Oligospermia: Low Sperm Count

An in-depth look at how sperm production is measured, what causes a low sperm count, how many sperm it takes to make a baby and what men can do to improve sperm production.

counting goldfish

The testicle is a high-powered machine that typically cranks out over 1,000 sperm per second. Sometimes, the machinery can get gummed up, slowing down sperm production.. This article explores in-depth how sperm production is measured, what causes a low sperm count, how many sperm it takes to make a baby and what men can do to improve sperm production.

How sperm count is reported on lab results

Lab reports will often report two separate numbers for sperm count. The first is sperm concentration (sometimes called sperm count) and the second is total sperm count. What’s the difference? Sperm concentration is is the number of sperm in each milliliter of semen and the headline result that most people refer to when discussing male fertility, total sperm count refers to the total number of sperm in the entire sample. The amount of semen impacts the total number of sperm cells available in the sample. Calculate total count by multiplying the concentration by the volume. The table below shows a couple of examples:

Sperm Concentration Semen Volume Total Sperm Count
10 Million per mL 2 mL 20 Million
10 Million per mL 5 mL 50 Million

Semen volume is an important parameter to consider when evaluating sperm count. Alone, a sperm concentration of 10M per mL would be considered a “low” sperm count. But if accompanied with a high semen volume, the total sperm count is may not be that low.


How labs measure sperm count

To understand the challenges associated with semen analysis, imagine a 10,000 gallon pool full of thousands goldfish and you wanted to count them. How would you do it? You could stand there and try to count them all. But they are swimming so it’s difficult to keep track of which fish you already counted. You could reach in and scoop out a gallon jug full, count the fish in the jug and then multiply by 10,000 to estimate the total number. What if you scoop out a jug with water but no fish? Obviously there are fish in the pool.

The most widely accepted method for counting sperm is to view a small fraction of a semen sample under a microscope and counting the sperm cells. Special microscope slides called hemocytometers contain a visual grid to make it easier for a technician to count the cells. The grids are cleverly designed to make math simple so a technician can easily calculate how many million cells are in the sample based on how many sperm are in each square and how many squares the technician counts.

Some labs have computer-aided semen analysis (CASA) machines that take a video of sperm cell swimming under the microscope and use analysis software to automatically count and characterize sperm. Various other technologies have been invented to measure sperm count, but no test is perfect. Depending on the method, the technology used, and the skill of the technician there are many sources of error that can occur. The most major sources of error include:

Counting error: Counting errors happen when sperm are moving too much, there are too many cells to easily count, or the technician doesn’t count enough squares to accurately estimate the true sperm count. One way to reduce this error is to de-activate, or “fix”, sperm so they can’t swim, making them easier to count. Increasing the number of grid squares or number of cells counted can also improve accuracy.

Sampling error: Going back to the swimming pool metaphor, imagine all the fish go to the bottom and you take a bucketful from the top. This would not be a good estimation of the true count. Similarly, sperm tend to hang out in clumps due to the viscosity and structure of semen. It is possible for a technician to draw a sample that has an abnormally high or low concentration of sperm. To overcome this challenge, some labs will require extensive sample mixing, or “homogenization”, to even out the distribution. They may also require technicians to draw and count multiple samples from the semen specimen to ensure that the counts are equivalent from sample to sample.

Performing a rigorous semen analysis can be both labor intensive and expensive. Most labs will do an initial analysis with a more relaxed protocol to save time and money. If the results come back low, then some will take additional efforts to ensure accuracy. It is important to recognize that semen analysis – even when performed under careful and well-controlled conditions – can have error of up to 20%. This means that if your sperm count is measured 10 million cells per mL (M/mL), it could really be anywhere from 8 – 12 M/mL. So you need to think of it more as a range rather than an absolute measurement.


Daily Variations in Sperm Count

A man’s sperm count varies greatly from day to day and week to week. In the short run, much of the variability is due to sample collection and handling. In the longer term, variations can be much larger and can be caused by a number of biological and physical events that impact sperm production – such as having a fever, taking a new medication, or changes in diet.

Variations due to sample collection & handling

If you are interested in seeing trends in sperm count over time, you will want to try to be consistent in the way you collect and handle the semen sample for each semen analysis. Here are the major causes of variation due to sample collection & handling.

There are three important factors during sample collection that can impact test results – abstinence period prior to sample collection, excitement level during collection and how much of the sample gets collected.

1. Abstinence: Abstinence greatly impacts sperm count. Sperm stores are depleted with each ejaculation and take about 2 days to refill. As abstinence period increases, sperm slowly build up. If abstinence is greater than 7 days, sperm begin to die and decompose causing the semen sample to be filled with excess cell fragments and other debris. For this reason the WHO recommends an abstinence period of 2 -7 days. When having a repeat semen analysis performed, you can optimize precision by abstaining for the same amount of time for each test.

2. Method of Collection: Your body can tell when it is “the real deal.” The more excited you are during collection, the more sperm are found in the ejaculate. Some studies have found that samples collected at home where the man is more comfortable have had higher values for sperm concentration, total count and motility. Excitement level during collection is obviously difficult to control but it does contribute to variation of semen analysis results and may be worth taking a mental note.

3. Collecting the Sample: Just be sure the entire sample makes it into the cup. The first few drops of the ejaculate contain the majority of the sperm cells, so missing the first drops can cause lower results. Likewise, the latter part of the ejaculate consists primarily of seminal fluid so if that part is not collected, the result can show up as artificially high.

Handling samples after they’ve been collected: When initially collected, semen can be very viscous and technicians may need to wait several minutes before analyzing the sample (the sample will become less viscous over time). However, as a sample sits in the cup cells quickly begin to die and deteriorate. If the sample is not analyzed shortly after collection, sperm motility data (the percentage of sperm cells that swim) drops dramatically and sperm count can decrease as cells break apart.

Because technicians need to know how much time has elapsed from collection until running the analysis, clinics prefer on-site collection. The fresher the sample, the more accurate the results will be. If collection on-site is not possible, it is important to be fastidious about the time of collection. Recording time of collection will help technicians ensure that the sample is processed in an appropriate amount of time.

Variations in sperm count due to lifestyle

Over the longer run, lifestyle or specific life events can cause spikes and dips in sperm count. Some of the biggest culprits include fever or heat exposure, diet, exercise, stress level, toxin exposure and BMI. There are even a number of studies that show sperm counts vary from season to season, probably due to temperature changes. How much can these things impact sperm count? Quite a bit.

This is a chart from the World Health Organization’s manual on laboratory semen analysis. demonstrating the variability in sperm count and sperm concentration in 5 men over the course of a year and a half.

To calculate the average sperm count in men, researchers have conducted large studies of over 1,000 men in a defined geographic region. Some studies further refine the study and recruit certain subgroups of men such as infertile men or recent fathers. Studies found the range of sperm concentrations to be anywhere from 0 to 250 million sperm per milliliter with an average of 60 – 80 million sperm per milliliter. The following graph from a study done in 2012 illustrates the breakdown of sperm counts among young men in Denmark.

The World Health Organization analyzed global data from over 2,000 recent fathers to define semen parameters for fertile men. In this study, the median sperm concentration (50th percentile) was found to be 73 M/ml. They also defined the 5th percentile to be the cut-off for a “normal” sperm concentration, which came out to be 15 M/ml. In other words, 95% of fertile men have a sperm concentration above 15 M/mL. Sperm concentration below the cut-off of 15M/ml does not mean infertility (as the study was done with recent fathers) but it does mean a man falls in the bottom 5% of the normal range.


Global Decline in Sperm Count

Because “normal” sperm counts are defined by gathering data from a large number of men, studies are done periodically to examine differences in semen quality from one country to another, from season to season and decade to decade. These studies help scientists identify trends.

Scientists are usually very careful about not drawing conclusions too quickly, so if you talk to a number of andrologists (scientists who study sperm) you would get a number of very long, nuanced answers, but there are a number of large studies that show sperm counts may be declining worldwide.

Infertility rates have increased the past few decades. Some of this is caused by the trend in developed countries to delay childbearing to later in life, and many experts have begun campaigns to raise education and awareness about the decline in female fertility that begins as early as age 30. As a result more and more women are being proactive to protect future fertility by freezing eggs. However, less publicized is the fact that men contribute to 50% of infertility cases. The global decline in sperm counts is also contributing to the rise in infertility rates worldwide. Sedentary lifestyle, poor diet, increased obesity and toxin exposures are some of the leading suspected offenders currently being studied by researchers.

How many sperm does it take to get pregnant?

The simple, but important answer is 1. So, why do men make so many sperm? From the time a sperm is made, it is constantly in danger of being destroyed. Inside the man’s epididymis, reactive oxygen species attack sperm cells. Once ejaculated in the vaginal tract, sperm are attacked by acidic vaginal fluids and white blood cells. Finding the fallopian tube is like finding a needle in a haystack. Most sperm get lost. Of the millions of sperm released upon ejaculation, only 10-30 make it to the fallopian tube where the egg is released. There, the sperm must survive long enough to meet and fertilize the egg.

Many factors influence a couple’s monthly chance of conception – the woman’s age, the “friendliness” or “hostility” of her vaginal tract, the quality of the semen that transports the sperm and the health of the sperm cells. When optimized, all these factors combined add up to something in the range of a 30-35% chance of conception. As factors become less optimal, the monthly chance of conception goes down to zero.

Sperm count is a factor that impacts the monthly chance of conception. However, it is very hard to precisely correlate sperm count to chances of pregnancy. A man that has a low sperm count with healthy sperm may have a better monthly chance of conceiving than a man who has a higher sperm count but the sperm are unhealthy. Several large scale studies have analyzed the relationship between semen quality and how long it took a couple to get pregnant. One study found that men with healthier sperm had a shorter time to conception. Another study found that the more sperm a man had (up to around 55M/ml) the better his chances of conception.

As sperm concentrations drop below 10 M/ml, odds of natural conception get pretty dicey and most reproductive endocrinologists will recommend some sort of assisted reproduction treatment. Sperm concentrations in the range of 1-10M/ml often have success with cervical cap or intrauterine insemination if there are no female factors present. When the sperm concentration is lower than 1M/ml, doctors will often recommend an in-vitro fertilization procedure called intra-cytoplasmic sperm injection (ICSI) for the highest chances of success. ICSI involves isolating a single sperm cell and carefully injecting it into the woman’s egg.

Causes of Low Sperm Count

Sperm count is not a static number like your height or your shoe size. It is a dynamic indicator of testicular health. Like other aspects of health – blood pressure, cholesterol or blood sugar levels – event shocks like high stress and fever can cause dips in sperm count. Long-term unhealthy lifestyle such as poor diet, smoking and a beer belly can also significantly suppress sperm production.

There are also medical reasons for a low sperm count in otherwise healthy men including the presence of a varicocele (varicose veins in the scrotum), past illnesses or infections, maldescent of testicles during childhood, prior surgeries in the groin (such as hernia repair), hormone imbalances and genetic disorders. Fill out our complete Risk Assessment to get a comprehensive assessment of risk factors that could be impacting your fertility.

Lifestyle: We like to use the acronym SHOT — Stress, Heat, Obesity, Toxins — as a quick way to remember the major lifestyle contributors to low sperm count. Studies have shown these factors can reduce sperm counts all the way to zero in extreme cases.

Varicocele: Varicose veins in the scrotum, known as varicoceles, have been known to impact testosterone and sperm production as well as sperm health (motility, morphology). Varicoceles are relatively common, occurring in about 15% of all men, and impact men differently. Some men can have large varicoceles with little to no impact on fertility, while other men are more sensitive and even small varicoceles can dramatically impact semen parameters. Varicoceles are repairable through surgery; it often takes 6-12 months post-surgery to fully improve fertility.

Genetics: There are a number of genetic disorders that contribute to male infertility. Because the molecular science is still relatively young, new genetic markers for male fertility are still being discovered. The good news is that most genetic causes of infertility are relatively rare. The most common disorders are:

Klinefelter’s Syndrome: Genetic condition in which a man has an extra X chromosome causing him to be XXY rather than the normal XY.

Y chromosome microdeletions: The deletions of genes from the Y chromosome that are responsible for sperm production.

Infection: Viral and bacterial infections – both in childhood and as an adult – can cause scarring on tiny microtubes of the male reproductive tract leading to a partial or complete blockage. Leading offenders include: mumps, tuberculosis, chlamydia, gonorrhea, mycoplasma, urinary tract infections and prostate infections.

Hormone imbalances: Hormones play a critical role in the production and maturation of sperm cells. For reproductive health, the most critical hormones include – Testosterone, Follicle Stimulating Hormone (FSH), and Luteinizing Hormone (LH). Hormonal imbalances can occur for a number of reasons including: impaired testicular function, thyroid disorders, diabetes, pituitary disorders or growths and abuse of androgens for athletic performance.

Tips for Boosting Sperm Count

Even in circumstances in which sperm production is suppressed by a medical condition such as a varicocele or hormone imbalances, lifestyle changes targeted to improve sperm production can dramatically improve sperm count, motility and morphology. It is important to recognize that start to finish it takes about 72 days to make a sperm, so things that you implement today will take a few months to really take effect. Here are some of the top tips:

1. Don’t smoke
2. Watch what you eat
3. Lose weight
4. Pay attention to sources of heat
5. Ice your balls
6. Lift weights
7. Go for a run
8. If you have a desk job, take breaks and walk around
9. Don’t do drugs — this includes mary jane
10. Read up on your meds – some medications can interfere with sperm production
11. Don’t juice (not talking about raw foods here)
12. Limit alcohol
13. Don’t wear tight clothes too many days in a row
14. Meditate, take a run or find some other healthy outlet for stress
15. Have lots of sex (but lay off the lube)
16. Play team sports
17. Don’t watch TV for longer than 1 hour at a time
18. Be careful if biking
19. Take a multivitamin
20. Try acupuncture

Getting Pregnant with a Low Sperm Count

Fertility is a team sport. To understand the best path to pregnancy, you need to consider what’s happening with each partner and if there are any compatibility issues. Sometimes there are very clear issues that can be identified and treated by doctors. Other times, infertility can stem from multiple factors or be unexplained which is damn frustrating. Patience, communication and education can go a long way in helping you figure out the best path forward.

From cheap and non-invasive to expensive and invasive, here are some tools for improving your odds of trying to conceive if your swim team is a little low. Note: taking steps above to improve sperm count will improve your chances of conception even if you decide to pursue IVF or ICSI.

Creating a Sperm Friendly Environment: There are a number of over the counter products available to improve the sperm-friendliness of the female reproductive tract including pre-seed, Astroglide TTC and GoBaby pH.

