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Sperm count

OUR HEALTH:

Too few, or too slow swimmers can affect pregnancy chances

February 28, 2011|C. Ruth Ebrahim, Our Health Magazine

From Our Health Magazine

Couples striving to become parents look for any explanation as to why pregnancy doesn’t occur.  Standard medical practice requests a couple to try getting pregnant for at least a year by having regular, unprotected sex.  Even that length of time can tax a happy couple who, as Dr. Dennis Garvin of Urologic Surgery in Salem says, have their identity wrapped up in being parents.  As a first step in fertility assistance, primary care doctors routinely ask the male partner to be tested for infertility issues like low sperm count, Dr. Garvin said.  While both partners may receive treatment to boost fertility, and some couples require assisted fertilization to become pregnant, identifying and treating a possible cause of low sperm count is an important, and relatively simple, first step toward becoming parents. 

“Most people who are unable to have a child and are even pursuing fertility assistance, they are committed to the idea of becoming a parent,” Dr. Garvin said.  Any disruption in that pursuit causes emotional strain and difficulty for the couple.  Men have a hard time coping with the fact that they may be unable to impregnate their partner without assistance, according to the local urologist, and some male patients think being diagnosed with a low sperm count speaks against their manhood.  Dr. Garvin said he tells men that there are many factors in a semen analysis and many causes of low sperm count or poor sperm performance.  Treatment options are usually simple and minimally invasive.  Men with fertility issues are most likely able to father children, even if getting their partner pregnant requires more intense fertility assistance.

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The inability to conceive a child is often the only sign or symptom that a man has a low sperm count, which is defined as fewer than 20 million sperm per milliliter of semen.  Normal sperm densities range from 20 million to greater than 100 million sperm per milliliter of semen.  The chance of getting a partner pregnant decrease along with sperm counts.  Other symptoms of low sperm count could include problems with sexual function, pain, swelling or a lump in the testicle area, or decreased facial or body hair or other signs of a chromosome or hormone abnormality. 

Dr. Garvin said he always acquires two semen analyses, before which the patient must abstain from sex or ejaculation for 72 hours.  Sperm count can vary as much as 3-4 million between counts, he explained, and taking two samples allows for a more accurate count.  In addition to looking at the number of sperm present in a patient’s semen count, doctors also analyze the sperm’s morphology, or shape, and motility, or forward-swimming motion.  There are several reasons why a man’s sperm may not be able to reach his partner’s ovary to fertilize an egg, and there are dietary and lifestyle adjustments that can be made to try to correct the identified issue.  For these reasons, Dr. Garvin always recommends a man who is struggling to impregnate his partner get a semen analysis.

“I don’t like the idea about a woman going through a multi-million dollar work up, and then a man says ‘Ok, I’ll get a sperm count,” Dr. Garvin said.  Instead, a sperm count should be one of the first steps in possible fertility assistance for a couple, and the male partner should be prepared for several possibilities. 

The most common causes of low sperm count or low morphology or motility are obesity, over-consumption of soy, overuse of hot tubs or other heat immersion, and presence of varicose veins on the scrotum.  Soy is a phyto-estrogen, Dr. Garvin explained, and overconsumption of any phyto-estrogen can lead to low sperm count.  In regard to heat immersion, exposing the testicles to high temperature levels can decrease sperm production because the making and maturing of sperm require temperatures of lower than normal body temperature, which is why the testicles are located outside of the body.  Other factors that could lead to low sperm count include history of chemotherapy or radiation, presence of infection, or the use of anabolic steroids, marijuana, or tobacco.

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