What treatment options exist for oligospermia (low sperm count)?

By (gynecologist), (gynecologist), (embryologist), (biochemist) and (fertility counselor).
Last Update: 04/04/2024

The treatment of oligospermia depends on what is causing the diminished sperm count in the ejaculate. However, in most cases, the etiology of oligospermia cannot be found, and subsequently applying a specific treatment option is complicated.

There exist natural treatments that can help improve male fertility, as well as hormonal treatments or surgery, as long as the cause of oligospermia is known. It is important to point out that recovering a normal sperm count is difficult in many cases, and for this reason, the best option to become parents would be In Vitro Fertilization (IVF).

Natural treatment

Some males have temporary oligospermia due to higher stress levels, fever, or exceptional circumstances. In these cases, recovering an adequate sperm count is possible as long as you follow these tips:

  • Establish a healthier lifestyle
  • Follow a healthier, balanced diet
  • Practice sports regularly
  • Quit toxic habits, such as alcohol, tobacco, and drug use
  • Do no use anabolic hormones
  • Avoid exposure to environmental toxics

On the other hand, there exist certain natural herbs that have been traditionally used as a natural remedy to improve sperm quality, even though their effectiveness has not been scientifically proven to date.

Some of the most common natural remedies for asthenozoospermia are: damiana tea, Asian ginseng supplements, or maca root powder.

Maca root is a plant that grows in central Peru and is taken in combination with other herbs as a tea or as a supplement. It contains high levels of potassium, which triggers cell exchange and enhances the transmission of nerve impulses.

Maca root is beneficial for diminishing oxidative stress levels. Moreover, it contains folic acid (vitamin B6), which fights agains sperm cell aging.

Pharmacological treatment

Other therapeutic options to cure oligospermia are medications based on vitamin or hormone-balancing supplements. As in the case of home remedies, their efficacy has not been scientifically proven although in some cases they help improve or recover sperm production.

Vitamin supplements
consist of tablets rich in vitamin E, C and/or B6 that contain great amounts of antioxidants, which protect sperm DNA from fragmentation. Androferti® is an example.
Hormone-balancing supplements
for those patient with testosterone deficiency problems or other types of hormone imbalances, these supplements can rebalance hormone levels and help the testicles produce sperm normally again.
Clomiphene citrate tablets
this medicine is more commonly used by women with ovulation problems. However, it is also effective in males with hypogonadism, since it stimulates the function of the testicles.

For any of these treatment options to be applied, you need the prescription of a duly qualified urologist, and the treatment should be supervised to see if the male fertility improves.

Surgical treatment

In order to perform a surgical procedure to cure oligospermia, knowing the exact cause is crucial. For example, an obstruction or blockage typically require surgery for their removal.

Sometimes it is possible to treat testicular or post-testicular causes of oligospermia with surgery. Some examples include:

These cases are the ones with the best prognosis to increase the sperm count and be able to have children naturally.

Considering seeing a fertility specialist? Don't forget that, in the field of Reproductive Medicine, as in any other medical area, it is crucial that patients rely on the doctors and staff that will help them through their treatment cycle. Logically, conditions vary from clinic to clinic. For this reason, we recommend that you generate your Fertility Report now. It will offer you a list of clinics that have passed our rigorous selection process successfully. Furthermore, the system will make a comparison between the fees and conditions of each clinic so that you can make a better-informed decision.

FAQs from users

Is there any treatment to achieve natural pregnancy with oligozoospermia?

By Guillermo Quea Campos M.D. (gynecologist).

Decreased sperm concentration (Oligozoospermia) could be one of the reasons why pregnancy cannot be achieved in a natural way.

In the clinic we always request a sperm capacitation apart from a semen analysis. In this way we can decide if this sample is suitable for intrauterine insemination (IUI), in vitro fertilization (IVF) or ICSI cycles.

What is clomiphene citrate treatment for oligospermia and when is it used?

By Elisa PĂ©rez Larrea M.D., M.Sc. (gynecologist).

Clomiphene citrate is a safe drug that acts as a selective estrogen receptor modulator. It exerts its effects on the hypothalamic and pituitary systems, increasing the secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH), which in turn act on the testes, increasing testicular testosterone production and sperm production.

In men with oligospermia, normal testicular volume and low or normal LH levels, clomiphene citrate therapy can improve semen parameters at the level of volume, density and motility. However, fertility results are mixed, with some studies finding no benefit and others showing only a very small improvement in pregnancy rates.

Physicians generally do not recommend the use of clomiphene to treat male infertility, but it is sometimes prescribed because it is easy to use, safe and inexpensive. Reported side effects include headache, dizziness, visual changes, gynecomastia, and testicular enlargement.

Clomiphene citrate is therefore a safe and effective drug that can be used in men with oligospermia to improve semen parameters, although this improvement does not appear to have an impact on fertility.

What recommendations should I follow to increase my sperm count?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

It is true that your doctor can give you some tips that may help you increase your sperm count and quality, but actually, miracles do not exist. Oligospermia may be due to anatomical or endocrine problems that cause the man to be unable to produce sperm. Some health recommendations that should be followed by males with low sperm count include:

  • Avoiding alcohol, tobacco, and street drug use
  • Practicing regular exercise, since it improves blood flow, increasing the blood supply to the testes and favoring sperm synthesis
  • A healthy, balanced diet, with natural antioxidants present in fruit and vegetables, can improve the survival rate and motility of sperm, preventing oxidation as well
  • Practicing relaxation techniques such as meditation or yoga to diminish stress levels, since stress affects sperm vitality and leads to erectile dysfunction
  • Avoid sauna visits, hot baths, too tight clothes, putting the laptop on your lap, etc. These habits increase scrotal temperature and hinder sperm formation
Imagen: Tips to increase sperm count

What is the best treatment for severe oligospermia?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

For all types of oligospermia, that is, from mild to severe, the treatment to apply depends on the cause that originates a diminished sperm count. If the cause cannot be found and the patient has severe oligospermia, it is likely that he has to undergo IVF to have a baby.

