t mean pregnancy is impossible, but it might take longer—or require medical assistance.

Slow Swimmers Don’t Win the Race

Next, the ability of your swimmers to, well, swim, matters. If they’re slow, this is called low motility, and it makes reaching the egg even harder.

Poor motility often goes hand-in-hand with low sperm count, making conception even more challenging. In some cases, the sperm may never reach the egg at all.

Morphology Matters

While we embrace our differences, this isn’t necessarily something to celebrate when it comes to sperm.

Not all sperm are built the same, and if too many have weird shapes (aka, abnormal morphology), it can further reduce fertility. Sperm with odd shapes—like double heads, tiny tails, or wonky structures—often struggle to move properly or fail to penetrate the egg.

Even if you have a decent sperm count, a high percentage of morphologically abnormal sperm can make conception difficult.

Diagnosing Low Sperm Count

If you and your partner have been trying for a baby with no success, you might be wondering: Is it me? Is it her? Is it the universe playing a cruel joke?

Before you spiral, let’s talk about how low sperm count is diagnosed. The only way to know for sure is through proper testing, which can be done through one or more of the following methods.

Semen Analysis

If you suspect a low sperm count, the first step is a semen analysis, which involves providing at least one semen sample for microscopic examination.

It will be evaluated for:

Sperm count (are there enough of them?)
Sperm motility (are they moving properly?)
Sperm morphology (do they look normal?)
Semen volume and consistency (is everything within normal parameters?)

For guys who need to know the stats, here are the basic parameters that would indicate normal findings from a semen analysis, according to the World Health Organization:

Sperm concentration of at least 15 million sperm per mL of semen
Total sperm count of 39 million or more
Motility of at least 42 percent of sperm showing some movement, with 30 percent exhibiting progressive motility (swimming forward)
Morphology (shape and structure) should have at least 4 percent normal-looking sperm
Semen volume should be 1.4 mL or more

Hormone Testing

If your hormones are slacking off, sperm count can take a hit. A simple blood test can check the levels of these main hormone players:

Testosterone: Testosterone is essential for sperm production, and low levels can lead to reduced sperm count and poor sperm quality.
FSH (follicle-stimulating hormone): FSH stimulates the testes to produce sperm, so low levels can result in decreased sperm production.
LH (luteinizing hormone): LH regulates testosterone production, and without enough of it, sperm development can be impaired.
Estrogen: High estrogen levels can suppress testosterone and sperm production, leading to lower sperm count.
Prolactin: Elevated prolactin can interfere with testosterone production and reduce sperm count, sometimes causing infertility.

If your hormones are out of whack, the problem might be a hormonal imbalance, which can often be treated.

Scrotal Ultrasound

Sometimes, the issue isn’t in the sperm-making process but in the privates themselves. A scrotal ultrasound helps check for:

Varicocele: Enlarged veins in the privates that overheat sperm, like a sauna your swimmers didn’t ask for and definitely don’t enjoy
Blockages: If sperm are being produced but can’t get out, there may be a blockage in the tubes
Testicular abnormalities: Checking for swelling, masses, or other structural issues

Genetic Testing

If it turns out your sperm count is extremely low (or nonexistent), genetic testing may be recommended to check for conditions like:

Klinefelter syndrome: An extra X chromosome that affects sperm production
Y chromosome microdeletions: Missing genetic material that can impair fertility
Cystic fibrosis gene mutations: Can cause congenital absence of the vas deferens—aka, missing sperm transport tubes

Genetic causes are less common, but when they do occur, they usually require alternative fertility treatments.

Testicular Biopsy

If all other tests come back inconclusive, a testicular biopsy might be done. This involves removing a small tissue sample from the privates to check if sperm production is happening inside the factory or if something is blocking their exit.

We know this doesn’t sound pleasant, and it’s not, but It’s usually only done if sperm retrieval for assisted reproductive technology (like IVF) is being considered.

Low Sperm Count Treatment Options

Sperm production isn’t set in stone, and there are ways to improve it. Depending on the cause, treatment options range from simple lifestyle changes to medical and surgical interventions.

