Like most things about our bodies, there is a wide range of “normal” when it comes to sperm count. On average, men produce anywhere from 40 million to nearly 1 billion sperm cells each time they have sex.
It is hard to say exactly how many sperm you need to get pregnant, but here are a few rules of thumb.
More is better: S analyses and home tests generally show a cut-off of about 15 million per mL of semen as “normal.” The truth is, many studies have shown that fertility improves as sperm count increases. To optimize your chances of conception, sperm count should really be higher than 55M/mL.
Quality can make up for quantity: Men who produce healthier sperm don’t need as many to conceive. Improvements in motility or morphology can also improve chances of conception.
How low can you go? As sperm count goes down, chances of conceiving also go down. When sperm count dips below 10 million / mL, chances of conceiving naturally get pretty low, even when motility and morphology are within the normal range.
In-vitro fertilization is a miracle of modern medicine that has enabled millions of people to conceive who otherwise would never have been able to. However, having a low sperm count does not automatically mean that you have to go directly to IVF as a means to conception. Here are some things to do if you discover that your partner has a low count:
Establish a baseline: Sperm count can fluctuate by quite a bit, so it is important to measure sperm count more than once understand your baseline fertility. Taking the average of two tests that are done about a month apart can help you understand what your average sperm count really is.
Talk to a urologist: Find a urologist who has specialty training in male reproduction. Usually this will include a fellowship or other training in fertility. A full male fertility evaluation generally includes a semen analysis, physical exam, hormone measurements and genetic screening. Talking to the right doctor will help you get to the heart of what’s going on, and what your options really are.
Get healthy: There are lots of things men can do to improve their health and their fertility. Some simple ideas include avoiding things that can elevate heat below the belt, such as hot tubs or saunas, laying off on alcohol or cigarette use, losing weight, or starting a multivitamin regimen. For some men, just doing a few of these things has been shown to double or triple their sperm counts.
Know the cut-offs: In the world of assisted reproduction, sperm are typically measured by the total progressively motile sperm present in a sample. Studies have been done to correlate success rates of natural conception, IUI, IVF and IVF using ICSI with various sperm counts. It is important to get educated on the success rates and trade-offs between various procedures before making a decision about how to move forward.
Ultimately, conception is a team sport and a process that medicine cannot fully quantify. There is no “right” way to make it happen, but learning about each of your bodies and taking steps to improve your health can help open more doors.