At-home assisted reproduction: Cervical cap insemination is a technique that has been used by OB-Gyns for decades to increase odds that sperm will make it to the egg. In this technique, sperm are collected into a container that is placed directly on the cervix. This shortens the distance sperm have to swim and reduces the obstacles along the journey. Modern technology makes it possible to bring this proven medical technique into the home. Cervical cap insemination is recommended when total motile sperm count is above 1 million

Intrauterine insemination (IUI): Commonly called IUI, intrauterine insemination is commonly practiced by many OB-Gyns and fertility clinics as a low cost procedure to improve chances of conception when the male partner has a low sperm count. It is recommended when total motile sperm count is above 1 million. The procedure involves producing a semen sample on-site. Healthy sperm cells are “washed” or removed from semen and placed in a nutrient rich solution which is placed into a “straw” and inserted directly into the uterus.

Intra-cytoplasmic sperm injection (ICSI): This is the highest-tech baby-making option. The procedure on the female side is identical to a normal IVF cycle. Medications are administered to hyper-stimulate ovaries and mature eggs are harvested. The semen sample is “washed” and then placed on a special microscope. A single sperm cell is selected and the tail is cut off by a technician. It is then sucked up into a tiny needle and injected directly into the egg which is held in place by a specialized micro-pipette. The process is repeated for each egg harvested. Resulting embyros are then monitored and the top 1 or 2 are selected for implantation. The rest are frozen for future use.

Sara SDx

Sara SDx

Editor of Don't Cook your Balls, Co-Founder of TrakFertility.com, Health Coach and Men's Health Advocate. Passionate about sperm, men's health and helping people build their families.
Sara SDx

Author: Sara SDx

Editor of Don't Cook your Balls, Co-Founder of TrakFertility.com, Health Coach and Men's Health Advocate. Passionate about sperm, men's health and helping people build their families.

318 thoughts on “Oligospermia: Low Sperm Count”

  1. Hello Sara,

    Can you please help me to intrepret these results ?

    Volume= <. 5ml
    Liquifaction time – 30 min
    Viscosity- normal
    Reaction- 7. 4
    Sperm count- <5 Million/ml
    Rapid progressive mobility- 10 %
    Sluggish progressive mobility- 5 %
    No mobility – 85 %
    Pus cells – 6-8/hpf
    Whether being totally uncomfortable and strain affect the results ?

    What would the doctor tell about this results regarding fertility treatment ?

  2. Hi Dr,

    I would like to check on my results. Im 32 Married for 4 years but no kids. Seeking your feedback based on my results.

    Viscosity: Liquify
    Appearance: Transparent
    Volume: 3.2ml
    Sperm Count: 8
    Total Sperm Cout: 26
    Total Motility : 29%
    -head defects 80%
    -tail defects: 5%
    -Cytoplasmic defects: 15%

    Remarks: Debris Heavy and No Droplets

  3. Comment…My results
    Volume 3ml
    morphology 80% normal
    motility 70% actual 10% sluggish 20%
    count 14.0 × 10’6 cells
    ous cell 1-2
    please with this result can I be able to impregnate my wife, she is 31 & I am 36

    1. Count is a little on the low side but sperm look healthy. I can’t tell what the progressive motile or even overall motility number is from the way this is written. My guess is that your chances of natural conception are lower than most but totally possible. Anything you can do to boost numbers even a little should increase your chances and help you conceive more quickly.

      You might want to visit a urologist to see if there are any medical issues that could be contributing. You could also download this app or read this article to learn more about things you can do to boost sperm count.

  4. HI


    VOLUME= 2.0ML
    REACTION PH = 7.5


    ACTIVE = 80%


    NORMAL= 80%

    PUS CELLS 12-15


    1. I think these results could be contributing. You may want to see if there are ways that you can change your life to help improve sperm. Here’s a nice app that is useful to figure out what things you can do. I might also recommend visiting a urologist to get a full evaluation to see if there are other recommendations.

  5. hello Doc
    I am 26 and not drinker nor smoker. My results are

    Volume[ml]: 10
    Conc[10^6/ml]: 4
    Total sperm count 40
    WHO AB :20
    WHO C: 30
    WHO D:50

    Is that a normal result ?

    1. Volume is really high
      Concentration is low
      Total sperm count is on the low side
      Motility is low.
      Overall, I’d like to see the numbers a little higher (except volume)

      You might want to visit a urologist for a full exam. You might also want to take risk assessment or download this app to see if you have any risk factors that might be contributing to lower sperm numbers.

  6. My sperm count is only 4millions. doctor suggested to me for IVF. Now my question for you now should I go for IVF or first need to treatment for low sperm count?

    1. It depends on your partner’s age and your patience. Sperm can take a while to improve and sometimes it doesn’t. If you can figure out the cause if it being low that can really help know if you can improve it. Have you been to a urologist? They can help determine the cause.
      Your count might be high enough (I don’t see all the numbers) for an IUI which is less invasive and expensive. You could do that while trying to improve sperm count.

      You might want to download this app to see if you have any major risk factors that could be contributing to low sperm count. You might also want to start cooling your testicles. I know that sounds like a strange suggestion, but sperm like to be cooler and this can really help some guys improve.

  7. HI i have done sperm a nalysis. MY Results are:
    Sperm volume 1.5ml
    LIquifacation 90 mins
    MOtility 40%
    Motility progressive 20%
    Motility non progressive 20%
    Motility immotile 60%
    Viability 30%
    Sperm count 6m/ml
    PLese suggest if normal pregnancy is possible

  8. My husband had a semen analysis done they told us it looked okay and he was fine but it was at a 0.5 level and they didn’t explain to much to me I’m also having test done and taking meds to jump start my period and make me ovulate? I’m concerned with his levels of 0.5 is that a okay level for being able to conceive?

    1. I’m not sure what 0.5 means. Most numbers that I know of should not be that low. Maybe ask for the full report from the lab and I can help you understand what it means.

  9. […] Sperm Concentration (M/mL) X Sperm Motility (%) X Semen Volume (mL) = Total Motile Sperm Count (M) […]

  10. good day doc,
    i just got mty result now , please advice me
    volume ….3.0m/s
    color …creamy
    morphology….50% normal 50«NORMAL
    motility.. full active 5%, sluggish active 15% immotile80%
    total sperm count…..8million
    other…pus cell (1-2)hpf

    being married for two years, my wife got pregnant 2006, but later got miscarriage.

  11. Hi Doctor,

    Kim here again. Thanks for answer yesterday. The article suggested by you was insightful. Now I have better picture on what to expect while working on improvement.

    I need your views on my numbers shared yesterday. Where do I stand?

  12. Hi Doctor,

    I am 32 years old. 5’11” & 95 Kg. We are trying to conceive for 6 months. My wife is 30 & her reports are normal. I did sperm test recently & results are follows,

    Volume: 2ml
    Color: Greyish White
    Viscosity: Gelatinoius
    pH: 8.0
    Fructose: Positive

    No. of sperms per ml: 16 m/ml
    No. of sperms per ejaculation: 32 million
    Progressive motility: 65%
    No-progressive motility: 15%
    Immotile sperms: 20%

    Total Normal Forms: 64%
    Abnormal head forms: 17%
    Mid-Portion abnormalities: 16%
    Tail abnormalities: 3%

    Epithelial cells/hpf: 0-1/hpf
    Leukocytes/hpf: 0-1
    Red Blood cells: Occasional

    What are our realistic chances with this report? I don’t drink or smoke. With all precautions related to diet. stress & exercise are taken then how much time it should take to improve this no. to say 40-50 m/ml.
    Please guide.

  13. Hello saara

    Need your help

    i m from india
    working in qatar
    I am 31 year old & MY wight is 81kg …i take proper 6 to 7 hrs sleep..exercise daily, no junk, no processed food, eat lots of fruits and i eat home made food in my home

    4 months before i got marriage. i m doing daily intercourse with my wife,

    i discus with one doctor he told me low sperm only 1m volume
    Volume –1 ml
    MOTILE 60%
    ABNORMAL 30%

    1. Low volume can be caused by frequent sex. Did you abstain for at least 2 days when you took this test?
      Overall, your health and sperm look ok from what I can tell. Being apart from your wife for long periods can make it difficult to conceive.
      You may try having sex every other day rather than every day. (But if you want to every day, I think it is ok)

  14. I hav volume 3.0
    Ph alkaline
    Total sperm count 30
    Motalily 55
    Grade I 20
    Grade II 10
    Grade III 10
    Grade IV 15
    Morphology normal

  15. Hello saara

    Need your help in knowing what’s our chances of conceiving.
    I am 31 year old & a moderate smoker…i take proper 7 hrs sleep..exercise daily, no junk, no processed food, eat lots of salad twice a day…drink beer on weekends… Below is my ASA & recent blood test report.

    Abstinence – 4 days
    Volume – 3 ml
    Liquefaction – 30 min
    PH – 8
    Sperm Concentration – 38 mill / ml
    Total ejaculate – 114 million
    Total motility – 25% (with Rapid progressive – 0% & Slow progressive – 20%)
    Normal Forms – 3%

    FSH – 9.1
    LH – 9.5

    We are married for 2 yrs, wife’s reports have come out normal. We just started trying for baby, until now we used protection.

    Need your help to know, chances given my report..


    1. Given this, I would recommend cutting back on cigarettes (or quitting entirely if that’s possible) and increasing antioxidants (some good foods to include are spinach, peppers, lentils, citrus, berries, avocados). I would also limit weekend drinking to just a couple. A general good gauge is how drunk you get. A slight buzz is ok, impairment shows that the liver is overworking. Alcohol can prevent the break down of key nutrients needed for DNA replication which in turn can lower sperm production / cause sperm defects. It can also have an impact on testosterone production. Smoking can cause a specific sperm defect that slows sperm movement. Antioxidants can help repair sperm defects more quickly.

      I helped make an app that has a really good list of superfoods and other things you can do to improve sperm health. There’s also a ton of specific information if you fill out the questionaire about your lifestyle that can give you specific guidance on how to improve numbers.

      Numbers to aim for
      Sperm concentration above 60 million
      Motility 50% (rapid greater than 20%)
      Morphology: greater than 10%

      Overall, I think you should be able to conceive but it could take a bit of time…making these changes should speed up the process.

      Is that helpful?

  16. Hi Sara, Could please help me..I am 31 & below are my test results..
    Sperm Conc – 38 mill/ml
    Total ejaculate – 114 million
    Motility – Total progre (a) – 20% & (b) – 5%, Immotile – 75%
    Rapid progressive – 0%, Slow progressive – 20%
    Morphology – Normal- 3%, Overall defects – 97%

    Does above indicates any concern

    1. Its a borderline result. You should be able to conceive, but it may take a bit of extra time. Are you currently trying? How long?
      It looks like a case that you might benefit from some lifestyle changes to help boost things a little (you may also want to get checked for varicocele).
      Here’s an app that can help you figure out what to do to improve results.

  17. hi sara
    will you help me out. I am 31 yrs old and got married for 4 yrs.i hade surgery before 5 years which is on my left scrotum scrotum cyst after it removed my two balls are not balanced .and i saw same linkage some times
    I have had a Semen Analysis done. The results are as given below :
    colur ——whitish
    coagulation and liquification —–20
    volume ————————————6.2
    motility with in 60′ ——————nill
    semen count———————-nil
    Remark===Normally sperm are pear shapedheads with long and single tail.
    comment —Few pus cells seen

    1. The surgery may have caused a blockage which is preventing the sperm from coming out of the body. I would recommend that you visit a urologist (maybe the doctor who did the surgery) to discuss what can be done.

  18. HI Sara !
    We married 3 years ago. Now we want a baby. Please give us suggestion. My semen test analysis is given under
    Day of absentia 1 day
    total count 45 millions
    Active motile 55%
    sluggish motile 15%
    Dead 30%

  19. Hi Sara, will you help me out… I am 32 yrs old my wife and I have just begun trying to get pregnant, i had a Semen Analysis donde because I had an orchidectomy 7 years ago. The results are as given below :

    Abstinentia : 6 days
    Volume : 2.8 ml
    pH : 7.9
    Sperm Count: 11×10^6
    Total Sperm Count : 31×10^6
    Grade A motility: 5%
    Grade B motility: 51%
    Grade C motility: 8%
    Grade D motility: 36%
    Leucocytes : <1×10^6
    Normal Sperm Morphologic : 33%
    agglutination : absent

    I am a casual smoker no more than to packs a month, 6'1" and 242 Lbs. Could you please let me know if I have the chances of becoming father? or what to do?

    Thanks in advance.

    1. You have a chance, but your sperm is a little on the low side. I would recommend that you quit smoking. That should help improve your sperm in lots of ways. You may want to download this app to see if there are other things you can do to improve. If you can boost your sperm even a little bit you should be able to conceive naturally. If it stays this low or goes lower you will probably need fertility treatments which can be uncomfortable and very expensive.

  20. Hi Doctor
    My husband’s semen analysis report came yesterday and it says

    PH 8
    Vitality 52%
    Volume 3.8
    Count 18.8 million/ml
    Motile 1.3 million/ml
    Total motile 4.9 millions
    Motility 7%
    Progressive (A+B) 3%
    Non progressive (C) 4%
    Immotile (D) 93%

    What are the chances of having a baby according to this report results?

    1. There are chances of having a baby but it could take a while. His sperm count and motility are both lower than they should be. They are not infertile range but more swimming sperm would increase your chances each month.

      You might want to fill out this risk questionnaire and see if there are things he can do to improve his sperm.

  21. I am about 73kgs and try to maintain an active lifestyle and do no smoke or drink alcohol . Me and my wife have been trying for the past 1 year and we conceived normally 2 times but had mc both times at around 8-9 weeks. We got a bunch of tests but including detailed physical and thyroid profile, so far we have not found anything abnormal. I also had a semen analysis done and the results were shocking based on my interpretation. Can you provide your thoughts? Could the semen analysis be off?

    TOTAL SPERM COUNT : 7.0 million (total volume 2ml)

    Abstinentia : 13 days
    Volume : 2 ml
    Appearance : MUSTY
    Liquefaction : 25 mins
    Viscosity : VISCOUS
    pH : 8.0
    Odour- MUSTY
    Progressive Motility (PR) : 25%
    SLUGGISH Motility : 15%
    NON Mtality : 60%
    Total Sperm Count : 7 Ml/ml
    Sperm Concentration : 7 M/ml

    in advance

    1. It could be off. It would be unlikely that you would have conceived twice with these numbers.

      I have seen situations where technicians have miscounted and results were half of what they should have been. I would recommend a second analysis at a different clinic if that is possible — to confirm.

      I would also recommend taking our risk assessment to see if there are other factors that could be contributing to low count. Sperm can contribute to miscarriage. You may want to think about your diet and increase the amount of fruit and vegetables that you eat or consider taking a multivitamin to make sure you are getting all the necessary nutrients (particularly folate / folic acid)

  22. Comment…nenye ,pls this is my husband test
    appearance. greyish white
    volume. 3ml
    viscosity. moderate
    motility. 40% sluggish
    non motile. 60%
    morphology. 16 abnormal
    pus. cell+ ,RBC +
    sperm count 23*10 sperm cels/ml
    yielded a significant of stafloccocus urea.
    please what will we do? thanks

    1. I would recommend talking to the doctor about possible infection. You should get it treated, then repeat the semen analysis in a few months.

