2 March 2019

Why does a low sperm count affect one in five men in the UK?

low sperm count
Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London


Research carried out by IVI has shown that levels of male infertility have almost doubled in just over a decade. In a ground-breaking study led by Dr. Ashley Teigs, her team found that the proportion of men at risk of needing fertility treatment has risen from 12.4% in 2004 to 21.3% in 2017. This is a huge increase of 72% compared to the 2004 starting point and represents 9% of the total male population in Europe and the USA in addition to the 12.4% who were known to have a low sperm count in 2004. The shocking conclusion is that 1 in 5 men in the UK can expect to encounter fertility problems.

In this IVI blog article, we explore the implications of these statistics, their causes, how and where to check sperm fertility and the possibilities for different types of treatment both through the NHS and through private fertility treatment.

Infertility in the UK: no longer a women’s issue?

The research puts paid to the old-fashioned belief that still lingers in parts of the UK and among some groups of people that infertility is mainly a women’s issue. Not any more. The fact is that male infertility now represents half the cases treated by assisted reproduction clinics and in general approximately 30% of fertility issues are due to male fertility factors, 30% due to female fertility factors and the remaining 40% are due to either a combination of factors or unexplained. So this is a firmly ungendered topic and one which can affect any adult hoping to start a family.

The reason for the current focus on male infertility it that its sudden increase has caused alarm bells to ring. There is no longer any doubt about the scale of the problem. The unprecedented numbers sampled in Dr Teigs’ study gives her results remarkable scientific weight. Almost 120,000 men across Europe and the United States were studied, making this the largest sample used to date in world scientific literature. The significance of the research results has been recognised with the Academic Award by the Society for Male Reproduction and Urology. The facts about the decline in sperm quality have been established. But the question remains: why?

What are the factors that cause a low sperm count?

Alarm about this phenomenon is fuelled by apocalyptic scenarios in popular fiction such as The Handmaid’s Tale or doomsday dystopian visions such as the sci-fi thriller Children of Men. The fact that these uncomfortable narratives have caught the public imagination does not help us to pinpoint the causes with accuracy, even though it may keep us on red alert. There is no shortage of speculation about the causes, ranging from environmental pollution to agricultural chemicals or hormones in the drinking water, from a diet dominated by processed food to over-exposure to electromagnetic radiation, to the more mundane overheating as a result of too-tight underwear. Although practitioners specialising in fertility can take educated guesses about the causes of declining sperm quality, the fact is that no-one knows for certain.

Last year, Professor Richard Sharpe from Edinburgh University Centre for Reproductive research gave a briefing at the Science Media Centre in London in 2018. “Our understanding of the key male fertility questions has moved on very little from the 1990s, according to Professor Sharpe. “We still don’t know what causes most cases of male infertility, which means we don’t have the tools to correct them,” he said. This was echoed by Dr. Garrido of the IVI research team. “There is a lot of research about the adverse effects of toxic lifestyle and constant exposure to negative environmental influences on sperm quality, but it is not yet known exactly how harmful these factors are” he said, adding “a continuous and more accurate study of these factors is required.”

What do we know so far about male infertility?

The NHS also acknowledges that although a low sperm count is the cause of the majority of cases of male infertility, in many cases, it’s not obvious what causes it. However it can make some suggestions for likely and possible reasons. These include:

  • a hormone imbalance or a genetic problem
  • having had undescended testicles as a baby
  • a structural problem such as the tubes that carry sperm being damaged
  • a genital infection such as chlamydia, gonorrhoea or prostatitis
  • varicoceles (enlarged veins in the testicles)
  • previous surgery to the testicles or hernia repairs
  • the testicles becoming overheated
  • excessive alcohol consumption, smoking and use of drugs such as marijuana or cocaine
  • certain medications, including testosterone replacement therapy, long-term anabolic steroid use, cancer medications and some antibiotics and antidepressants.

The NHS also recommends that you can help maximise your chances of conceiving by having sex every two or three days, moderating your alcohol consumption and stopping smoking, staying in good shape, exercising regularly and having a healthy, balanced diet. Probably none of these recommended measures will come as a surprise to any man hoping to become a parent. But how do know where to check sperm fertility to find out whether you are among the roughly one in five men in the UK with a low sperm count?

Finding out how and where to check sperm fertility levels

Even if you feel reluctant to consult your GP, it really is the best route to finding out whether a low sperm count is the problem behind difficulty conceiving. You can then get the specialist help that you may need if you want to start a family. You may feel tempted to buy one of the home testing kits available from chemists, but you should be aware of their limitations. In the IVI study, researchers stressed that total mobile sperm count (TMSC) is the most important parameter that predicts the probability of achieving a pregnancy. The problem with many home tests is that they only give an approximation of numbers of sperm, but not their motility. They could therefore give you a result that is not all that helpful.

If you get your fertility checked at a clinic that is licensed by the Human Fertilisation & Embryology Authority, whether through the NHS or through a clinic offering private fertility treatment, you can be confident of an accurate result.

How can you access fertility treatment?

If it turns out that you need some level of assisted fertility treatment, you may be able to access this through NHS funding in certain circumstances. However, fertility treatment funded by the NHS varies across the UK and waiting lists for treatment can be very long in some areas. The eligibility criteria can also vary. Your GP will be able to advise you on your eligibility for treatment. For some people in some areas, the best course could be to seek private fertility treatment.

IVI is a world leading fertility group with over 65 clinics in 11 countries. We are partnered with leading UK fertility experts, and we are committed to bringing the most innovative techniques and treatments in scientific research and development to our patients. If you have been diagnosed with a low sperm count, you may like to know that our clinic in London offer treatments at every level. You could also take the opportunity to browse our website for the full range of options plus facts and figures about the programs and treatments that we offer.

What treatments are available for a low sperm count?

Depending on whether the sperm deficit is mild, moderate or severe, there are 3 main treatments which could be recommended. These are intrauterine insemination, In Vitro Fertilisation (IVF), or IVF with the added technique of Intracytoplasmic Sperm Injection.

Intrauterine insemination (IUI)

IUI is one of the most straightforward forms of assisted fertility treatment. Sperm is prepared in the laboratory and is then placed directly into the woman’s uterus, increasing the chances that the sperm will reach and fertilise the egg.

In Vitro Fertilisation (IVF)

IVF is a well-established technique for creating embryos by fertilizing the egg with the sperm in a laboratory. The resulting embryo can then be transferred to the woman’s uterus.

Intracytoplasmic Sperm Injection (ICSI)

ICSI is an assisted reproduction technique used as part of an IVF treatment. The semen is provided in a sample or via testicular biopsy if necessary. Embryologists individually select the most promising sperm, which is subsequently used to fertilise the eggs. You may like to have a look at our video about ICSI and IVI which will take you through the process and how it works.



Contacting us at IVI

If you would like to find out more, or contact us for an appointment without obligation, you can get in touch by calling us on 0800 52 00 161. Alternatively use our online contact form and we’ll call you back.

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