To know the sperm count in the ejaculate it is necessary to perform a semen analysis. In addition to other semen characteristics, in this male fertility study it can be evaluated whether there is a sufficient amount of sperm to achieve a natural pregnancy.
The number of spermatozoa in a man's semen is important when it comes to achieving a pregnancy, as many of them die on the way to the egg. However, if a man has a low concentration of sperm in his ejaculate it does not mean that he will not achieve pregnancy, but it will be more complicated.
The vagina, the passage through the cervix, and the arrival to the fallopian tubes are a biological gymkhana in which many sperm do not reach their destination, so it is essential to start the race with a good sperm concentration.
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Sperm count
When a male obtains a semen sample by masturbation and collects it in a sterile container, it remains at rest in the laboratory for about 20 minutes to promote liquefaction of the fluid. This time is necessary for the seminal sample to lose viscosity and become more liquid. In addition, the temperature must be adequate so that sperm motility is not affected.
A drop of semen is then taken and placed in a counting chamber so that it can be observed under a microscope.
The most commonly used sperm counting chamber is the Makler chamber, which consists of a perfectly defined 10-row x 10-column grid that facilitates counting.
The counting method consists of counting the spermatozoa in every 10 squares, that is, in each row or column. This result must be multiplied by the factor106/ml (1 million per milliliter) and, finally, the sperm concentration expressed in millions of spermatozoa per ml is obtained.
To make the count more reliable, it is necessary to count several rows or columns of the grid and average all the results obtained. Similarly, there are specialists who prefer to count in two different drops of semen so that the result is closer to reality.
Finally, the sperm concentration obtained is multiplied by the volume of the semen sample to know the total amount of spermatozoa contained in an ejaculate.
Normal values
The normal number of sperm in the ejaculate of a fertile male should be equal to or greater than a concentration of 15 million sperm per milliliter or at least a total concentration of 39 million sperm in the ejaculate.
These parameters have been set by the World Health Organization (WHO) in its last report in 2010 with the aim of unifying the criteria and establishing lower reference limits in all andrology laboratories. However, in 2021 the manual was updated, although the 2010 criteria are still often taken into account.
This lower reference limit for sperm concentration was 20 million/ml of spermatozoa (WHO 1999) in the past. However, male fertility has suffered a general decline in recent times, and, in addition, men who have children naturally nowadays have an average of 15 million/ml or more.
Therefore, men who have less than 15 million/ml of sperm in their sperm count will have difficulty in getting their partner pregnant. This sperm alteration is what is known as a oligospermia.
If you want to learn more about this sperm disorder, we recommend you to visit the following article: What is oligospermia - Causes, types, and treatments.
Low sperm count
Oligospermia or oligozoospermia is a low sperm count in the ejaculate taking into account the 15 million/ml that the WHO considers normal.
There are different degrees of oligospermia depending on how high or low the sperm coun tis. Therefore, the appropriate fertility treatment to achieve pregnancy will vary in each case:
- Mild oligospermia
- artificial insemination may be sufficient if the woman has no infertility problems.
- Cryptozoospermia
- is the most serious case of oligospermia (100,000 spermatozoa/ml) and ICSI will be necessary to fertilize the eggs.
The most extreme case would be azoospermia, that is, when no sperm is found in the semen. Sometimes it is possible to retrieve the sperm directly from the testicle with a biopsy but if this is not possible, a sperm donation is necessary to become a father.
Causes
The causes of low sperm count in men are very diverse and sometimes unknown. There are more common factors or situations that can cause an alteration of sperm characteristics in certain circumstances. Some of them are as follows:
- Nutritional deficiency.
- Fever episodes in the last three months.
- Stress.
When these symptoms disappear, the sperm concentration normally returns to normal and the man regains his fertility. Therefore, it is essential to repeat a second semen analysis after a while of trying to follow a healthy lifestyle and taking care of one’s health.
FAQs from users
How much amount of sperm is considered optimal in a sperm sample?
When we perform an evaluation of a semen sample, we analyze several factors, most importantly density (the amount of sperm per millimeter of ejaculate), motility (the percentage of moving sperm), morphology (the percentage of normal shaped sperm), volume (the amount of the ejaculate), and pH.
As a result, the measurement of density is not sufficient to provide reassurance for the adequacy of the semen sample. Ideally, if all parameters at the time of the semen analysis are near or above normal ranges and there is greater than 20 million motile sperm following semen processing in preparation for insemination of the eggs, then the semen sample is considered optimal for IVF.
How many sperm cells does a man need in order to be considered fertile?
According to the reference limits for the analysis of semen samples established by the WHO, a semen sample is considered normal when it presents a minimum of 15 million spermatozoa per milliliter and 39 million spermatozoa in the ejaculate.
Although these are the reference values for classifying a semen sample as normal, this does not mean that men with semen samples below these values are infertile.
Can you increase sperm count?
Yes, as long as the male testicles are functional and there is sperm production. There are nutritional supplements that can help improve sperm production, such as vitamin complexes and antioxidants that reduce the damage caused by free radicals to spermatozoa.
Read more
How many sperm cells are required for artificial insemination?
Artificial insemination requires a TMSC (total motile sperm count) of at least 3 million, i.e. at least this concentration of sperm must be moving adequately to have a chance of reaching the egg and fertilizing it.
On the other hand, for in vitro fertilization or ICSI, no minimum number of sperm is required, especially for ICSI, since only one sperm is chosen for each egg and introduced directly into it.
For more information about TMSC, see this link: Advanced Semen Analysis: Evaluating the Motile Sperm Count.
Suggested for you
We have talked about oligospermia as a cause of male infertility due to low sperm concentration. If you want to continue reading about this topic you can enter the following link: What is oligospermia?
ICSI is the technique that offers the highest success rates in patients with low sperm count. To find out what this treatment consists of, we recommend that you read on at the following link: What is ICSI?
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References
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Guzick DS, Overstreet JW, Factor-Litvak P, Brazil CK, Nakajima ST, Coutifaris C, et al. (2001). Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med 2001; 345: 1388-1393 (View)
Kirby EW, Wiener LE, Rajanahally S, Crowell K, Coward RM. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril. 2016;106(6):1338-1343 (View)
McLachlan RI. Approach to the patient with oligozoospermia. J Clin Endocrinol Metab. 2013;98(3):873-80 (View)
Meistrich ML. Effects of chemotherapy and radiotherapy on spermatogenesis in humans. Fertil Steril. 2013;100(5):1180-6 (View)
Sermondade N, Faure C, Fezeu L, Lévy R, Czernichow S; Obesity-Fertility Collaborative Group. Obesity and increased risk for oligozoospermia and azoospermia. Arch Intern Med. 2012;172(5):440-442 (View)
World Health Organization (WHO) (2010). WHO laboratory Manual for the examination of human semen and sperm-cervical mucus interaction. Cambridge Academic Press (View)
FAQs from users: 'How much amount of sperm is considered optimal in a sperm sample?', 'How many sperm cells does a man need in order to be considered fertile?', 'Can you increase sperm count?' and 'How many sperm cells are required for artificial insemination?'.
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