  23. Hi
    I’m a 33 year old diagnosed as severe OAT ,i did some investigations like hormonal analysis,chromosomal analysis and scrotal ultrasound
    All is good except the scrotal ultrasound which showed bilateral varicoccele (grade 3 at the left side and 2 at the right side)
    My question is “can such varicoccele lead to SEVERE OAT”?? And am I going to benefit from doing varicoccele surgery?
    My SFA was less than a million total count (0.2 million/ml)
    Thank you

  24. PLEASE HELP. Just received these results on Friday. They are obviously horrible. Unfortunately everywhere is closed and I can get any information. Most devastating weekend of my life. I know that natural is not an option. But will IUI be?

    concentration: 3 (volume 3)
    Total motility: 23%
    progressive motility: 6%
    total sperm count 9.0
    total motile count: 2.1
    Ph: 7.4
    color: gray opalescent

    1. I wanted to give you some encouragement. This is a low, but IUI could be an option.

      It may also be possible to increase. Have you taken our risk assessment? I’m happy to help you put together a plan.

  25. Hi doctor
    Am a young man from Cameroon age 31 and i have low sperm count and i did a sperm test which the result says my case is Azoospermia,please doctor i need advice from you.

  26. My husband’s first 2 semen test result was nill. .in 3rd test <8000 total sperm he has . . He's 31 nd am 28. . Is there any chance to improve his sperm count?? First two times he took semen sample at hospital fully stressed, erection happened after a longg try . . Third semen sample was taken at home bt tat time also fully stressed nd erection problem. . We are totally confused tat choose ivf or wait few more months to improve his sperm count. . His Doppler study nd FSH , physical examination and few more test reports were very normal. .

  27. Hello, Sara! Below is the my husband’s semen analysis, I tried to do my best in translating it:

    Abstinence 4 days
    Volume 5 ml
    pH 8
    Liquefaction 30 min
    Appearence Opalescent
    Motility 20 %
    Sperm count / ml 1.2 mil./mL
    Germinal cells 2 per 100 sperm
    Leukocytes rare 2-3
    Normal morphology 60 %
    Abnormal morphology 40 %
    Conclusion Oligospermia

    Pretty bad, right? We are planning to repeat the test in a couple of weeks and go to an urologist with both results. Until then, could you give me a piece of advice? If the results will be the same, what are our chances of conceiving naturally?
    Thank you in advance!!!

    1. It’s not hopeless, but chances of natural conception are pretty low unless you are able to get to the bottom of this and find a way to improve the numbers.

      I have a few recommendations to help empower both of you to figure out the best foot forward.

      1. Be prepared to get the most out of the urology appointment. Here’s a guide to what you should expect and I would make sure that you get a good evaluation.
      2. Take time to fill out this fertility questionnaire. It should bring up any potential risk factors that you will want to discuss with the doctor during your appointment.
      3. In the meantime, there are lots of things you can try to do that won’t hurt and could possibly help. Here’s a good starting list of my top 20 recommendations. In cases like yours, my top recommendations include getting a pair of snowballs (or using a pack of peas to cool things down there) and looking into a multivitamin or supplement.

      Hopefully these things help you feel some empowerment and can help you move forward. I am happy to talk through the risk report if you have any questions or provide commentary after your visit with the doc to help you understand / think things through.

      Blessings to you both. Here any time you need a sounding board.

      1. Hi, Sara. In the months that have passed my husband took quite a few supplements. We didn’t improve anything else in his lifestyle because he already had quite healthy habits. We took the fertility questionnaire and he doesn’t have any risk factors. We didn’t go to the doctor just yet, because my husband is quite reluctant. We also didn’t repeat the SA sooner, as I first said, because I wanted for a full sperm cycle to pass.
        He did another SA this week we got great results:concentration 84 mil./mL, motility: 50%, normal morphology: 75%. I also asked for a sperm culture, just in case, and everything came back normal.
        What do you think? I can’t believe there could have been such a huge improvement, maybe one SA is wrong? We did them at different labs.
        Needless to say I haven’t gotten pregnant in these couple of months.

        1. Holy moly! That’s a big improvement. Perhaps there was a heat exposure, fever or something else that temporarily suppressed his sperm production.

          Semen analysis can be a bit inaccurate depending on who is doing it but I wouldn’t expect it to be THAT wrong.

          It’s possible that he was missing a key nutrient and the supplements are really helping. I would keep doing what you are doing… and if you don’t get pregnant, test again in a month or two to see that it is staying high. Some guys have pretty temperamental sperm and are very sensitive to even small changes in lifestyle. I don’t often see changes that big but anything is possible.

          If you are in the US, I totally recommend that you consider tracking sperm at home with this home tracker. Testing regularly might give you more insight as to what is going on.

          Please keep me posted. I’d love to learn more.

          1. There wasn’t anything like heat exposure, illness or fever. The only thing that was different the first time, except for the supplements, was the fact that we didn’t BD very often prior to the SA, because we were TTA and were always a bit stressed about messing up. I was aiming for a full year at my current workplace (because of the legal stuff in getting a maternity leave in our country), so getting pregnant was a big no-no. We we’re BD 3 times/month on average, and now it’s more like 7-8 times/month. I was thinking that maybe not getting enough action could hurt the swimmers?
            We don’t have access to the home tracker where I live and doing the SAs at the lab is quite expensive. In addition, the lab program overlaps my husband’s work schedule, so it’s pretty difficult to get it done. Right now we decided to just keep tracking my cycles so we fully hit my fertile window and see what haappens over the next few months.

          2. OK, well I would keep on the supplements because it seems to be helping.

            I would also recommend trying to BD 2-3 times a week if possible.

            I’ll keep my fingers crossed. Please let me know if you get good news. Happy to answer any other questions if they come up.

  28. I am about 210lbs and try to maintain an active lifestyle and do no smoke or drink alcohol . Me and my wife have been trying for the past 1 year and we conceived normally 2 times but had mc both times at around 8-9 weeks. We got a bunch of tests but including detailed physical and thyroid profile, so far we have not found anything abnormal. I also had a semen analysis done and the results were shocking based on my interpretation. Can you provide your thoughts? Could the semen analysis be off?

    TOTAL SPERM COUNT : 2.5 million (total volume 2ml)

    NON MOTILE :70 %

    NORMAL FORMS :80 %

    Thanks in advance,

    1. I feel like this might be off or unusually low for you. If you were able to conceive twice, I feel like your semen analysis results should be a bit higher. This result suggests very low chances of conceiving naturally. It is possible that your sperm count declined over the past few months due to something like a fever or exposure to something but it gives me pause… I would re-test.

      Did your physical reveal anything?
      Did you get hormone measures – Testosterone, FSH, LH?

  29. Hi Dr,

    Below are my SA:

    Volume : 2.0 ml
    Colour : Greyish white
    Viscosity :Viscous VISCOUS
    Reaction : Alkaline

    TOTAL SPERM COUNT : 2.0 : 20-120 millions/ml

    NON MOTILE :45 %

    NORMAL FORMS :40 %

    Pus Cells: 1-2/hpf
    Epithelial Cells: NIL
    RBC: NIL
    Fructose :PRESENT

    I don’t smoke, don’t drink. I do Walking /Jog 5 KMs every day.
    My height is 5’11 and I weigh 94 Kgs but not obese I am fit.
    My food habits a are not that great.However I’ve been eating lot of veggies and fruits for last 20 days.
    I was 6 Days abstain before taking this test, I took the fertility questionnaire and found only BPI risk which 30 for my Height
    I was diagnosed with Dengue about 15 months ago.
    I want stay positive and don’t want to disappoint my wife.

    Need your valuable suggestion’s and advise.
    Thanks in advance,

    1. Dengue could do some damage. I would have expected it to clear by now but depending on how bad it was, you may still see some impact.

      I would recommend going to urologist or endocrinologist and getting blood work done for hormone levels, physical exam for varicocele and genetic screen.

      2 is low enough that I would want to rule out medical issues especially since you seem in relatively good shape.

      Don’t get discouraged. Focus your energy on getting a good answer for why it might be low.

      You might try cooling cause it wouldn’t hurt and might help.

      I’m here to help. Keep me posted. You’re doing exactly what your wife needs ?

  30. Hello Sara, this is my report. Can you please comment how to improve it.

    Volume : 1.5
    Consistency : gelatinous
    Color : white gray
    Liquefaction : time >60 mins
    Sperm count : 13 mil/mL
    Sperm motility : 40 %
    Active Grade : 3- Fast but undirected movement
    Morphology : 28%
    Plus cells : 1-2 /HPF

    Pathologist comment :

    Liquefaction time are consistent with Oligo-asthenozoospermia. Disturbed sperm motility pattern. Many sperms with multiple cervical & cephalic abnormalities seen.

    1. It’s a little lower than i like to see. Ideally you want to have a count in above 50mil/ml

      Have you taken our fertility quiz to see what your risk factors are?

  31. I did my semen analysis done today, below are the test results.
    I do a brisk walking 4 times a week say about 5 KMs each time, I used to smoke heavily but now stopped since a year.
    We are trying for a baby for 6 months now but no positive results. Hence decided to do a semen analysis and I am very disappointed and going into depression.

    My results:

    Volume 2.0 ml
    Liquefaction Time > 3hrs
    Viscosity :Increased
    Reaction: Alkaline
    Fructose :Present
    Sperm Count 1.3 millions / ml
    Rapid Progressive Motility 10%
    Sluggish Motility 20%
    Non Motility 70%
    Normal Forms 60%
    Abnormal Forms 40%
    Pus Cells 2 – 3 /hpf
    Epithelial Cells Nil /hpf
    RBCs Nil /hpf
    Advised : Repeat analysis after 3 – 4 weeks with proper precaution.

    Please advise me. How to improve my counts to become a father

  32. Abstinence – 3 days
    Quantity – 3 ml
    Color – Straw
    Liquification time – 30 mins
    Viscosity – Viscous
    pH – alkaline
    Sperm Count – 40 millions/ml
    Rapid Progressive motility – 30%
    Slow Progressive motility – 50%
    Non Motile – 20%
    Pus Cells – 1-2/HPF
    Can you please let me know my chances of becoming father ?

  33. Hi Sara, will you help me out… I am 31 yrs old and got married for 4 yrs.
    I have had a Semen Analysis done. The results are as given below :

    Abstinentia : 4 days
    Volume : 3.5 ml
    Appearance : White
    Liquefaction : 15 mins
    Viscosity : Normal
    pH : 8.0
    Progressive Motility (PR) : 53%
    Non Progressive Motility : 11%
    Immotile : 36%
    Total Sperm Count : 2.1 M/ejaculation
    Sperm Concentration : 0,6 M/ml
    Leucocytes : 20.000/ml
    Normal Sperm Morphologic : 9% (WHO 2010 >4%)
    agglutination : absent
    Aggregation : Absent

    I am not a smoker, not overweight and not a drinker but little time to rest (4 hrs/day). we have intercourse only 3-5 times/mo. My wife doesn’t have any medical issues.
    Could you please let me know if I have the chances of becoming father? or what to do?

    Thanks a ton in advance.

    1. A couple of things to note.

      The sperm count is low. It will be difficult to get pregnant without a doctor with a sperm count this low. 4 hours is very little sleep. It may be that your body is not having enough time to recover. However, because it is so low, I think there might be something else going on. I would recommend going to a urologist for a full evaluation.

      If you are able to get your sperm count higher, the next thing you will need to do is have intercourse more frequently. You should at least have it once a week. And better if you can do it 2-3 times a week.

      At the moment, the sperm count is a bigger issue and you should see if you can figure out what is causing it to be low.

  34. Hi Sara,
    Please if you can review below report and advise accordingly.
    Is there any simple way to get more active sperms?
    is 35% really low active sperm?
    2 years before there was 60% active sperm and now they are 35%

    Volume: 4.5 ml
    PH: 8.0
    Liquefaction Time: 25 minutes
    Total sperm count :75 /ml
    Active: 35%
    Sluggish: 40%
    Dead: 25%
    Pus cells: 4-5 /H P F
    RBC: 0-1 / HPF
    Epi: cells NIL
    Clumps: NIL

    1. Sperm count and motility can change as your life changes. The healthier you are, the healthier your sperm are likely to be.
      Overall, this looks like a pretty good result and I wouldn’t be too worried about your ability to become a dad. But if you want to improve activity, you can eat healthier, exercise more, avoid alcohol, get good sleep, avoid heat and cigarettes. Does that help?

      1. thank you so much for your comment and it really helped. we are trying for baby since 3 years. having 2 miscarriages at early stage and later no success on positive result. doctor advised me to take COQ Forte capsule for 2 months? will it help to increase to motality?
        do you have any further advise what shall we do
        Thank you.

  35. Good afternoon Sara..!!

    Physical Exam –
    Duration of abstinence : 4 days
    Seman Qty: 3 ml
    Colour : White
    Liquification : 60 Minutes
    Appearance : Viscid opaque
    Viscosity : Slight
    pH : 7.5

    Microscopic Exam –
    Total Sperm concentration : 70 million/ml
    Percentage Motility : 60%
    Progressive motile : 50%
    Non progressive motile : 10%
    Immotile : 40%
    Agglutination : Negative
    Pus cells : 2-3
    RBC : 1-2
    Ephithelial cells : Few

    Morphology –
    Normal morphology: 70%
    Abnormal morphology: 30%

    Chemical Exam –
    Semen Fructose Qualitative : Positive

    Could you please let me know if I have the chances of becoming father? and also your some expert comment on report..!!

    Thanks a ton in advance..!!

  36. Hi Sarah, I guess you will help me out… I got married before 3 yrs and I’m 31 yrs old. I recently took semen test wr I got d results as follows : count 7m, motility active- 20%, non-motile 65%, sluggish-25%, color-grey white, volume-20ml, reaction-alcaline, time-more than 70 mins, viscocity-normal, morphology- 79% normal,vpink head-09% giant head-08%, tail defect-04%. Kindly reply with ur feedback n help me to overcome d defects

    1. Was the volume 2.0 ml or 20mL?

      7M is a low result but not impossibly low. My guess is that the volume was around 2ml which would be normal. If it really was 20 ml then that would be a abnormally high amount.

      Defects aren’t too bad. All semen samples have some defects and actually yours seems to be on the healthy side in this regard.

      I would focus on trying to improve sperm count and motility. A good starting point would be this questionnaire or this app.

      Happy to answer additional questions or help you out any way I can.

  37. (Sorry for my bad english) I use to shoot a lot of sperm earlier but it is decreasing (i masturbate everyday) I mean the amount of sperm is very low now. I recently masturbuted and a few drops of sperm came out. Is it a matter of concern?

