Grace Fertility

How does Severe Oligospermia Affect Pregnancy Chances and How to Conceive with It?

Authored & Verified by: 

Dr. Reubina Singh

Dr. Reubina Singh

MS (OB/GYN), MBBS - Senior Infertility Specialist

Chances of Getting Pregnant with Severe Oligospermia

Are you diagnosed with severe oligospermia and worried how it affects your chances of getting pregnant? This article can help.

In this comprehensive article, we will be trying to explain oligospermia, how it affects male fertility, its causes, its symptoms, how the condition is diagnosed, what are the chances of pregnancy with severe oligospermia, along with different ways to conceive with the condition.

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What is Oligospermia?

What is Oligospermia

Having a healthy sperm count is essential for any man’s reproductive health. Though sperm count in men tends to fluctuate throughout their lives, having a healthy count is absolutely necessary for them to be able to reproduce/induce conception.

According to a recent report issued by the World Health Organization (WHO), having a sperm count of anywhere at or above 15 million sperm per mL of ejaculated semen is considered healthy. Having a sperm count anywhere below that classifies as oligospermia.

It is the condition when a male’s ejaculated semen does not contain a healthy sperm count, causing infertility and other associated reproductive issues.

This condition has four common stages:

  • Mild oligospermia: Pregnancy can be achieved naturally. The man has 10-15 million sperm per mL of semen. 
  • Moderate oligospermia: Pregnancy can be achieved naturally. But, the pregnancy may take longer and the couple may require some conception assistance. The man has 5-10 million sperm per mL of semen.
  • Severe oligospermia: Pregnancy cannot be achieved naturally. The couple will require fertility treatments to attain pregnancy. The man has 2-5 million sperm per mL of semen.
  • Azoospermia: Azoospermia is an extreme case of oligospermia where there is an absolute absence of sperm in the ejaculated semen. It is of both obstructive (blockage that prevents sperm to ejaculate) and non-obstructive (testicles stop producing anymore sperm) natures. 

How does Oligospermia affect male fertility?

How does Oligospermia affect male fertility

Oligospermia does not only affect a man’s potential to reproduce due to lower sperm count. In mild and moderate cases, a man can still induce conception with a little medical help and extra effort. But, the condition often escalates the likelihood of other reproductive problems as well.

A man with oligospermia (low sperm count) is also at a risk of developing reproductive conditions such as erection and ejaculation disorders, and poor sperm quality and motility.

In some cases, it is also possible that a poor-quality sperm manages to fertilize the egg and result in a pregnancy. But the pregnancy will be more likely to end up in a miscarriage or delivering a child with genetic abnormalities.

Oligospermia Causes

Oligospermia Causes

A number of health conditions and lifestyle factors can increase a man’s chances of developing oligospermia. These include:

Sexually transmitted infections (STIs)

The presence of certain STIs such as gonorrhea and chlamydia causes the testicles to become swollen, affecting sperm count.


Varicoceles or scrotum varicose veins is a condition when veins in the scrotum (the skin that holds testicles) become enlarged. These veins are responsible for carrying oxygen and blood to the testicles. The enlargement of these veins disturb blood flow to the testicles, affecting testicle health and causing a sperm count decline.

Ejaculation problems

Ejaculation problems such as retrograde ejaculation can affect sperm count. In this condition, as a man reaches an orgasm and ejaculates, the semen goes into the bladder rather than ejaculating out of the penis. Other than this, certain injuries, surgeries or tumors that affect a man’s ejaculation can affect sperm count as well.

Certain medications

There are certain medications used for high blood pressure, arthritis, indigestion, certain infections, or anxiety and depression can also lower sperm count. These include antibiotics, alpha-blockers, and beta-blockers.

Hormonal imbalances

Pituitary gland and testicles produce certain hormones that affect ejaculation production of sperm. Having any of such hormones imbalanced might lead to a decline in sperm count.

Consumption of recreational drugs and alcohol

Recreational drugs such as marijuana and cocaine, alcohol and smoking cigarettes have been found in multiple case studies to drop sperm count in men.

Klinefelter’s syndrome

Klinefelter’s syndrome is a chromosomal anomaly when a male is born with an extra X chromosome. Men who are born with Klinefelter’s syndrome are likely to have lower testosterone, lower muscle mass, lower body and facial hair growth, and reduced production of sperm.