The key is figuring out what’s holding your sperm back and taking action, which is why it’s important to consult your healthcare provider for a comprehensive exam and plan of action.

Lifestyle Adjustments

Before diving into medical treatments, let’s talk about the things you can control—your daily habits. Your lifestyle directly affects sperm production, and making the right changes can lead to noticeable improvements.

Improve your diet: Eat foods rich in zinc, selenium, folate, vitamin C, omega-3s, and antioxidants. This is best done by eating a variety of healthy foods, like nuts, seeds, berries, citrus, leafy greens, legumes, and fatty fish. While you’re at it, ditch the ultra-processed food and sugary beverages—they offer zero health benefits and contribute to lower sperm quality.
Quit risky substances: We’ll keep it simple. Smoking damages sperm DNA and lowers count. Alcohol messes with testosterone levels. Recreational drugs like marijuana and anabolic steroids can tank sperm production.
Target stress and sleep: Chronic stress increases cortisol, which lowers testosterone over time. Poor sleep disrupts hormonal balance, reducing sperm count. Aim for seven to nine hours of sleep per night and find ways to unwind, whether it’s meditation, hitting the batting cages, or listening to calming music.
Stay active, within reason: Regular exercise boosts testosterone and sperm quality. Aim to intentionally move your body on a daily basis, but avoid overtraining as this can have the opposite effect.
Minimize heat exposure: Your privates like to stay cooler than the rest of your body, so give them space. Avoid excess warmth from things like hot tubs and saunas and stick to boxers over briefs.
Consider your medications: This one should be discussed with your healthcare provider first, but if you’ve been taking finasteride for a while, it’s possible that this is playing a role in reduced sperm count. Rest assured, though, that there’s no evidence finasteride causes permanent infertility, and sperm counts often bounce back when you stop using it.

Medical Options

If lifestyle tweaks aren’t cutting it, medical treatments for diagnosed underlying conditions may help improve fertility, such as:

Hormone therapy: If hormone levels are out of whack, medications can stimulate testosterone production and sperm development. Possible treatments include enclomiphene citrate to increase FSH and LH, hCG (human chorionic gonadotropin) injections to stimulate testosterone and sperm production in men with low LH, or aromatase inhibitors (e.g., anastrozole) to lower excess estrogen that might be suppressing testosterone.
Treating infections: If infections (like STIs or prostatitis) are affecting sperm health, antibiotics may help clear them up and restore normal function.
Addressing existing health conditions: If diabetes, thyroid disorders, or autoimmune diseases are affecting sperm count, treating the root condition is important and may improve fertility.

Surgical Interventions

If sperm production is fine but there’s a physical blockage, surgery might be needed to restore fertility. Options might include:

Varicocele repair: This involves tying off or sealing the enlarged testicular veins to improve blood flow, reduce overheating, and improve sperm production and quality—though research on fertility outcomes is mixed.
Vasectomy reversal: If you had a vasectomy and changed your mind, a reversal surgery can restore sperm flow, though “normal” semen analysis parameters are significantly lower in this population.
Sperm retrieval procedures: If sperm are being produced but not expressed, procedures like testicular sperm extraction (TESE) or percutaneous epididymal sperm aspiration (PESA) can retrieve sperm for use in assisted reproduction.

Alternative Options

Maybe the above options aren’t for you, or maybe you’re interested in additional things you can consider to help your swimmers. Here are some alternative support methods when it comes to how to produce more sperm:

Therapy: There are often other men’s intimate health-related issues coexisting with low sperm count—and it’s not uncommon for there to be mental and emotional factors. If you’re also experiencing things like PE, ED, or relationship issues, consider getting counseling or therapy.
Assisted reproductive technologies: If low sperm count is severe or irreversible, you and your partner may want to pursue something like IVF, donor sperm, or intrauterine insemination. Talk to a fertility specialist about your options.
Time: If you struggle with patience, just know that your sperm count isn’t going to immediately bounce back when you implement the changes we’ve talked about. The timeframe of sperm production can be up to a few months, so you might not see any significant increases until then. Consistency is key.