  38. Dear doc. Sarah
    I have been masturbating since 14 years of age not frequently but approx 10-15 times per month,as now I am going to be 19 years old,I surely want to quit this habit of chronic masturbation(according to me),I tried after each ejaculation that I won’t do it but again after 5-10 days I break my vow.This has been happening over past 6 years.I really want to quit as I found some side effects like eye floaters,low back pain,drop in memory quotient,etc.
    Pls help me to get rid of this hazard I don’t find it useful n Doc. One more question,How long will it take to heal my body n restore the optimum amount of sperm count as in my case n can I be able to become father?
    Also,Insist me on my diet or what supplements should I need to intake,I had consumed vitE n some multivitamins in past
    Please please Help me out.
    I will be highly obliged to you for this. Thanks in advance

    1. You should be ok to become a father someday. If you want to know for sure, you can take a semen test.

      About the masturbation. My best advice is to try to be active and try not to worry about it too much. If it happens just don’t worry. Instead, spend your time finding ways to advance your life – career, exercise, friends, girls, etc the things that will get you closer to one day having your own family. You will find that you are so busy that you will completely forget about masturbation. Does that help you?

  39. My husband had a vasectomy about 5 years ago and we never went back for a seamen test. Recently I had a positive pregnancy test but bleed that night. We are getting tested this Friday as we are confused to what is going on. My doctor believes I had a chemical pregnancy. What are the chances he actually have good sperm?

    1. Chances of a natural reversal is about 1 in 1,000. 5 years of unprotected sex without getting pregnant is a long time…Its a long shot but pregnancy tests don’t usually lie. I would probably have him go in for a test.

  40. Kindly advise on which of these two SA is more likely to result in conception from a clinical standpoint.
    1). A man who has a sperm count of 50 million/mil and a volume of 3 mils

    2). A mail how has a sperm count of 33 million/mil and a volume of 5 mils.

    Assuming Motility and mophology are almost the same

  41. Hello,

    Please what is the way out I have a son is just 4 yrs old my self and my wife have been having sex since last year buy yet no sign of concieve she do see her
    monthly cycle but meanwhile we were asked to go for lab test whic i was asked to bring my sperm for observation only to find out my spern count is low that i will not be able to pregnant a woman am relly confused how can please advice me on way forward.and the kindl of drugs to take.

  42. I had an SA 5 years ago and my numbers were: vol: 5, count: 31.5million/mil, motility: 75% fully active, 10 slightly active, 15 dead. Ever since then i have gotten more physically active. i excercise for 30 minutes atleast 4 times in a week and i have never had at case of illness (not even maleria) since then. i also feed well. now i have made two attempts to conciev with my wife without any success. We have sex once every other day (both on her fertile days). She’s begining to get worried. Please what other plan can we make to increase her chance of conception.

    1. you’ve tried for 2 months?

      Your old numbers are a little on the low side but not very concerning. Especially since you are living well now. I would recommend continue trying. If you are concerned, you could get a new semen analysis to see where you are at currently.

  43. hi sara,
    I got my 2nd test done today (but at a different lab), this ones results were better but not great
    volume 1.5ml (last time 2ml)
    ph 7.5 (last time 8)
    concentration 15mill/ml (last time 3)
    motility 70% progressive 55% (last time 40 & 30)
    morphology 65% (no result)
    pus cells 2/3 (last time nil)

    Over last couple of months I have taken fertilaid (they have fertilaid +count boost+ motility boost) twice a day
    did try some goji berries also for about a month
    avoided coffee/hot showers

    should I test myself for a 3rd time in a week or so just to check if there is actual improvement or just testing error

    it has now been 6/7 months for me & my wife for trying for a baby with no success (i am 30 wife is 29)
    also what other medication/lifestyle changes would you recommend


    1. This looks like a pretty good improvement. I would be quite encouraged by it. Sperm count can take a while to increase so continuing on like you have — eating well, avoiding heat, is a good plan. You’ve boosted into the range where natural conception is a possibility. As your count increases, so does your chances but these as significantly better numbers.

      with a reduced sperm count it can take a little longer to conceive — at the moment, you haven’t been trying so long that I would jump to something more invasive – especially since you’ve seen improvement.

      Semen analysis does have a pretty wide range of error so you are right to be a little cautious. But, wins are wins.. its enough of a jump that I would think that there are real improvements here.

      My recommendation — keep trying to conceive and doing all the stuff you are doing to improve your health / fertility. Then test again in a couple of months if you still haven’t conceived.

  44. Hello Sara,

    Seman Qty: 3.5ml
    Colour : greyish white
    Liquification : 1hr
    Reaction : Alkaline

    Total Sperm Count : 18M/ml

    Normal morphology: 70%
    Abnormal morphology: 30%

    Active motile : 70 %
    Sluggishly motile: 20%
    Dead : 10 %

    pus cells: 10-12 /hpf
    epithelial cell : 6-8/hpf
    RBC : Nil

    Could you please let me know if I have the chances of becoming father?

    Thanks a ton in advance!

    1. You definitely have chances to become a father. Your count is a little lower than I like to see but definitely in the fertile range. Are you trying to conceive right now?

      1. Hi Sara,

        Thanks for the reply.
        Nope, I am still a bachelor(29). I have Unilateral Undescended Testicle. Hence, I went for SA to see if I can still become a father. Could you please let me know if there are any safe ways to increase Sperm Count to normal range?

        Thanks a ton again!

  45. Hi Sara, I’ve been masturbating ever since I was 14, now I’m 22. I tend to over masturbate sometimes and I sometimes use hair creams and body creams during masturbation. What effect do u think the use of the hair/body creams can have on my sperm count level. I’m still single. Pls advise

    1. These things should not have too much impact on sperm. Depends particularly on what you are using. But if it is a lotion meant to go on the body, it should be fine.

  46. Hi Sara,
    thank you for the important advice. I am not exposed to high temp, usually a desk job for me. I try to move every now & then. does fertil man tablets help in this condition? my partner is also have an issue regarding thyroid labels.

  47. helo! married for 5yrs we r not able to conceive. now I’m 38 n my wife 37 age.we r woried. i have low sperm count. i smoke, drink cnt help smoking. before marriage we abort 2 times plz help

    1. Smoking can be a big issue. How low is your count?
      At this point age could be a factor as well. Has your wife been tested for egg reserve and quality?

  48. hi sara, i am a 31 yr old married guy.my lifestyle is healthy. we were trying for baby so i did semen analysis. count is 10 mil/ml. i m worried. pls advise.

      1. vol 1.5 ml, highly motile 50%, weakly 20%, non 30%. trying for 14-15 months. no hormone tests so far.

        1. hmm. I would definitely fill out the questionaire to see if you have any risks. The count is too high to be most of the normal medical causes (genetics, hormones, etc) 14 months is a while to be trying but these parameters would explain it.

          Good news is that men have conceived naturally with sperm counts in this range. Monthly chances are on the low side so if there are things we can come up with to improve sperm count your chances would go up.

          Are you exposed to high temperatures? Do you go long periods of sitting?

          Some things to consider — make sure you get enough vitamins and antioxidants every day. Eating veggies with every meal or taking a multivitamin is a good way to do this (sometimes I recommend a pre-natal vitamin because they contain a lot of nutrients that are particularly helpful for sperm), I would also consider testicular cooling — a bag of peas or for more comfort I recommend snowballs — http://www.dontcookyourballs.com/portfolio-items/snowballs

          You could also download the Trak app — I helped to develop it with a bunch of urologists to create personalized fertility improvement plans, It could help you identify if there are things you could be working on.


          Here’s another quick list of different things that you could try: http://www.dontcookyourballs.com/20-simple-ways-to-improve-sperm-count

          1. Hi Sara,
            thank you for the important advice. I am not exposed to high temp, usually a desk job for me. I try to move every now & then. does fertil man tablets help in this condition? my partner is also have an issue regarding thyroid labels.

  49. Hello dr. I am 24. I have been masturbating since 14, and I’ve been doing it 6-7 times a day. Two years back my penis started bending and the size seemed reduced as well. but I ignored n now two months back i got my semen test d

    And this was the result.

    Count:15 million
    Active 20%
    Puscell: 2-4

    Can you please help.

    1. Bending penis doesn’t impact sperm. But it can become uncomfortable. It is fairly common. If it gets worse, there are some things that doctors can do.

      How long did you abstain from ejaculating when you took this test?
      Are you currently trying for a baby?

      1. I ejaculated almost 1 day before d test
        No I am not trying for a baby yet. I just want to know how bad is my condition and what should I do to improve it.
        Thanks in advance

        1. It could be a little low because you had ejaculated recently. This can cause a temporary drop in sperm count. Typically, it is best to abstain from ejaculation for at least 2 days to get a good idea of your baseline sperm count.

          The best way to find out how to improve is to fill out this form — it can give you good advice: http://www.dontcookyourballs.com/risk
          or you can download this app: https://play.google.com/store/apps/details?id=com.sandstonediagnostics.v2.trak

    1. there are some links. In general, cardiac health impacts sperm health in a variety of ways. Erection is directly linked to cardio health. Also, certain blood pressure medications can impact sperm.

      Are you worried?

  50. Hi Sara, i had a semen analysis and this is the result. vol 5ml, sperm conc. 31.5million per mil, motility 75% fully active, 10% slugish, 15% dead. is this value okay to make me conceive in one attempt?

    1. Conception is like flipping a coin. It may happen or it may not.

      The more sperm you have, the more you have a chance of conceiving. But also, your chances for conceiving in one attempt depend on when during the month you made he attempt. Women are only fertile for a few days during their cycle. If you are with a woman during this time, the chances of making a baby go up a lot.

      Your numbers are good enough to make a baby. but chances are it will take more than 1 time to make it happen.

  51. I recently had a semen test & the report is as follows, could you please suggest & tell what are my chances of being a father?

    Colour: Greyish White
    Appearance: Opaque
    Odour: Musty
    Reaction: Alkaline
    Volume: 1.8 ml
    Liquefaction: within 30 mins.
    Sperm Count: 12 millions/m

    Sperm Morphology: 55% normal forms
    Others: Pus cells (2-3/hpf)
    Fructose: Positive

    *Progressive forward motility with no tail movements seen


    1. Your chances of fatherhood are pretty good 🙂 That said, there are a few issues on this report.

      The count is a little lower than I like to see. I’m not sure what the motility note is — did they give you a motility number? Were none of them swimming?
      Are you currently trying to conceive? If so, how long?
      Have you taken our fertility questionnaire? If so, what risks did it list?

  52. Hello Sara,
    I went through semen specimen.
    Age of specimen – fresh
    volume – 3 ml
    viscosity normal
    reaction alkaline
    liquification time – 25 mins
    actively motile- 20%
    sluggish – 15%
    non motile- 65%
    normal spermoatozoa- 90%
    Rbc- Nil
    Pus cels 1-2
    casts -nil
    spermatozoa count – 25 million

    can you help me in that. will my wife concieve a baby. or I need doctors advice in that. I am very stressed. Please help me the with the best solution

    1. Trying to have a baby can be stressful. How long have you been trying?

      Overall, these numbers look pretty good. Your total count is 75 million. You have 15 million fast swimmers. In general, you need to have more than 5 million fast swimmers to have a good chance of conceiving naturally. But your chances increase the more you have. It is a good goal to try to have more than 20 million — so at 15, you are close.

      Have you taken our fertility questionnaire? You can also try this app to take some steps to try to boost your count.

  53. hi doctor, i have semen analysis,
    sperm count 16 million per ml
    actively motile 40%
    sluggishly motile 40 %
    non motile 20%

    abnormal forms10%
    pus cells 1-2 hpf
    red cells absent
    autoaggiutination absent
    impressions mild oligospermia

    can my wife concive, please help me.
    i have under treatment of fortege tablets. and multivitamin and minerals..
    please reply me…

    1. How long have you been taking tablets? Were you taking them when you had this semen analysis? How long have you been trying to conceive?

  54. I read maximum conversation&find out my problem solution but I am not get satisfactory solutions. Doctor tell me iam suffering from oligosparmia.My semen is watery&I having a sex one in a day duration time is only 3-5min, my partner is not satisfied that.Please tell me what can I do.
    Note:I have a one baby in 8 years old.I will try 2nd baby failed. Please give me proper solution. My wife has a tubectomy in last 5 years ago.

    1. What is the main concern — not lasting long or trying to have a baby?

      If you try to have sex every other day rather than every day you might have higher sperm count.

      How low is the sperm?

  55. Hi Sara

    me & my wife have been trying for past 4 months, just got the shock of my life last friday with semen results

    vol 2ml ph 8.0 count 3mill/ml motility 40% active 30% sluggish 10% diagnosis severe oligospermia

    I saw a doctor and got the scrotum doppler & testosterone/LH/PH tests done but everything is normal

    what other tests can be done to diagnose the cause of such poor count? should we try naturally for a few more months or should we approach fertility clinincs for IUI/IVF straight away (I am 30, my wife is 29)

    1. Really sorry to hear this. It can be a hard shock.

      I am glad to hear that you got both a full check and hormone tests. That rules out a lot of issues. Mostly it rules out that there is something anatomical going on.

      3 million X 2mL X 40% active = 2.4 million total active which is currently an ideal range for IUI.

      You have some options.

      I would first recommend taking this questionnaire to identify any areas that you could work on to improve sperm health.

      2nd, you could try a home IUI kit if you are anxious to try to conceive. I would recommend Stork as one that is easy to use.

      3rd. There are a few things that many doctors recommend men who have low counts try doing to improve -1. Antioxidant suppliments to improve sperm health. (You can take pre-natal vitamins or just eat a ton of vegetables) 2. Testicular cooling to lower the average daily scrotal temperature. I would recommend snowballs as an easy way to do this but you can also just use a bag of peas.

      4 months isn’t terribly long to be trying. But 3 million is pretty low. I would recommend being pretty aggressive about improvements and getting retested in 3 months or so.

      Does that help?

    1. Sorry for the delay in responding. It depends on the count. It looks like your volume would be 1.5 ml. But there should be a measurement of sperm count which would be reported in M/mL. Do you see that on the report?

  56. Hi sara, i am 42 year of age married for 10yrs, i did semen analysis and it was confirmed i have total count of <0.1 million cell/ml with vitality of <10%. a further hormone analysis shows FSH=17.57 mIU/ml, Human Prolactin = 39.49 ng/ml, Testosterone 5.38 ng/ml. based on the result kindly advise how my sperm count be increase. however, a visit to Urologist identified my high prolactine. suggest i should be on Bromocriptine 2.5mg tablet for a month. will this enhance my chances of increase in of my sperm count production. kindly advise extensively as am beginning to be tired of all process. and possible hope of having baby

    1. Bromocriptine is a medication that is designed to lower prolactin levels. It could improve things.
      Does the urologist have an idea why prolactin is high?

      Often high FSH + low testosterone = damage to testicular tissue. Did you have any past events that could harm the testicle?

  57. Hi Sara
    I have been trying to get my wife pregnant though i leave abroad some times i hve erections problems but still it will erect n i cum but she went for a pregnancy test the doc said my sperm is not working what could be the problem?