Previous injuries or surgeries

Certain past injuries and surgeries that affect scrotum and testicles can also contribute to causing lower sperm production.

Psychological stress

Psychological stress increases the production of cortisol, the stress hormone whose presence for extended periods of time affects production of certain essential hormones including testosterone, leading to poor sperm count.


Several case studies have confirmed the connection between fertility and body weight. Men who are obese or overweight are at a risk of producing low sperm. Commonly, it is due to the abnormal hormonal and structural changes in the body.

Oligospermia Symptoms

Oligospermia Symptoms

For most men, there are no visible early signs or symptoms of oligospermia (low sperm count). Usually, men tend to find out about the condition when they see a doctor for fertility complications. However, in some cases, the following symptoms can indicate that there is some problem with the reproductive function. 

  • Sexual dysfunctions such as: Inability to get or maintain an erection and/or low sexual desire.
  • Pain, swelling or development of lumps around the testicles.
  • Pain during urination, and
  • Swelling of the veins in the scrotum

Oligospermia Diagnosis

Oligospermia Diagnosis

A semen analysis test is generally performed to diagnose oligospermia or examine overall sperm health. This test assesses sperm count, quality, motility, morphology and any present abnormalities.

However, in some cases, the doctor may order some further tests such as:

  • Endocrine system test to assess hormone levels
  • Genetic testing
  • Urine test to diagnose retrograde ejaculation, and
  • Ultrasounds to examine reproductive organs

What are the chances of getting pregnant with severe oligospermia?

What are the chances of getting pregnant with severe oligospermia

In cases of mild and moderate oligospermia, a man can likely induce conception naturally, sometimes requiring a little medical help and more effort. But, in severe cases where a man’s sperm count is at or below 5 million sperm per mL, seeking a fertility treatment might be absolutely necessary. Because, men with severe oligospermia have a very rare chance of inducing natural conception.

Ways to conceive with severe Oligospermia

Ways to conceive with severe Oligospermia

There are a number of effective treatments available for oligospermic couples to achieve conception that are as following:

Conception assistance

Conception or reproductive assistance is a clinical procedure that intends to assist infertile couples become pregnant and sustain a healthy pregnancy. Assisted conception technologies (ARTs) that can help oligospermic couples get pregnant are:


Intrauterine insemination (IUI) is an ART involving the retrieval of sperm, washing and concentrating them and directly inseminating them around the uterus throughout an ovulation cycle. IUI treatment is best for mild and moderate cases because this treatment requires the retrieval of a specific volume of sperm to proceed which may not be possible in cases of severe oligospermia. 


In-vitro fertilization (IVF) is another ART involving fertilization of the egg outside the woman’s body. This procedure requires sperm retrieval, egg retrieval, fertilization, fertilized egg incubation, and embryo transfer. Oligospermic couples who did not have a positive outcome from IUI procedure, IVF is a more advanced choice. One can find best IVF Center near their residence by searching on internet.


Intracytoplasmic sperm injection (ICSI) is an advancement to the conventional IVF procedure. Followed by conventional IVF, this treatment involves sperm extraction and injecting the retrieved egg with the healthiest single live sperm during the fertilization process. Though it is a complicated yet costly procedure, it is considered the most effective pregnancy treatment for men with severe oligospermia.

Lifestyle Improvements

If a man has a mild or moderate oligospermia and he is intending to try natural conception before heading towards a specific treatment, making some right lifestyle improvements will help. Making habitual changes such as eating healthy, managing body weight, cutting off smoking, alcohol and use of recreational drugs, and taking certain essential supplements could support sperm production.

Mild to moderate oligospermic men can conceive naturally. It may take a bit longer, he may need to put extra effort, and sometimes require a little medical help, but it is likely that conception will happen eventually. If things do not work out, the patient always has several treatments available for the same. 

The Bottom Line

Treatment options for oligospermia

Oligospermia is more common than you think it is. Most people do not discover it their entire life and still manage to have children. In most cases, oligospermia is mild or moderate that does not require any treatment and natural pregnancy is still possible.

The condition becomes a concern when it is severe and the couple is not capable of natural conception. This requires them to undergo a certain clinical procedure such as IUI, IVF or ICSI to assist their conception. But, pregnancy is still possible medically.

If you have also been diagnosed with oligospermia and cannot conceive naturally, you can always see a fertility doctor to identify its underlying cause and seek an effective treatment accordingly.

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