Low sperm count

M looked depressed when he came into my consultation room with his wife. They have been married for 3 years and were grappling with fertility issues.

“Doc, my wife has been checked. She is alright.”  He said, “The problem lies with me. My sperm count is low. The other doctor suggested IVF but I am not very keen for my wife to undergo the procedure as I know it is quite uncomfortable, stressful and doesn’t guarantee success. Are there any ways that you can help me improve my sperm count?”

M was overweight with a BMI of 29. He did not smoke or drink. There was no history of sexually transmitted diseases or past surgery on his reproductive system. Examination of his genitals and ultrasound scan of his testis were normal. His blood hormone levels were within normal limits. A repeat semen analysis showed a sperm count of 12 million per ml. which is below the normal value of 15 million per ml.The motility of the sperm and shape of the sperm were slightly below par.

Low sperm count or oligospermia is a common cause of male infertility It is a complex problem and in about 50 % of patients, no cause can be found.

Other causes of low sperm count include:

· Frequent use of saunas or hot tubs, sitting for long periods, wearing tight clothing and working on a laptop computer for long stretches of time

· Taking drugs, drinking alcohol and smoking cigarettes

· Infection of testis and prostate gland caused by tuberculosis, mumps and sexually transmitted diseases like Chlamydia and gonorrhea

· Presence of varicoceles or testicular tumours

· Previous hernia or testicular operations

· Genetic causes resulting in children born with small and undeveloped testis

· Abnormal hormone production from the brain causing small testis and low sperm count.

· Long standing liver or kidney diseases

I advised M to wear loose undergarments and trousers and to lose weight by regular exercise such as swimming. I also told him not to go for sauna and to try to bathe with cold water as far as possible. As for a balanced diet, M was instructed to take food rich in vitamins and trace elements such as brightly colored fruits and vegetables like carrots, tomatoes, spinach, broccoli, green beans, oranges berries and nuts like almond and walnuts.

I also prescribed supplements rich in Vitamins A, B complex, C and E and trace elements Zinc and Selenium.

M took my advice seriously. He felt better after losing about 7 Kg in 5 months. His sperm quantity and quality improved gradually. His wife conceived recently after the second attempt with IUI (intra-uterine insemination of the sperm).

Recently, I received a greeting card from him. “Doc, thank you for helping us bring a new life to this world. It is the best gift for this new year,” he wrote.