  58. Hi Doc. My wife and I have trying for a baby for about 15 months. My last SFA shows zero motility, mophorlogy and it says no development after 48 hours of incubation but it says occasional dead sperm cells seen. Please do I have a reason to be positive or should I just resign to fate?

  59. hello how can i increase my sperm volume i m only 20years old my sperm is very low and watery. plzz tell me help me

  60. hi, sara
    my husband semen analysis is not good he has low sperm count that is 2 million and active is 20% morphology is fine what test we have to do

  61. Hi sara I am 31 yes old married a year back and my sperm count is zero and got impression is azoospermia. So what will the solution for this. Please reply.

    1. There are lots of causes of azoospermia. Sometimes it is temporarily caused by some extreme heat source — like a high fever or a hot tub. More commonly, it is caused by some bigger health issue that is impacting sperm production. Some common causes include being overweight, a varicocele, previous or current infection, genetic issue or damage to testicle.

      In general, the next steps to do if you find that you have azoospermia are to get a second semen analysis to confirm that it is actually zero — sometimes it can be a lab error. Next you should visit a urologist specializing in fertility for a complete evaluation. The urologist will determine if the problem is due to hormones, a problem with the tissue in the testicle or if it is a blockage that is preventing sperm from getting out of the body. Depending on the cause, the urologist should be able to recommend treatment options. Most of the time there are things the doctor can do to help get sperm.

  62. Hi Sara,

    I have had a Semen Analysis done. Could you please explain it to me and what are my chances of being a father? Please reply to my email. The results are as given below :

    Volume : 1 ml
    Appearance : Creamy White
    Viscosity : Fairly viscous
    Total Sperm Count : 19 M/ml
    Normal morphology : 60%
    Abnormal morphology : 40%
    Pus cells : 1-2/HPF
    Sperm activity motile-50%
    semen sluggish motile-20%
    Semen non motile-30%

    1. Count and volume are a little lower than I like to see and conceiving may take longer than average but natural conception is still probable.

      Are you currently trying?

  63. Hii Sara.. My husband has a low sperm count.. That is 2 million… Then please tell us..we can conceive a baby naturally

    1. It depends on a few things —

      1. if the motility is high and the semen volume is high, there might be enough good swimming sperm to make pregnancy happen naturally.
      2. It could be possible to improve the sperm count depending on what is causing it to be low. Has he been evaluated by a urologist specializing in fertility? Have you completed our risk assessment?

  64. Hello Sara,

    Seman Qty: 2ml
    Colour : Milky White
    Liquification : 25 Min
    Consistency : Normal
    Reaction : Alkaline

    Total Sperm Count : 18M/ml

    Active motile : 10 %
    Sluggishly motile: 10%
    Dead : 80 %
    pus cells: 6-8 /hpf
    epithelial cell : 2-3/hpf
    RBC : 2-3/hpf
    germinal cell : nil

    please tell me that, is the possible pregnancy with this results? this test after 12 hour or ejaculation/


    1. Usually you should wait 48 hours before testing. How often do you usually have sex?

      The numbers are a little low here but frequent ejaculation will reduce the number of sperm present in each sample.

  65. I test my semen analysis and found 4 million per 1.5 ml
    I am worried about my child
    Can I be a father pls tell me if any pills will help… Thanxs

  66. I had this test last time bt some problem b’cz of I thik use off ashwagandha & gokhshura…is that true it’s make problem …
    I use ashwagandha & gokshura b’z i’m going gym 5-6 days in week …..pls tell me how I get high level off progressive sperm ..tell me pls

  67. Hello! Can you offer me any insight on my husband’s semen analysis? Results are below. He just saw a urologist who said everything looked good, he didn’t feel any varicoceles, etc. He ordered blood work on my husband which we are still waiting on results. My husband is a big craft beer drinker, and normally would drink 5-6 times a week, 2 beers on average. Per instruction from the doctor, he has cut this down to MAYBE 2 beers a week, sometimes not even, over the past month. He’s also started up on a multi-vitamin, vitamin C, Zinc, and CoQ10 the past few weeks, after never having taken a vitamin in his life. We’ve been trying to conceive 8 months now, one cycle at month 4 resulted in a chemical pregnancy. He’s at a healthy weight, doesn’t work with radiation or heat, eats generally healthy, but he does wear boxer briefs. I’m basically trying to figure out if IVF with ICSI is really our only shot, and how much could his change in alcohol and vitamins effect all his numbers?

    Count- 4.5 million/ML, total count in sample was 15.8 million.
    Motility- 44%
    Morphology- 1% (kruger)
    PH was normal, viscosity was normal, color was normal, liquefaction was normal etc.

    All my blood work has come back normal.

    Thank you!

    1. Hi, sorry for the delay. Have you gotten blood work back?

      Hard to tell how much he will improve. Some men really respond well to lifestyle changes and some, no matter what they do just stay flat.
      I would say enough people are able to improve that it is definitely worth doing, even if you do assisted in the end better numbers help success rates across the board.

      You’ve already gotten pregnant so it is possible. This gives me more hope that you should continue the natural route. Given his numbers the expected time to conceive is closer to 2-3 years, but he is in the range of possible natural conception.

      Any increase to any count, motility it morph are going to drastically improve chances. If I were you, I would take on a 6 month effort to boost count – alcohol, vitamins, heat avoidance and if he is good with it, testicular cooling. Measure at 3 months and 6 months to see what numbers look like. If at 6 months you haven’t conceived, I would explore IUI or intra-cervical insemination. His numbers are at a sweet spot for that show high success rates for those. There are home kits that make this cheaper too if you want to try something lower cost.

      Overall, you have lots of options… IVF with ICSI is one of them but unless there is something else going on, I personally wouldn’t make it a first choice at this point.

    1. Some people have reported success with it. I haven’t read studies on it specifically to know how effective it is, but it contains ingredients that have been well studied and are known to help. You can also take a prenatal or multivitamin or read the label to get something comparable.

  68. Hi Sara,

    I have had a Semen Analysis done. The results are as given below :

    Volume : 2 ml
    Appearance : White
    Liquefaction : 7 mins
    Viscosity : Normal
    pH : 7.4
    Total Sperm Count : 20 M/ml
    Total Motile Count : 8 M/ml
    Total no. of Abnormal Spermatozoa : 57
    Total no. of Normal Spermatozoa : 43
    Epithilial cells : Few
    Pus cells : 2-4/HPF
    Red blood cells : Absent
    Granular debris : Slight
    Clumping & type : Absent
    Crystals : Few

    1. It is ok for conceiving. It is a little lower than I would like to see, so it might take you longer than average to conceive. I would suggest you take our risk assessment or read this article to learn more about things you can do to try to improve your count and motility. If you don’t get pregnant in a few months, I would recommend getting another test done to see if the numbers have improved or not.

      1. Dear sir,
        this is krishnan
        Ten months before i am getting married, still we dint get pregnancy. so three months before i take the semen analysis it comes 9 million sperm . the doctor suggest the tablet i take that in 3 months,nuts and health foods . but their is no improment in sperm count . yesterday i take the semen analysis it gives the result as 1 or 2 sperm are seen its called as oligospermia.why its happend i am very confused i hadn’t drinking habit and smoking habit. i job is very peaceful job. their is no lot of stress in that. then why it happens please suggest sir . i had guilty feeling.
        please sir give some suggestion . can i able to get a baby sir . my body is very heatsir.

        1. Very low sperm counts can be caused by genetic conditions, varicoceles or other medical conditions. The best course of action is locate a doctor trained in male reproductive health – usually a urologist with specialty training. If you cannot find a doctor like this, then you will need to request the following —

          1. A hormone profile (Testosterone, LH, FSH, Estrodial and Prolactin)
          2. Genetic screen (XXY and Y chromosome deletions, CF carrier status)
          3. An exam of the testicle to check for structural abnormalities.

          You can read more in this article on next steps if you find out you have a low sperm count.

  69. Hi Sara, I have gone through your information regarding Seman Analysis result and other info, It is really very much helpful to learn about Seman analysis related question,Facts and doubts. Thank you very much for your information.

    I am a married guy since dec 2015, After seven months from Marriage we tried for pregnancy and conceived within two months. but unfortunately Root was not established in egg and we discovered during 12th Week of pregnancy later we went for D&C for Abortion in the month of Feb 2016, and we are waiting to try next pregnancy for four month till May. Now we started trying for Pregnancy. Now because of relative pressure I have undergone seman analysis test on 20th Jun,

    Can you please check and let me know whether my parameters are okay or not?. Also Please let me know the whether theses parameters are root cause for first abortion?

    Volume 1.5 ml
    color : greyish White
    Viscosity : normal
    self liquification : 30 mins
    chemical examination – Reaction – Alkaline

    sperm count (million/ul) : 16 million / ul
    active forward motility : 35%
    rapid progressive motility ; 25 %
    sluggish motility : 20 %
    non motile : 20 %

    normal : 70 %
    abnormal : 30 %

    Pus cells : 1-2/hpf


    1. The results are borderline. There is enough sperm here to conceive, but your chances are slightly reduced. Usually when I see a semen analysis like this there is some lifestlye issues (like diet, heat exposure, alcohol, big belly, smoking, chemical exposure, high stress, or something like that) that is reducing sperm count by a little bit. OR sometimes this result can be caused by a varicocele (which is a bundle of veins in the scrotum)

      You can fill out this questionnaire to see if you have any risks. If it comes back with a low risk, I would recommend that you visit a urologist to check for varicocele.

      You can also read this list of healthy habits that improve sperm count to find some ideas of things you can try to improve you results.

      1. Hi Sara,

        Thanks for your reply!! I just want to inform you that I had a fever just seven days before from Seman analysis date and I was not aware that I should not take Seman Analysis if I have fever in recent past.

        What should I do, Whether this result is providing some significant information or Do I need to take one more test?

        Are there any dependency between Missed Abortion and My Seman analysis results?


  70. hello Dr.
    i m 24 year old.
    masturbate dally last 9 year.
    some time once in week or may be whole week or may be two time in a day.
    i cannot able to controle it.
    this time i m underweight since last 7 year i want to increase my weight.
    can you tell me i am also lies in low sperm cont or how to increase my weight

    1. Haave you tried exercising and eating a high protein diet? The best way to start increasing weight is to lift weights. Particularly, it is a good idea to do squats, deadlifts and other exercises that involve your legs. As you exercise, it is important to eat enough calories to help build muscle tissue.

      Frequent masturbation generally doesn’t cause a problem with weight unless it prevents you from doing normal activities or exercising.

      Does that help?

  71. Hi Doctor,

    I am married since 1.5 years and been trying for a baby since one year. I have done all tests and my wife is suffering from PCOS while I have low sperm count, done 3 tests and it came below 2 million/ml. I am having just low testosterone level and my endocrinologist mentioned not to take testosterone medicine, as it would drop sperm count. I really look forward going for medication as don’t want to spend monies on IVF/ISCI treatments at this stage. I am 28 years and my wife is 24.

    I have taken fertilaid and count boost since 2 months and then I recently started herbal medicine, which contains WITHANA SOMNIFERA, DAMIANA, CALTROPS, CURCULIGO ORCLOIDES since one month.

    – See more at: http://menfertility.org/male-fertility-supplements-review/#sthash.CDow5fpH.dpuf

    1. Have they discovered the reason for the low testosterone?

      There are medications that can increase testosterone and can help improve sperm count like clomid, FSH or HCG. These medications are only useful in certain situations… have you had a blood test to measure LH and FSH levels?

  72. Pls i need reply and what to do to make my sperm go to normal cos its just tiring seeing my wife feeling rad nd shes already 33yrs of age

  73. I amTested to have a low sperm and watery sperm at same time but i guess it all happened because of too much act in sex in the past six month and i now feel waist pain anytime i have sex. Now i realy need to make my wife concieve pls help me out with what to do

    1. How low was the count? How long did you wait after your last ejaculation before you took the test?
      How often do you typically have sex? When do you feel the pain — all the time, during sex, during ejaculation? where is the pain exactly and what kind of pain is it?

  74. Hi.my problem is, i produce sperms of about hav a teel_spoon or some times less. Very tick at times.
    My question is with other factors being desame will this amont of sperms be ok for fertilizetion? Pls help cuz some times am just disturb.

    1. Have you had a test done at a lab? A teaspoon worth of semen isn’t abnormal. Thick is also normal. To know what your fertility is, you will need to get a lab test done.

  75. Hii Sara,
    we married 1 years back and till date not concieved.
    My semen analysis report as below
    Semen volume-3.0ml
    Semen Liquificatio time-30 min
    Semen reaction-ankaline
    sperm count-23.5
    Sperm activity motile-20%
    semen sluggish motile-10%
    Semen non motile-70%
    Semen normal form-50%
    Semen pus cell-3-5hpt
    Can you please spare some time to view and comment..
    Is normal pregnancy is possible.Wife dont have any medical issues and her periods are quite normal…Please review

    1. Normal pregnancy is definitely possible, but your chances are a little reduced. Count and motility numbers are both lower than I would like to see. Ideally, count should be above 50 and active motile should be over 30%. Semen analysis results go up and down based on what your habits are. When I see results like these I often ask about diet, alcohol, sleep, hot tub use, and other things like that. Typically, there are things you can do to improve your sperm.

      If you’d like to try to improve. Here is an article with some quick ideas of things that are helpful for improving sperm.

      Also, you can fill out these questions and you can get a report of things that you are doing specifically that could be causing problems with your fertility.

      I hope this is helpful. Let me know if you have any other questions, I’m happy to try to help.

  76. Hi Doctor, we got married 3 years before and I’m trying to conceive with no luck. Recently my husband got semen analysis done by and the report is below

    colour: greyish white
    viscousity: viscous
    Opacity : Normal

    Sperm count: 5 million/ ml
    motility: rapid progress: 0.2%
    slow progress: 0.3%
    non progressive: 0.5%
    Immotility: 90 %

    I know getting conceive normally is not possible, is there any way that he can increase the sperm count so that we can go for IVF or ICS treatments?

    1. There are several things you need to do to determine why his sperm count is low and if there are things you can do to improve.

      First, I would recommend filling out this questionnaire to determine if there are any major risks or lifestyle problems that could be contributing.
      2nd, I would recommend both hormone (FSH, LH, Testosterone) and genetic testing.
      3rd, I would recommend a physical exam by a urologist to check for structural issues that could contribute.

      Overall, this count is feasible for doing ICSI. The motility is a little low for IVF. It could be possible to increase to an IUI range if there is a readily identifiable cause of low sperm count that he can work on.

      1. Thank you so much sara, now we are trying for ayurvedha treatment to increase the count. hope it will increase

  77. Hi
    I will masturbate daily 4 Times
    Will it lead to reduce my sperm count or cause infertility problem??
    Howmany times a person can masturbate normally in a week ?
    How we can reduce over masturbation. .??

