Medical questions & health advice by board certified doctors
"What causes low sperm count?"
My husband is wondering what may have caused him to become sterile or azoospermic
There are many possible reasons for a low sperm count. A basic question for your husband is whether or not this is a new problem. Has he previously fathered a child? Does he have any major medical history, such as diabetes or heart disease? Is he on any medications? Does he smoke or drink a lot of alcohol? Has he ever been examined by a doctor to confirm that he has descended testes? Has he ever had any surgeries in the groins, such as hernia repairs, or pelvic region for prostate problems? Or, has he had any radiation in the pelvic area? Sperm genesis requires proper nutrients as well as blood supply in and out of the testes. A common problem occurs in patients with varicocele or venous hypertension that both causes pain and reduced sperm count. This can happen because the testicular vein is narrowed or blocked. A patient with liver cirrhosis can also have portal hypertension leading to the same problem. Infection of the sperm production cells, such as chlamydia, gonorrhea, chronic inflammation or infection of the prostate (prostatitis), or mumps orchitis as a child can all affect one's sperm count. Some men can get an autoimmune reaction where their bodies specifically attack the sperm cells. Lastly, sperm production is regulated by a man's hormones that are controlled within the brain. Men with low testosterone levels will lead to reduced sperm count. Your husband should follow up with a primary care physician who can order basic testings and direct him to appropriate specialists in your area (i.e. urologist and infertility specialist) for treatment.
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