Abnormal semen analysis are one of the most common causes for difficulty conceiving in a couple. In an abnormal semen analysis, one of the most common abnormalities is a low sperm count. Sperm counts are considered low if the count is generally less than 20 million sperm per milliliter of ejaculate. Some experts consider less than 15 million per milliliter as being the lower limit of normal.
Why do men have low sperm counts? Some have low sperm counts due to genetic abnormalities where they actually produce very low numbers of sperm. Some actually have obstructions in the reproductive system whereby sperm can't go from the higher end of the testicle down into the urethra to come out in the ejaculate. So there are both non-obstructive and obstructive causes of abnormal semen analysis and low sperm count.
Many men have absolutely no sperm in the ejaculate and yet they're not necessarily completely infertile when using certain infertility specialists. Many men have absolutely no sperm in their ejaculate but they are not necessarily infertile if they are subject to the proper treatments.
In the event that a man has a very low sperm count, he needs to undergo a very detailed and comprehensive physical examination by a urologist, and also a detailed endocrine evaluation that is checking certain hormone levels. Infectious disease levels are also checked and often a man's chromosomes are checked, especially the Y chromosome to determine if there are any abnormalities that have caused the man to be unable to produce sperm.
In cases in which the sperm is determined to be obstructed in its flow, then the urologist can often obtain sperm by, under anesthesia, placing a needle into the testicle and sampling the testicular tissue above the level of obstruction. In these cases, many pregnancies have been achieved by in vitro fertilization using that sperm.
Even a single sperm will often result in a pregnancy by injecting that one sperm into the egg and creating a viable embryo. In cases of mild abnormalities and sperm count, there are certain medications that can often induce a man to create more sperm. Some of these medications, for example clomiphene have been used in women too, to induce ovulation.
This medication stimulates the brain to stimulate the ovaries often causing sperm production to rise. These are the different treatments that can be used for men with poor semen analyses. They include medical treatments, lifestyle changes and surgical options.