    1. Are you currently trying to conceive?

      If not, masturbation will not cause a fertility problem. It is fairly common for young men to frequently masturbate and it will not lead to health issues.
      If you want to reduce masturbation, I would recommend other activities that can help you blow off steam. Lifting weights or running can be a good alternative. Getting up and going outside can also help you to find alternative things to focus on.

      Hope this helps.

  78. Hi,

    I am 35 years old. I had done semen analysis a week ago and it showed very low sperm count (,1 M/ml), also the technician couldn’t exactly derived other factor as motile, non motile and they had writtend as “occassional %”. Later on upon further doppler analysis varicocele grade III has been idenfied in the Reports. However I don’t feel any pain or any thing unusal in my body that may lead myself to go for need of surgery option for varicocele.

    Also please note here that I was a chain smoker and use to smoke 20 to 23 cigarattes per day. I had done semen analysis only once as mentioned above and during that period i use to smoke. Now that I have left smoking since a week and I itend to quit smoking permanently.

    I have visited couple of doctors and they are advising either surgery or IUI/IVF option etc. I want to become a father in natural way and I am ready to chang my self in all the ways for the same. I believe that after 70 days post i quit smoking i should go for semen analysis again. I hope it will make some different. Is it possible that smoking would have done more harm then varicocele? Is it possible that with improvind diet and quit smoking i can still be a father in natural way?

    Requesting for your advice ASAP on this.

    1. The combination of varicocele and smoking definitely could cause results that low.

      If you would like a more detailed picture of what is going on and how likely it will be to recover, I might suggest getting a hormone test done to measure Testosterone, FSH, LH and prolactin. If it is easily available I might also add for a genetic screening test of Y chromosome deletions to rule out additional potential causes.

      Varicocele repair surgery improves semen quality about 60% of the time. Other options to improve fertility when you have a varicocele and do not wish to undergo surgery include testicular cooling, taking nutritional supplements and exercising regularly to improve blood flow.

      Quitting smoking is also likely to show improvements in semen quality, including an increase of count, motility and morphology. It takes about 3-6 months from the day you quit until you start seeing improvements in sperm.

      You might want to take our risk assessment survey to see if you have any additional risk factors that could be contributing to low sperm count.

      1 M/mL is very low but it is possible to improve to the natural conception range if you can identify all the risk factors and if the problem is not genetic or caused by injury to testicular tissue.

  79. I am visakh 24 years old.
    i am a bachelor.
    I would like to check my sperm count..
    For this Whome should i meet??
    where should i go ??
    Is there any special lab for this??
    Is this test possible in all labs?
    How much cost it will occur?
    Please give me a detailed answer….

    1. It will depend on where you live. Testing locations vary from city to city and country to country.

      Typically, semen tests are performed in a specialized lab called an andrology lab which is most often attached to a fertility clinic, Ob-Gyn or Urology office. Generally, it doesn’t cost too much or take too much time to schedule. When looking for a place to get tested, I personally prefer urology offices or fertility clinics that have a good reputation. Generally, they are better at performing the analysis which requires specially trained technicians.

  80. Hi Sara,
    My age is 33 years
    My sperum count is zero.
    My left testicle is damaged but right is ok.
    Following test are done with results
    Fsh 7.38 miu/ml
    LH 6.59 miu/ml
    Prolactin 12.58 ng/ml
    Testosteron 1.94 ng/ml
    A fine needle aspiration biopsy suggest there are germ cell along with spermatozoa and normal spermatogenesis.
    I am amore habituall to masterbate.
    I am married for last two years.
    I want to baby but all result other then semen analyses are normal.
    My Testosteron is little low also.
    Please suggest

    1. Sounds like it might be a blockage. You’ve had a biopsy, that means you have a specialized urologist that you are working with… What did doctor say?

      Normal spermatogensis is good, means sperm exist — typically in these cases, sperm are retrieved for IVF / IUI depending on numbers they can get or if the blockage is easy to identify and fix, sometimes doctors can surgically repair.

      Here’s a recent interview that I did with a leading doctor on obstuctive azoospermia that you can watch to learn more.

  81. Hi Sara ,
    I’m 40 years old from a 3rd world country and i’m trying for my second baby since last 4 months without success .
    I went to a sperm test last few days in my country ( which is third world medical laboratory ) and I’m having difficulty to understand my test result . here is my result .

    Amount : About 8ml
    Result unit Range
    Pus cell : 4-6 / HPF
    RBCS : 8-10 / HPF
    Epithelial : 0-2 / HPF
    PH : 8
    In Wet film – Active form : 40 %
    – Dead form : 50 %
    – Sluggish form : 10 %
    In Stained film – Normal oval head : 40%
    – Giant head form : 20%
    – Small head form : 10%
    Sperm count : 40×10(6) /ml 60-150X10(6)
    Remark : Oligospermia

    Medical standard in my country is quite poor , I had a bad experience with some medical checkup before and some test result i got here were easily marked in red where everythings marks in green when i went to foreign hospital .
    So i’d like to know if this result is showing me in the red zone ? Possible to conceive ?
    I’d also like to mention that I’m taking tenofovir pill everyday for hepatitis , possible effect my sperm quality or even may harm the new born ?
    I’ve asked some my local doctor regarding my situation and some advice stop taking medicine for 3 months atleast before trying for baby and some said nothings to worry ,
    Forgive me bad english . Thanking you in anticipation .
    Regard ,

    1. This is not too bad. I would continue trying for at least 6 more months.

      8ml = high
      active 40% = normal
      count 40 M/mL = a little lower than average
      40% normal = good

      8 X 40 X 0.4 = 128 million total active sperm. This is a pretty good number. You want to have at least 20 million.
      You should be able to have a baby. It can take 12 months even for people who are very healthy to conceive a baby.

      Some ideas to help it go faster:
      – eat healthy food, exercise and get good sleep
      – have sex 2-3 times each week

      1. Hi sara , Thank you so much for your help and your time to help out peoples . I’ll try my best to stay healty as you advice . And also try to be helpful person like you . May godbless you .
        Best wishes ,

  82. hi,
    me (26y) and my husband (31y) tried for baby from past one year ,no success so we consulted doctor and found that my husbands sperm count is low then had some mediccations.Now it is 25million but still not happening dont know what to do shall we try naturally for some tym ???can u plzz suggest

    1. So sperm count correlates with chances of conception. The higher the count the better the chances (up to around 60 million). Below 15, chances get really low that natural conception will happen (though it motility and morphology is good, some men will conceive naturally with counts lower than 15). At around 25 million, it could realistically take 2 years to conceive. Kind of depends on what the motility is — if motility is high, and volume is high chances are better. If not, they might be lower.

      I would continue with efforts to boost count and monitor every 3 months or so.

      Some tips to optimize chances of conception on the sperm side
      1. Ejaculation should happen regularly — around every 2-3 days. Too often and there won’t be enough sperm to be helpful for conceiving, too long waiting and the sperm will die inside of him. At a minimum he needs to ejaculate about 1x a week to keep sperm fresh.

      2. Sex should be exciting. For whatever reason, men’s bodies respond biologically to exciting sex and studies have shown that semen quality is better when sex is better

      3. There are lots of tips for boosting count. This site has a ton of articles. If the medicine he was on was effective, I would continue with that. The higher you can get it, the higher your chances.

      4. If you want to try to boost chances and your cycle is super regular, you could consider the Stork. it’s a OTC home kit for insemination that would bring the sperm up to the cervix and increase chances when there is a lower count.

      Good luck and let me know if you have any other questions.


  83. My semen culture showed klebsiella pneumoniae ssp deducted will this affect the sperm motility and morphology. Count is 20mil/ml immobile 67% morphology 1‰normal forms. Please advise

      1. Hi Sara,
        Am already taking a course of anti biotics for this I just wanted to know whether this can affect the quality of the sperm

        1. Infections can impact sperm. So can antibiotics temporarily. I would complete the course and then wait a few months to get re-tested…

    1. It can take up to 6 months for medicine to work fully. I would continue with that and test again in a few months.

      You can also consider cooling your testicles. 1 or 2 times a day put them near something cold or take cold shower. Many men find this can help sperm. There are special underwear for this if you want to try them.

  84. Thanks sara sdx you reply me.how can i improve my sperm?My health is fine.body is mediam not slim not fat.yes i eat normally.meat vegitables grains fruits milk and some natural herbs for power and sex i also take in my food.i dont drinking and no smoking.i look my own small buseness.doctor advice me take nolvadex twice daily.before use this medicine i had tatal sperm dead and i take tow month this medicine then 30% slugish.i nothing exercise only walking one hour daily.every four or five days after i do sex with wife.i hold my sperm four days for this test.after ten days i will doing new test and also shair here.i write here opratiom note becuase you understand my problem.
    Opration note.
    Uasm,RT.scsotal inision made.RT.sided micsosurgical vasography done,vas was obstructed distaly,vasal fluid for sperm -ve.LT sided microsurgical vasography don,vas patent,vasal fluid for sperm -ve.epididymal fluid for sperm +ve.LT microsurgial single tubular En to side vasoepididymostomy done.

  85. Hi i have very poor englsh.i am maried 12 years.i have no child.first i have no sperm.it was sperm blockage.then i had microsurgery to open sperm blocked since 1 year.my semen report.volume:2 ml.
    Spermcount:15 milionml.
    Pus cel:2-3.
    Active sperm not coming yet.FSH,LH normal.this problem be cure able?My age 42 years.

    1. Good you have sperm. They are a little low — but not too bad. You need to try to improve sperm.

      How is your health?

      Body fat?
      Diet? What do you eat normally?
      Do you drink alcohol?
      What is your job?
      Do you smoke?
      Do you take any medication?
      Do you exercise?

      How often do you have sex?
      When you took this test, how long did you hold your sperm?

  86. Volume 2ml,viscosity low,liquefaction within 1hr,ph 8.0,morphology 50per normal,50per abnormal fast progressive 00per,slow progressive 00per non progressive 20per,immotile 80per,total count 3millions cells wat is d chances of conceiving with dis result?

  87. Hii Sara,
    we married 3.5 years back and till not babies
    My semen analysis report as below

    Semen reaction-alkaline
    sperm count-120 Millions/ml
    RED cells – Nil
    PUS cells 1-2 H.P.F
    Actively -65%
    semen sluggish motile-15%
    Semen non motile-20%
    Semen normal form-70%

    Is normal pregnancy is possible.Wife dont have any medical issues. I also want to know about my PUS cells ranege (is it normal or bad) …Please review.

    1. pus cells look ok

      Sperm count is high
      Active motility – good
      normal forms – high

      Overall this is very healthy.

      3.5 years is a long time. Have you had regular unprotected intercourse every month during the whole 3.5 years? How often on average do you have sex?

  88. Hello Sara,

    Whats your thought on whey protein on sperm count and quality. Will it affect them or boost them.

    1. Whey protein and protein in general is a healthy component of a diet as long as you do not have too much. Too much protein can be hard on the kidneys.

      Overall, protein is useful for the creation of cells and repair of cells — which is why guys use it when trying to bulk up. It can help build muscle mass. It is also useful to slow digestion of food and reduce insulin spike after eating. So it can help regulate hormones a little bit.

      It hasn’t been shown to directly impact sperm but it definitely won’t hurt and has other health benefits that I would think could indirectly impact sperm. Hopefully that helps.

  89. Hello Sara,
    As you suggested I took your online questionnaire, following is the report for your further advice;

    Risk Assessment Report

    You are at a moderate risk for infertility. We have identified the following risks to your fertility.
    While this risk assessment covers a wide variety of possible lifestyle risks to your fertility, there are a few things
    that can cause infertility even in men with no other risk factors. Learn more…

    About Me
    Risk: Overweight: We have calculated that your BMI is 26.6. A number of studies show that there is a correlation
    between high BMI and reduced fertility. The higher the BMI, the greater the risk to your fertility. A high bmi
    affects your fertility on two fronts: hormonal imbalances and heat. The hormonal imbalance is cause by the high
    amounts of aromatase, an enzyme that’s very active in fat cells. Aromatase converts testosterone into estrogen,
    and too much of it can cause a major drop in testosterone levels. The increase in heat is due to the extra layer of
    insulation that fat provides, damaging the temperature sensitive sperm.

    No Risk: Trying to Conceive 6-12 Months: Congrats! Starting a family is a big decision. But certainly one that
    requires some stellar people who are up for the rewarding challenge. It usually takes up to a year or less to
    successfully conceive a baby. Here are a few tips to optimize chances of conception: 1) practice healthy
    lifestyles by eating your veggies, exercising, limiting your alcohol intake, and avoiding constant exposure to heat;
    2) have sex every 2-3 days; and 3) try not to stress and enjoy this time you have with your partner.

    At Work
    No Risk: Sometimes Stressed: Keep an eye on your stress level. While you may seem to strike a balance, the
    stress you do experience may cause some issues. Higher stress levels convert your testosterone into cortisol, a
    hormone that prevents the body from absorbing testosterone. Testosterone plays a vital role in sperm
    production and an imbalance, due to stress, can harm the vitality and quality of sperm cells. Try to find positive
    outlets to reduce stress like taking a brief walk everyday, jamming out to your favorite tunes while you’re stuck in
    traffic, or taking a few extra minutes each day to think about all the things to be grateful for. These habits could
    go a long way for your fertility and your outlook on life.

    Minor Risk: Sitting for Long Periods: Sitting for long periods at a time isn’t good for your health or your fertility.
    Taking regular breaks to walk around increases blood flow and reduces scrotal heat.
    Learn More:
    Heat and Male Fertility

    At Home
    Risk: Not Enough Sleep: Sleep is important for resetting your body’s hormones. Chronic fatigue may impact both
    your testosterone production and other key reproductive hormones needed for sperm production/maturation.
    Minor Risk: Long period of sitting: Sometimes it’s hard to turn off the tv. But sitting for an extended amount of
    time can do damage to your health and your fertility. Try taking regular breaks to walk around the block, do a
    quick household chore, anything that gets you up and moving. If it’s a show you just can’t miss, try standing or
    getting in small workouts while you tune in.

    I am waiting for your quick and positive reply.


    1. How long did you abstain (not ejaculate) before taking the sperm test?

      My best advice is to start a regular exercise program and to take regular breaks while you are at work.

      Here are some ideas of things that would be easy to do to help improve your health and fertility.

      1. When you are at work, set a timer for 30 minutes. Concentrate hard on your work for 30 minutes. When the timer goes off, get up and take a short 5 minute break. Walk somewhere and maybe get a glass of water. Regular breaks will help make sure that your testicles do not get too warm and will make your blood flow through your body.

      2. During your lunch break, try to take a walk at least 3 days a week. Walk for at least 15-20 minutes. It will help you be more productive during your work day and will help give you some exercise

      3. At least 3 times a week in the morning or evening or on the weekend, try to do 1 hour of focused exercise. Some good ideas for this include a sport, jogging, a tread mill, or lifting weights. The exercise should get you a little bit out of breath / feel a little difficult for your body. But after, you should feel more awake, more alive and stronger.