Can acupuncture be used to cure oligospermia?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Some investigations have shown that acupuncture might be beneficial for male infertility when it is due to a reduced sperm count, specially in cases of oligospermia due to unexplained causes.

Is there any natural treatment that can cure oligospermia?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

There exist some natural remedies such as damiana or tribulus terrestris for infusion, Korean ginseng in capsules, Maca root powder, or certain Ayurveda treatments that are believed to improve oligospermia. Some experts state that acupuncture can be helpful as well. However, the natural remedy that best works involves following a healthy lifestyle, a balanced diet, and quitting unhealthy habits such smoking or drinking alcohol.

Can olive oil help with poor sperm quality?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Olive oil is a monounsaturated fat that is rich in oleic acid. If taken in great amounts, it helps destroy and eliminate the presence of "bad" cholesterol (LDL) in blood flow, which can help reduce the risk of having a cardiovascular and/or brain disease.

In relation to reproductive health, regular use of olive oil (especially virgin olive oil) along with the elimination of LDL cholesterol boost the arrival of oxygen to the testes. In other words, spermatogenesis will occur in optimum conditions.

To learn more about the causes of oligozoospermia before trying to find the best treatment option, please visit this post: What Causes Oligospermia?

In case you are unable to recover sperm production with the above mentioned treatment options, you may have no alternative but to undergo a fertility treatment to become parents. Continue reading: Achieving Pregnancy with Oligozoospermia.

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References

Adamopoulos DA. Medical treatment of idiopathic oligozoospermia and male factor subfertility. Asian J Androl. 2000;2(1):25-32.

Foresta C, Selice R, Ferlin A, Garolla A. Recombinant FSH in the treatment of oligozoospermia. Expert Opin Biol Ther. 2009;9(5):659-66 (View)

Jeremy T Choy, John K Amory. Nonsurgical Management of Oligozoospermia. J Clin Endocrinol Metab. 2020 Dec 1;105(12):e4194-e4207. doi: 10.1210/clinem/dgaa390 (View)

Li J, Hu Y, Zhang Q, Ma B, Wu Z, Wang Y, Sun J, Zhu J, Ying H, Ouyang P. Strontium fructose 1, 6-diphosphate alleviate cyclophosphamide-induced oligozoospermia by improving antioxidant and inhibiting testicular apoptosis via FAS/FASL pathway. Andrologia. 2015;47(9):995-1003 (View)

Lunglmayr G. Potentialities and limitations of endocrine treatment in idiopathic oligozoospermia. Acta Eur Fertil. 1983;14(6):401-4

McLachlan RI. Approach to the patient with oligozoospermia. J Clin Endocrinol Metab. 2013;98(3):873-80 (View)

Niederberger C. Re: Clinical outcome of microsurgical varicocelectomy in infertile men with severe oligozoospermia. J Urol. 2015;193(1):255 (View)

Sermondade N, Faure C, Fezeu L, LĂ©vy R, Czernichow S; Obesity-Fertility Collaborative Group. Obesity and increased risk for oligozoospermia and azoospermia. Arch Intern Med. 2012;172(5):440-442 (View)

FAQs from users: 'Is there any treatment to achieve natural pregnancy with oligozoospermia?', 'What is clomiphene citrate treatment for oligospermia and when is it used?', 'What recommendations should I follow to increase my sperm count?', 'What is the best treatment for severe oligospermia?', 'Can acupuncture be used to cure oligospermia?', 'Is there any natural treatment that can cure oligospermia?' and 'Can olive oil help with poor sperm quality?'.

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Authors and contributors

 Elisa PĂ©rez Larrea
Elisa PĂ©rez Larrea
M.D., M.Sc.
Gynecologist
Dr. Elisa PĂ©rez Larrea is a graduate in Medicine and Surgery from the University of Zaragoza and a specialist in Obstetrics and Gynecology from the University of Oviedo. She also has a Master's degree in Human Reproduction from the Complutense University of Madrid. More information about Elisa PĂ©rez Larrea
Licence number: 203311163
 Guillermo Quea Campos
Guillermo Quea Campos
M.D.
Gynecologist
Guillermo Quea, MD has a degree in Medicine and Surgery from the University of San Martin de Porres. He also has a Master's Degree in Human Reproduction from the Universidad Rey Juan Carlos and another in Public Health and Preventive Medicine from the Universidad del PaĂ­s Vasco. More information about Guillermo Quea Campos
Member number: 282860962
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Michelle Lorraine Embleton
Michelle Lorraine Embleton
B.Sc. Ph.D.
Biochemist
PhD in Biochemistry, University of Bristol, UK, specialising in DNA : protein intereactions. BSc honours degree in Molecular Biology, Univerisity of Bristol. Translation and editing of scientific and medical literature.
More information about Michelle Lorraine Embleton
 Sandra Fernández
Sandra Fernández
B.A., M.A.
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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