What is low sperm count?
Oligospermia, or low sperm count, is a condition where the number of sperm present in ejaculate is lower than normal because sperm production has become inhibited. This is defined as less than 20 million sperm per cc of semen. When all sperm is absent from the ejaculate, the condition is called azoospermia.
You can read my post on normal values for sperm analysis and a brief interpretation of those results by clicking here.
A number of factors can cause low sperm count or a decrease in sperm production, so it’s important to have a very thorough conversation about lifestyle factors with your practitioner. The most common causes of decreased sperm production are being a workaholic (AKA stress), smoking, excessive alcohol consumption, very frequent sexual intercourse or masturbation, being overweight, and wearing tight underwear or sitting for long periods of time. These causes are easily remedied. Other causes may take a little while to resolve, or may even require surgery.
Is low sperm count different from Male Factor?
Male Factor is the umbrella category for infertility related to problems on the man’s side of the conception equation, so low sperm count is included in Male Factor Infertility. Approximately 15% of couples these days have issues with fertility, and for 30-50% of those couples infertility issues are related to the man. Research has shown that acupuncture and herbal medicine can help. In my opinion, it is always best to treat both the man and woman trying to become pregnant. It takes two to tango, after all.
What are the symptoms of low sperm count?
Low sperm count is often symptomless. When symptoms do occur, they may include:
- The inability to conceive a child
- Sexual dysfunction
- Testicular pain, swelling, or lumps
- Signs of hormonal disorders, such as loss of facial hair or sweating abnormally
What causes low sperm count?
Sperm count is affected by the level of hormones that signal sperm production, proper testicular function, and the successful release and transport of the sperm. Specific factors that cause low sperm count may include:
- Retrograde ejaculation
- Swelling of the veins (varicocele)
- Infections or tumors
- Undescended testicles and defects in the sperm duct
- Hormone imbalances
- Chromosomal defects
- Obesity, malnutrition, or vitamin deficiency
- Exposure to environmental toxins or other elements, such as heat
- Alcohol and/or tobacco use
- Medications or medical treatments
- Psychological disorders, such as stress, overwork, or anxiety
How is low sperm count diagnosed by my doctor?
In a semen analysis test, the number of sperm is counted; a count below 20 million sperm per milliliter (cc) of semen is considered low. Other medical tests to identify the specific cause of low sperm count include:
- Physical exam and medical history, which can identify an underlying medical condition or lifestyle factor that may cause low sperm count
- Ultrasound to visualize the internal structure of the reproductive system
- Blood or urine tests to detect abnormal hormone levels or retrograde ejaculation
- Biopsy of the testicle to determine sperm production
- Genetic tests to determine if the patient has a genetic disease or chromosomal abnormality
How does an acupuncturist diagnose low sperm count?
This is a tricky one. Acupuncturists cannot diagnose you with low sperm count. We work with what’s visible to the naked eye since our medicine was created thousands of years before the microscope, computer and blood test. Most men who come to my clinic looking for help with low sperm count have already been to the their doctor for all the requisite tests, and now need to do something about their non-optimal results. Bringing your test results with you to your visit is helpful because I can use that information in creating a treatment plan for you. For example, we have herbs that can help improve sperm motility specifically. This is one of the benefits of taking an integrative approach to health and wellness – we combine ancient and modern to get better results.
Generally speaking, we consider a couple as having an issue with fertility when they have been having unprotected intercourse for two or more years without conception in the absence of other factors.
Beyond interpreting the results you bring from your doctor, I will ask you a number of questions about your general health, how long you have been trying to conceive and other fertility related questions, and lifestyle questions, like what you eat and what your work habits are. I also use the traditional diagnostic methods of acupuncture and Chinese medicine – pulse taking, tongue diagnosis and abdominal palpation. I do not conduct any physical exam of the genitals.
Commonly, I will treat both the man and woman who are trying to conceive in order to help the couple achieve optimal fertility. Treatments during IVF cycles and ICSI procedures have been shown to improve outcomes (i.e., conception).
How is low sperm count treated by my doctor?
Treatments for a decrease in sperm production may include:
- Hormone treatment to correct imbalances
- Surgery to treat swelling (varicocele)
- Drugs to treat infection
- In vitro fertilization (IVF) to allow conception: combining egg(s) with sperm in the laboratory and then placing the fertilized egg(s) back into the woman’s uterus
- Intracytoplasmic sperm injection (ICSI, pronounced “icksee”): injecting sperm directly into the egg as part of an IVF procedure
How does acupuncture treat low sperm count?
Chinese medicine has several different disease categories, also known as patterns, that describe the disharmonies in the body leading to infertility, and specifically low sperm count (oligospermia).
The first discussion of male infertility dates back to the Huangdi Neijing, one the oldest acupuncture texts. This book dates back to the late Warring States period (475-221 BC) and the early Han period (206 BCE–220 CE). Male fertility issues have been around for a while, and acupuncture has been used to treat them for just as long.
This text also talks about the normal cycles of life and how to maintain health throughout our lifetime. This gives rise to the concept of Yang Sheng, or nourishing life, which informs how we can eat, sleep, live our lives and always be healthy.
I combine acupuncture, herbal medicine, and dietary therapy with Qigong, self-massage, other lifestyle modifications to treat low sperm count as it relates to infertility. Acupuncture can always be used without herbal medicine, but results will be more significant if acupuncture and herbs are used together.