      4. Make sure to feed your body a healthy diet. Limit the amount of rice, bread, sugar and fatty foods. Increase vegetables, fruits and seafood. These will support improved health and help your sperm be the best they can be.

      5. Have regular intimacy with your wife 2-3 times a week. If possible, do not masturbate in between but save your sperm for her. When you are with her, find ways to make the experience enjoyable for both of you. This will help your chances of conceiving and will help you feel closer as a couple.

      You should be able to improve your sperm and you should soon be able to conceive.

  90. When I over mastubate my penis forehead will turn red and i apply candid b it will cure but when i over mastubate it will return i see that my semen is watery

    1. You are probably masterbating a little too much. Red forehead is likely a sign of irritation and watery semen is typically caused by frequent ejaculation. You aren’t hurting yourself really but you should probably use lubrication if you don’t. Also, if you are trying to conceive, you will want to avoid masturbation as it takes sperm away from making a baby and can make it take longer to conceive.

      Hopefully this helps. Let me know if you have other questions.

  91. Hello Sara,
    We are trying for baby from last 1 year but not able to succeed. My report is normal but my husband semen analysis report is as follows
    Appearance: whitish
    Volume: 2.5ml
    Liquefaction time: 25 min
    Fructose: present
    Sperm count: 10 million/ ml
    Motility: 80%
    Progressive motility : 65%
    Non- progressive motility : 15%
    Nonmotile: 20%
    Morphology : 90% normal
    10% abnormal with bent neck, coiled tail, tailless heads and tapered head

    Pus cells: occasional
    Impression : Oligozoospermia
    Notes : advise clinical correlation

    Please suggest me that will I be able to get conceive normally or what to do?

    Please help me out

    1. Your count is low but volume, motility and morphology are all very good. You definitely have a chance at natural conception but odds are a little lower than average.

      There are a couple of things you could consider doing at this point.

      1. You husband could visit a urologist that specializes in fertility. I would recommend a physical exam and hormone test just to make sure things are normal.
      2. I would recommend filling out this questionnaire to see if there are any major risks in your husband’s life that could impact sperm count.
      3. If you have an android phone, you could try downloading this app that will give you detailed recommendations about how to boost sperm count and give you a place to track semen analysis over time.
      4. You can check out this list of common things that people can do to improve sperm count to see if there is anything that would be easy to start trying now.
      5. If you have regular ovulation, you could boost your chances by using a tool like the stork, to do a home insemination.

      Does this help?

      Let me know if you have other questions…

  92. Hi Sara,
    Have got the analysis report, and is as given below :

    Time of Liquification : 30 minutes
    Color : Grayish White
    Appearance : Turbid
    Consistency : Viscous
    PH : 8.0
    Volume : 01 ml

    Sperm Count : 18 million/ml

    Sperm Morphology:
    Normal : 70%
    Head Defects : 10%
    Midpice Defects : 10%
    Tail Defects : 10%

    Active : 50%
    Sluggish : 10%
    Non-Motile : 40%

    WBC : 08/HPF
    RBC : Occasional
    Epithelial Cell : Nil
    Fructose : Positive
    As per report there seems to be a problem in Sperm Count and RBC.

    Please guide me how to improve these, waiting for your positive reply.


    1. The count and volume are a little lower than I would like to see. Good news is that the sperm look pretty healthy, many of them have a normal shape and are swimming well.

      There are lots of ways to improve sperm count, but it depends on the underlying problem. As a starting point, I would suggest that you take our online questionnaire and let me know what it says your major risk areas are. If you have an android phone, you can also check out this app, which will give you some good guidance on how to improve your sperm count.

      Because you have occasional RBC and some WBCs, I would also recommend a visit to the urologist to check to see if you have a mild infection which could also impact your results.

  93. Hello Sara I m trying for baby from past one year but I could be succeed I have done semens test and in my report came like this
    Investigation Observed Value Unit Biological Reference Interval
    Abstinence 3 days
    Time of Collection 9:20 am
    Time of examination 9:50 am
    Physical Examination
    Volume 2.5 ml > 1.5
    Appearance Homogenous grey
    Homogenous grey opalescent
    Liquefaction Time 30 min Upto 60 min
    Viscosity Within normal limit 7.2)
    Fructose (Qualitative) Positive Positive
    Microscopic Examination
    Sperm Count 10.00 million/mL > 15
    Sperm count per ejaculate 25.00 40 million or more
    Sperm motility (Total=PR+NP)
    (Evaluated 200 spermatozoa)
    70 % > 40 (PR+NP)
    Grade: Progressive motility (PR) 40 % > 32 (PR)
    Grade: Non Progessive motility (NP) 30 %
    Grade: Immotility 30 %
    Sperm Morphology
    Normal sperms 85 % >4% (WHO 5th edition, 2010)
    For IVF prognosis(Krugger)-
    Above 15% – Best
    4 to 15% – Good
    Below 4%- Poor
    Abnormal Head 3
    Abnormal Neck 7
    Abnormal Tail 5
    Can you please help me out

    1. It looks like your sperm are pretty healthy, but your count is a little low and might be making it take a little longer to conceive. If you keep trying, you should be able to conceive by 2 years of trying.

      There are things you can do to boost your sperm count. Eat more fruits and vegetables, exercise more, avoid alcohol and cigarettes, lose weight if you have extra wieght, avoid heat. If you have an android phone, this app will give you detailed recommendations about what you can do to boost count. You can also read this article on boosting sperm count.

  94. Hello Sarah,

    I am 29 and I had unprotected sex 5 years before with my gf and she got pregnant, but now my sperm count reduce as mentioned below. How did it happen, I work most on desk and on laptop. I got some extra weight also in this 5 years. My height is 5″6 and weight is 74 KG. Is there any chance to improve my count? urologist is not sure why this happened.

    My current semen analysis report

    Volume: 3 ml
    Sperm Count: 10Million/cc
    Active: 5%
    Sluggish: 10 %
    Non Motile: 85%

    1. Not sure how it happened exactly. If you have an android phone, this app might give you the best insight about what could have happened.

      Did you have a recent fever, long bike ride, heavy drinking, or anything out of the ordinary in the 3-4 months preceding the semen analysis?
      Are you currently trying to conceive again? Same partner? Did she carry baby to term last time?

      1. PS… there are lots of things that can cause temporary dips in sperm count. Or, if your lifestlye is generally a lot less active, it can cause a general decline in sperm values. Exercise, good diet, good sleep and losing a few pounds will always help and definitely wouldn’t hurt 🙂

      2. hello sara,

        thanks for your reply

        I married to other girl, I am trying for baby for last 1.5 years but not succeed , diagnosed wife everything was fine. then I checked my semen analysis and got that result.. I dont ride bike, yes I am less active for last 2 years. so Do you think excersize and good diet can help me and have you seen thins kind of case, how much time it can take to recover if you can tell me

        1. Yes. If your count was good before and it is totally possible to get it back up. Living healthy is the best way to do that.
          If you have an android phone, I’d recommend using this app to help monitor all the things that you can do to boost your sperm.

          You can also read this article on boosting sperm count.

          It takes about 3 months to see some improvements in sperm count. You can learn more about how sperm are made here. I would recommend re-testing in 3-6 months to see if you have made progress.

          Big things to do:
          – avoid heavy drinking
          – avoid cigarettes
          lose extra weight
          – take breaks from sitting at your desk — sitting too long can overheat your balls and kill sperm
          – avoid hottubs and suanas
          – consider testicular cooling
          – eat vegetables, nuts and seafood to get key vitamins and antioxidants
          – have sex 3 times a week, try not to masturbate in between
          – Get exercise 3 times a week for at least 20 minutes (a long walk, jogging or lifting wieghts)

          I think if you do these things you will feel awesome and you will improve your sperm.

          Let me know if you have other questions. Good luck.

          1. Thank a lot Sarah, I will certainly apply your suggestion and will get back to you after my next testing.. I was very worried and you made my feel positive..

  95. I have sevre oligiospermia and very small number volume 2. 8 number 0. 05x10ml how can improve

  96. Hi Sara….. My husband is suffering wid oligozoospermia. I had an iui on 22 feb 2016 but not succeed. My husband’s parameters were Semen parameters : Volume : 3.0ml. , Sperm count : 09 million/ml. Motility : 60%. Sperm preparation.: Volume : 0.5 ml. , Sperm count : 16 million/ml. Motility : 85%. Procedure. : DDGC + wash. Need to know is iui is possible wid these numbers or else I have to go for ivf??? Please reply as soon as possible as I have to visit my gynac tomorrow for next move.

    1. IUI success rates are pretty good in that range if there are no issues with the female side. Chances per cycles are typically around 30% ish. So it could take a few rounds.

      Have you checked fallopian tubes?

      How long have you been trying?

      1. Hi…. Thank u for ur valuable advice. Yup my tubes are absolutely fine n we were trying naturally for past 1 year nod I had undergone IVF in month of November…. It was unsuccessful. Then we had gone IUI in feb. This was our first IUI

        1. Good tubes and low count = generally good candidate for IUI.

          Has he been evaluated by urologist to see if there is anything going on with him?

          The only thing on his side that could impact IUI chances is poor morphology, I might get that assessed esp if you are paying IUI out of pocket.

          Also, if you are paying for treatments, I might also consider Stork — it is a home conception kit that has rates similar to IUI and is more affordable and nice to do at home.

          I might recommend taking our risk assessment to see if you can take some steps to improve count. A few more sperm would boost chances of conceiving naturally and really he’s not that low.

          Did you get any feedback on IVF round? How many eggs and how many fertilized?

          Hope this is useful. TTC can be a long, complicated, frustrating journey. Sending all my good thoughts, love and support.

  97. I use viagra for two years will this affect my fertility. Married for three years but wife not conceived yet

    1. From everything I’ve read, I don’t think I’ve seen anything to suggest that viagra would cause a problem. But I’ll do some investigation.
      Have you had a semen analysis? Have you taken our risk assessment? Have you been trying for the whole time that you’ve been married? How often are you able to be intimate with your wife? Do you have underlying medical conditions that contribute to ED?

      1. Hello Dr,
        Thanks for getting back
        Initially I had premature ejacculation and urologist prescribed the blue pill. Ever since I use it before sex I get normal election every morning and I can perform properly during her normal days but not during the ovulation time may be mental issue. Also I took SA last March it was 25.2m/ml with rapid progression 2% and I took it after 6 month the count was 19.2 m/ml with 6.2 rapid progression and then after three months I took it was 12m/ml.i smoke heavily got about 1 pack a day but I had stopped smoking. Tried one iui without success. I took the risk assessment of says high school risk
        Please advise whether I can ever become a dad it is totall depressive and I feel like no use living

        1. How long ago did you quit smoking? Did the risk assessment highlight any other issues besides smoking?
          I see a trend in the sperm count going down. I really don’t think that viagra would cause that… smoking can contribute to erection and ejaculation issues.

          IUI has about 30% chance each cycle, so just like anything else, it can take multiple tries to work.

          Your numbers are low but not so low that you can’t become a father. Don’t feel bad about this. Fatherhood is reachable. You can do it. The most important thing it to figure out how to best improve your health so that you can increase your chances. Improving your health will make you feel better and should help improve your sexual function which may make life more enjoyable and less stressful while you are trying to conceive.

          I am happy to be a sounding board to help you work through these things. I am continuing research on the blue pill and will get back to you on that shortly. I’d like to hear if there are other things besides smoking that came up on the risk assessment — bmi? exercise? diet? heat? other issues?

          1. Hello Sara,
            I have been diagnosed with Grade 1 rt varicocele but the doctor said it was very minimal and should not cause any issue. My bmi is obese and started to lose weight and am working out 5 days a week
            Quit smoking for just over a month but before that 15 cogs a day. How long will it take to improve the sperm after quitting..
            My morphology was 2% please advise whether iui will be successful or should we try ivf
            I have started icing my testicles as per doc advise and I could see some improvements in exertion and sperm volume.
            My post wash count was 4m with 100%motility will this be OK for a successful iui

          2. Good work. You are tackling the tough issues. I’m sure you are going to feel really good as you work to get yourself in better shape.

            Your sperm should gradually improve over the next 6-12 months. I would anticipate it taking at least a month or 2 to start seeing improvements in morphology or motility. A little longer to see increases in count.

            Post wash count of 4m with high motility is good for IUI. 2% normal morphology may impact chances depending on what types of defects. I would ask what % are head defects.

          3. What’s the success rate of that much head defects and bad morphology. And what about ur research on the blue pill

          4. Sorry for the delay. I took a bit of time to do my research. It looks like Viagra does not have very strong impacts on sperm. There are a number of studies where they gave it to men and did follow up semen analysis to see if it reduced any of the parameters. It didn’t show to cause any systematic impacts on sperm production. There is a little bit of controversy about viagra and motility. Some people think it might impact motility, but the research that I saw some of the studies showed it increased motility, some showed it decreased it. So, in the end, I don’t think it does very much.

            In regards to morphology, there aren’t any hard stats on success rates. Generally with better morphology and motility, the better your chances of successful IUI with a lower count. I think your numbers are good enough to give it a shot. If it is expensive to do, I might wait a few months and see if you can boost your morphology. It tends to respond pretty well if you stop smoking. Icing should help overcome some heat issues and you might see pretty big changes in a few months. You can take a multi-vitamin to help improve recovery speed. I would also recommend filling your diet with fruits and vegetables. Especially the ones I’ve listed in this page.

            In your case, I think smoking, stress and being overweight is contributing to both sperm issues and erectile function. Living a healthier life should help boost your sperm and make sex work better. I know this is tough, but I once found myself in a similar situation and taking on the hard work to lose weight and get myself healthy was the best hard decision I ever made. I can’t tell you how much better I feel in my body. I know you can do it. You are doing lots of the right things and I think you will make progress. It can take time, but stick with it. Your body can heal.

            Here’s a video that motivated me when I was making life changes.

      2. Oh Sara that was an amazing confidence booster and am so thank full to your investigation. I feel a lot better now. I will keep you updated with my improvement and again thank you very much

  98. One day before sperm count, i masturbate. And the result of the sperm count os zero. There is no sperm detected at all in my semen. And i only get little semen during masturbation for sperm count. How much possible that i have azoosperma

    1. Hard to say, I would expect to see sperm even if you masturbated the day before. But It is a good idea to repeat the test with at least 3 days maybe even 5 days abstaining to confirm the result.

  99. Hi Sara,

    Can you suggest. What is the reason baby formed on women tube. We have overcome this problem a year before. After that doctor confirmed it’s ectopic pregnancy. It’s cured through injection.

    My sperm is like watery. If we avoid sex for a month, can it came to normal fluid sperm. please suggest me.

    1. Ectopic pregnancies are generally just a random occurrence, although there are risk factors on the woman’s side that can increase the chances that one would happen. Your wife can discuss the matter with her doctor to make sure she is clear to try to conceive again.

