Fertility problems
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Problems with sperm

Most men with fertility problems have one or all of these problems:

  • Too few sperm (low sperm count)
  • Abnormally shaped sperm
  • Sperm that don't swim well.
Low sperm count
A normal sperm sample should contain at least 40 million sperm or at least 20 million sperm per milliliter (ml for short). Half of these should be moving.
 
 
 
 
 
Source:
Institute for Clinical Systems Improvement.
Diagnosis and management of basic infertility.
May 2004. Available at http://www.icsi.org/infertility/diagnosis_and_management_of_infertility_2301.html (accessed on 29 July 2009).
 
 
 
 
 
1

If a man is infertile, it may be because he makes too few sperm. Or the sperm may be abnormal.

If you have fewer sperm than this, you have a low sperm count. This doesn't mean that you and your partner can't get pregnant, but it may take longer.

Doctors define borderline sperm quality as between 10 million and 20 million sperm per milliliter of semen, 30 percent to 50 percent mobile sperm and 4 percent to 14 percent of sperm with normal appearance.
 
 
 
 
 
Source:
van Rumste MM, Evers JL, Farquhar CM, et al.
Intra-cytoplasmic sperm injection versus partial zonal dissection, subzonal insemination and conventional techniques for oocyte insemination during in vitro fertilisation Cochrane review).
In: The Cochrane Library. Update Software, Oxford, UK.
 
 
 
 
 
2

Doctors define very poor semen quality as less than 10 million sperm per milliliter of semen, under 30 percent mobile sperm and under 4 percent of sperm with normal appearance.
 
 
 
 
 
Source:
van Rumste MM, Evers JL, Farquhar CM, et al.
Intra-cytoplasmic sperm injection versus partial zonal dissection, subzonal insemination and conventional techniques for oocyte insemination during in vitro fertilisation Cochrane review).
In: The Cochrane Library. Update Software, Oxford, UK.
 
 
 
 
 
2

Some men have a very low sperm count or no sperm at all.
 
 
 
 
 
Source:
Debuse M.
Endocrine and reproductive systems.
In: Horton-Szar D (editor). Mosby's Crash Course. Mosby, London, UK; 1998.
 
 
 
 
 
3 A low sperm count may be caused by:

  • An imbalance of
     
     
     
     
     
    hormones
    Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone estrogen is made in a woman's ovaries. Estrogen has many different effects on a woman's body. It makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.
     
     
     
     
     
    hormones
  • Previous damage to the testicles
  • An infection in the testicles
  • Your
     
     
     
     
     
    genes
    Your genes are the parts of your cells that contain instructions for how your body works. Genes are housed on chromosomes, structures that sit in the nucleus at the middle of each of your cells. You have 23 pairs of chromosomes in your normal cells, each of which has thousands of genes. You get one set of chromosomes, and all of the genes that are on them, from each of your parents.
     
     
     
     
     
    genes: A low sperm count sometimes runs in families.
Sometimes doctors do not know why someone has a low sperm count.

Abnormal sperm
Sperm may be abnormally shaped. They may have two heads or two tails, for example. This may stop them moving normally or fertilizing an egg. We don't know why this happens.

See More about sperm.

Sources for the information on this page:
  1. Institute for Clinical Systems Improvement.Diagnosis and management of basic infertility.May 2004. Available at http://www.icsi.org/infertility/diagnosis_and_management_of_infertility_2301.html (accessed on 29 July 2009).
  2. van Rumste MM, Evers JL, Farquhar CM, et al.Intra-cytoplasmic sperm injection versus partial zonal dissection, subzonal insemination and conventional techniques for oocyte insemination during in vitro fertilisation Cochrane review).In: The Cochrane Library. Update Software, Oxford, UK.
  3. Debuse M.Endocrine and reproductive systems.In: Horton-Szar D (editor). Mosby's Crash Course. Mosby, London, UK; 1998.
This information was last updated on Aug 06, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
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