The average sperm count is 75 million sperm per milliliter of semen. Sperm count is considered low if it dips below 15 million sperm per milliliter of semen. Sperm count can fluctuate, so clinicians typically confirm a diagnosis with multiple semen analyses over time.

Low sperm count can make it harder to conceive naturally and may be linked to other health issues like hormone imbalances, chromosomal abnormalities or varicoceles.

Possible Causes of Low Sperm Count

Scientists suspect a combination of factors may be contributing to the global decline in sperm count:

• Lifestyle choices. Obesity, poor diet, tobacco use, alcohol consumption, marijuana use, cocaine use, anabolic steroid use and lack of exercise are all linked to lower sperm counts.
• Environmental toxins. Exposure to chemicals like pesticides, heavy metals (like lead and mercury) and industrial pollutants might play a role.
• Increased stress level. Chronic stress can disrupt hormone production and impact sperm health.
• Heat exposure. Overheated testicles can affect sperm production. Using hot tubs and saunas, or keeping a computer on your lap for long periods can temporarily decrease sperm count. "One of the biggest enemies to sperm production and sperm quality is heat," says Dr. Bennett.
• Medical conditions. Varicoceles, a condition where veins in the scrotum become swollen and enlarged, can increase testicle temperature and lower sperm count and quality. Other medical conditions that can impact sperm count include genetic disorders like Klinefelter syndrome and cystic fibrosis, as well as hormonal imbalances.

Steps to Improve Sperm Count and Quality

If you're trying to conceive, a diagnosis of low sperm count can be stressful. However, you can take action to improve your sperm count and overall reproductive health.

• Avoid harmful habits. Quit smoking, limit alcohol consumption and stop using recreational drugs. If you need help, consult your primary care physician.
• Eat a healthy diet. Eat a lot of fruits, vegetables and lean proteins. Research shows a healthy diet is linked to higher sperm counts.
• Exercise regularly. Maintain a healthy weight through regular exercise, but avoid muscle-building steroids. They can negatively impact sperm production.
• Keep your testicles cool. Beat the heat and keep your testicles at room temperature. This means keeping your laptop off your lap, staying out of hot tubs and saunas, and wearing loose underwear and pants to lower the risk of trapping heat.
• Manage stress and prioritize sleep. Aim for seven to eight hours of sleep each night, as it can help with sperm production. If stress starts to affect your quality of life and sleep, consider seeking help from a behavioral health professional.

Dr. Bennett often advises patients on the connection between diet and sperm health, saying, "What's good for your heart is good for your penis and testicles. So, do what the cardiologists say to do. Eat a Mediterranean diet with plenty of fruits, vegetables, simple grains, and clean protein from fish and chicken. Not a lot of red meat."

However, he emphasizes that diet should not be the only focal point. "It's not just, 'Eat this one thing or eat this conglomeration of things, and your sperm count and quality will go up,'" Dr. Bennett explains. "It really is a combination of diet, exercise and lifestyle choices that do it."

When to Seek Medical Care

If you have been trying to conceive for an extended period without success, or if you are experiencing symptoms such as erectile dysfunction or low sex drive, which may indicate low sperm count, talk to your primary care physician about options. They may recommend consulting a urologist or infertility specialist to conduct a baseline semen analysis.