      Watery sperm should not interfere with conception. I would recommend regular sex 3 or so times a week.

  100. Hi Sara,
    We have discussed with a doctor about his sperm and the procedure but the doctor has Said the procedure shouldn’t affect his good testicle therefore fertility shouldn’t be a problem…
    In all honesty most of the doctors we have seem just seem to not listen to our upset of the situation and try to rush us out of the room, I fear we will never have a child?
    Also in regards to the urologist they done an ultersound and decided he never had a testicle at all as they couldn’t find it and no more has been done since then..
    We have been trying to concive for over a year…
    Is there any tips that can help?

    1. Has he had a semen analysis done?

      In the short term, the hernia could be causing sperm issues by heating up the area. You might consider regular testicular cooling — using a pack of frozen peas or you can look into snowballs for a more comfortable option.

  101. Hi Sarah,

    I am a 26 year old male, I don’t smoke, have never taken drugs and very rarely drink. I’m not overweight and take a multivitamin formulated for men as well as omega 3. I do however take antidepressants and recently took a Spermcheck test (available from pharmacy) and it tells you whether you have more or less than 15 million sperm cells per ml. It told me mine was less but I don’t get why? I don’t masturbate but have regular sex with my girlfriend and don’t have a job that exposes me to heat/radiation/harsh chemicals etc. Is this normal? Could the test be wrong? How common is oligospermia in young healthy males?

    1. So, antidepressants depending on which type you are on can cause a low sperm count and would probably be my first suspicion. Since the result is less than 15, but you don’t know how low it might worth getting a full analysis. If you want to give me the name of any meds you are on, I can do a bit of research to let you know if there are any studies linking them to sperm count issues. Many of them are known to cause problems.

      However, it may not be the medication — about 15% of men have a condition known as a varicocele. Most of the time varicoceles don’t interfere too much with sperm but sometimes they can really mess things up. The other possibility are a variety of genetic or congenital conditions that impact a small number of men and do not have any symptoms other than a low sperm count / zero sperm count.

      If I were you, I’d look into a full analysis. If you have insurance it should be covered through a urologist office. If you are able to choose a doctor, I would look for a urologist who lists experience in dealing with fertility issues. They should complete a semen analysis along with a few follow up blood tests to see what the cause might be. If the blood tests and physical exam come back normal, then it would be worth a discussion with the doc about your meds to see if they could be contributing.

    1. Well, chromosomes is something that can’t be fixed so that is really good news that it is normal.
      Did they run any hormone tests? Did you get a physical exam?

      Were there any illnesses in your past that came up on the questionnaire?

      1. Actually i did FSH LH PROLACTIN AND TSH all were normal, my diet and lifestyle in the past 6 months were not healthy at all and I used to smoke marijuana almost every day and I’m having sex also almost every day, and my first SFA test revealed severe OAT, I quite smoking at all and started to take multivitamins like ANDROFERTI,vitamine D E C ZINC FOLIC ACID OMEGA 3 6 and 9 . Do your think things may become better and when do you suggest to redo the second SFA?
        Thank you for your information
        Note : no previous infections or illnesses in my past

        1. Well, it seems like you need to give your body a chance to heal a little. The supplements will help. Try not to overdo it, sometimes people try to rush things with supplements, more isn’t better. Too high of supplements can also be bad for you, so everything in moderation.

          Drinking lots of water, getting good sleep and exercise, doing things that feel good for the mind or feel empowering can all actually contribute to total health, which surprisingly can impact individual cells in your body. I would also recommend avoiding alcohol if possible. Alcohol inhibits your body’s ability to process nutrients that are necessary for healthy cellular division.

          Give yourself a few months — 3-6 worth of good living. It may take longer depending on how low things were.

          Are you currently trying to conceive? How was morphology?

          1. I’m doing exactly what you said, yes I’m trying to conceive and the morphology was bad as the analysis said severe OAT !

          2. Well. The best you can do is give your body time to heal. If you treat it well, it should recover. Keep me posted on progress and if you have any questions along the way, don’t hesitate to ask.


  102. I stopped like 2 weeks ago and i used to smoke it almost daily during the last 3 months and i also quite smoking at all and started to take some multivitamins like Androferti,zinc,selenium,folic acid , omega 3 6 and 9 .. I did chromosomal analysis and waiting for the results

  103. Hello,
    I have two questions regarding sperm count and quality..
    Q1.can marijuana makes severe OAT? If yes q2. Is it permanent or it needs a period of time to has its effect off? Note that FSH LH PROLACTIN are normal

    1. 1. Marijuana can have significant impacts on sperm. generally, I see it knocking guys down from normal into the 10s-20s depending on usage. How severe are we talking? How often / how much did you use /
      2. Generally it is temporary / how long ago did you stop?
      3. FSH, LH and prolactin normal means that there is not evidence of permanent damage and you have a proper hormone profile. Have you had a test for y deletions?
      4. We have a questionnaire that could help identify other potential risk factors. You might check that you.

  104. I did a SfA test one month a go and the sperm count was 28 million per ml. After one month I did it it Has dropped to 9 million per ml. Why is this happening?? Really worried..

    1. Sperm counts fluxuate due to lots of life circumstances. They are a reflection of your health 3 months ago. So what you do today will show up in a semen analysis in 3 months because it takes that long for sperm to develop. Have you visited a urologist? Have you taken our risk assessment?

  105. Hi Sara my semen analysis on SQA-|| Impression is
    OLIGOSPERMIA- poor quality semen.
    In a week how many times i can do sex, what is the possiblities to get pregnancy. and
    How much it effects my testicles?

  106. My husband has a hernia in his left testicle which is an empty sack we believe he never had a testicle as when having an ultersound they never found the missing testicle. We are currently trying for a baby and finding it difficult, could this be affecting us? Also could this affect his sex drive? And finally sorry I no its a lot of questions after the procedure how soon could we start trying and could the operation cause problems with fertility? Or should we be fine as his right testicle is normal.
    He has been sent for a semen test although I’m not sure if the results will be affected due to the hernia heating up in that area??? Please please help!!!

    1. You should get the semen analysis to see where he stands. If his other testicle is working well, I would leave things alone and continue efforts to conceive. The procedure should be relatively safe but there are rare complications that can block tubes and cause fertility issues. I would talk carefully to doctor about the options and timing. You may also consider banking samples ahead of surgery just in case.

      How long have you been trying?

      Sometimes missing testicles can go way up into the abdomen or other random places in the body. I’m guessing a urologist is working with you on this…

  107. My sperm count is 6 is there any chances to improve sperm count if possible then how and what are chaces of become father for that count

    1. There are lots of things you can do to improve your sperm count. At a count of 6, you might consider visiting a urologist who specializes in fertility to do a full evaluation and make sure there isn’t anything medically that is causing reduced sperm production. Your chances of concieving naturally are low, but it really depends on your semen volume and motility. If those things are high, you might have a fair chance of conceiving on your own.

      You are a good candidate for IUI or Stork, if you have decent motility and morphology.

  108. Hello dr.
    My sperm volume is 1ml. If i had sex 2 times in a day, sperm volume will not get out.
    Can i be a father? Or if there are any treatment for the same.
    Please le me know.

    1. If you have low volume, you need to conserve and try to have sex maybe every 3rd day. Waiting 2 days will build up a larger volume and help get more sperm to the egg. You only need to abstain while you are trying to conceive. When not trying to conceive — multiple sex a day won’t hurt you, you are just unlikely to get a baby from it.

  109. Hi. I am a heavy drinker. Have stopped now for over a month. Will my sperm be ok ? What can I do to improve sperm quality. Any advice would be greatly appreciated. I am 46 and have one child already

    1. Depending on how heavy, it will depend on how long for sperm to recover. If moderately high, your sperm may already have started to recover by improving motility and morphology. It will take 4-6 months of sobriety to see full repairs of sperm. If you have been a chronic heavy drinker for a long time, you may have damaged other functions of your body which indirectly can impact fertility.

      Did you have your 1st child recently or a long time ago? Were you a heavy drinker at the time? Have you had a semen analysis? Are you currently trying to conceive?

  110. Hi my husband had a vasectomy reversal June last year. His 3 month analysis showed return of sperm numbers were low though. He done another analysis late December it’s showed 0 sperm present.
    Going to sound stupid but need advice/ guide…
    Is it possible that because the first analysis was done after 3 days abstinence and the second one was 7 that there there but not strong enough?
    He drank heavily few days before sample could have this made it false 0?
    Is there anything he can take/ do to get them back?

    1. Drinking very heavily can take a low count to a zero. Depends on how low the count was and how heavy he drank. Hard to say if that was the cause. if it was, it could take a month or two to recover. Did he have a lot of WBCs? Taking a pre-natal vitamin might counteract the alcohol as long as he avoids very heavy drinking. What was count at 3 month? What was WBCs each time?

  111. Hi sarah

    I recently had a vasectomy 5 days ago. On my 6th ejaculation I had unprotected sex. Now I know there is possibly active sperm still in my system but what would the quality and quantity be from pre vasectomy level. I realise its tough to tell but I just want to know the chances of achieving pregnancy as opposed to before the operation.

    1. Hard to tell. You would need to know your starting sperm quality to see how much it might be reduced after vasectomy. Did you get a semen analysis done before the vasectomy by any chance?

      In general, there are still quite a few sperm left in there post surgery that need to get flushed out. Over time the count goes down as they come out and the quality of the sperm drop off pretty dramatically after a week or two as the ones that are there are old and begin to die. 5 days is still fresh enough that some were probably still alive, though, older. If definitely is possible to get pregnant, though you would need probably need to nail timing pretty well since those sperm are not likely to live as long in the female reproductive tract.

      Wish I had a better answer but it’s kind of hard to tell.

      1. Hi Sarah

        Thanks for the reply…

        No I didn’t get any pre seman analysis.

        I ejaculated the night before then within 12 hours later I had the
        unprotected sex. She thinks she ovulated the day before so I suppose the chances are slim..

        my seman volume seems to have reduced also.

        1. it seems chances are relatively slim. I’ll keep my fingers crossed. Good news is, this is the last time you’ll have to hold your breath 🙂

  112. Hii Sara,
    we married 3 years back and till date not concieved.
    My semen analysis report as below
    Semen volume-3.5ml
    Semen Liquificatio time-30 min
    Semen reaction-ankaline
    sperm count-23.5
    Sperm activity motile-50%
    semen sluggish motile-10%
    Semen non motile-40%
    Semen normal form-50%
    Semen pus cell-3-5hpt
    Can you please spare some time to view and comment..
    Is normal pregnancy is possible.Wife dont have any medical issues and her periods are quite normal…Please review.

    1. According to these results, normal pregnancy should be possible. The sperm count is a little lower than optimal but not so low that it should prevent natural pregnancy. Morphology is another factor that is commonly measured during a semen analysis and I don’t see any records of it here. In any case, I would anticipate that you should have some success in 3 years of trying.

      Three years is a long time to try without any success. Sometimes there are factors that are difficult to diagnosis on both the male and the female side.

      First questions are — are you able to have sex 3-4 times a week, especially during the middle of her cycle?
      Did you have any long periods of time away from each other during the 3 years that you have been married?

    1. Marijuana impacts people differently. In scientific literature, studies show that there is a consistent difference in sperm quality between pot users and non. That said, plenty of pot smokers are able to conceive and so, like everything else, it is controversial.

      How much it impacts an individual depends on your body’s ability to deal with toxins (some people have more efficient systems for toxin removal than others) and how much and how long you’ve smoked. The only real way to know your chances of conception are to

      1. Try to conceive
      2. Get a semen analysis done to see what your sperm health looks like.

      Marijuana can contribute to genetic abnormalities that can cause miscarriage or in rare cases birth defects. So it is a good idea to stop using at least 3 months prior to trying to conceive. This should also give sperm a chance to heal a little.

      3 months is the minimum time to clean up the testicle from acute toxin exposure. Long term users may take longer 6-12 months or even up to 24 months to fully recover fertility (as long as they did not damage testicular tissue) My recommendation if you are thinking about fatherhood is to lay off for 3 months before starting to try. During that time it would help to clean things up if you ate a lot of fruits and veggies to get nutrients into your system that can combat some of potential damage done by marijuana. You can also take a pre-natal vitamin to help get sperm in to tip top shape.

      Good luck buddy.

  113. i will masturbate daily 4 times…
    when i am masturbating, sometimes my sperm will be little watery….
    is watery occurred due to low sperm count…??
    why sperm like watery sometimes.??

    1. Frequent masturbation depletes the semen stores. Watery semen is typically just the fluid from the testicle and very little actual semen (which comes from the ejaculatory ducts near the prostate) It isn’t a problem.

      1. i allready told you that i will masturbate daily 4 times..
        my question is that..will this lead to infertility..??
        please give me a clear answer…

        1. frequent masturbation will reduce sperm count temporarily. By ejaculating too often, your body does not have enough time to refill the sperm stores. This is not a permanent problem. If you stop masturbation, you should have a higher count the next day and the day after that. Does that clarify?

          1. There is no entirely safe period to avoid pregnancy except when the woman is actively bleeding. Chances are very low in the 1st 5 days after she stops bleeding and in the 5 days before her period is due to come. But this is not 100%.

  114. hi…
    i got married 1 week ago. we dont want kids now…
    so will you please suggest me the safe periods to have sex to avoid pregnancy???
    also i would like to know the period to get pregnant,,???

    1. Congratulations on your wedding.

      There are lots of options for how to avoid pregnancy. The most sure forms of birth control are womens hormonal controls — pills or implants — that prevent ovulation. You can also use condoms which block the sperm from entering her body. Sometimes people use spermicides, which are gels or creams that kill sperm inside the woman’s body.

      The least reliable method, but the most natural, is to monitor ovulation and avoid sex during her fertile days or to pull out before ejaculation. These methods can work but if you are both very fertile can cause accidental pregnancy sometimes. They are useful when you are just trying to delay pregnancy for a little while. But you should know that they are not 100%.

      To monitor her cycle, the easiest way I know is to get an app on her phone (or yours) and you enter the first day of each period. You can monitor additional symptoms like body temperature and cervical mucous to find out when ovulation is likely to occur.

  115. I am 26 now. I masturbated 10years . Now my penis became much smaller. It’s about 10cm while erected.. How to get strong lengthy penis

  116. in my penis there is a lot of hair is there.not like others i think
    hair around the penis i think natural.but i have lot hair in my penis(long organ). i think it will be uncomfortable for the intercourse(fucking process)
    will this make any problem.???
    how can i remove the hair in the penis permanently.??

  117. hii… i am arjun 23 years old. for the past 8 years i was masturbating.
    daily i will masturbate 4 times.
    so will it reduce my sperm count?
    will i have babies in future.?

    1. Masturbating will not reduce your sperm count.

      Your ability to have babies in the future depends more on your health and on how many healthy sperm you have, which can measured by semen analysis.

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