What can cause low sperm count?

There are several things that can go wrong with the hormone system whch can result in a low sperm count:

• The brain can fail to release gonadotrophic-releasing hormone (GnRH) properly, causing a lack of testosterone and a cessation in sperm production.
• The pituitary can fail to produce enough luteinizing hormone (LH) and follicle stimulating hormone (FSH) to stimulate the testes and testosterone/sperm production.
• A man may produce other hormones and chemical compounds that interfere with the sex-hormone balance.

Hormonal Disorders That Can Disrupt Male Fertility

Hyperprolactinemia
Elevated prolactin is found in 10-40% of infertile men. Greater elevations of prolactin reduces sperm production, reduces libido, and may cause impotence. This condition responds well to the drug Parlodel (bromocriptine).

Panhypopituitarism
Complete pituitary gland failure: lowers growth hormone, thyroid-stimulating hormone, and LH and FSH levels. Symptoms include: lethargy, impotence, decreased libido, loss of secondary sex characteristics, and normal or undersized testicles. Supplementing the missing pituitary hormones may restore vigor, and a hormone called hCG may stimulate testosterone and sperm production.

Hypothyroidism
This condition is found in only 1% of infertile men. Low thyroid hormone levels can cause poor semen quality and poor testicular function. This may be caused by a diet high in iodine. Reducing iodine intake or beginning thyroid hormone replacement therapy can elevate sperm count.

Congenital Adrenal Hyperplasia
This condition is found in only 1% of infertile men. It occurs when the pituitary is suppressed by increased levels of adrenal androgens. Symptoms include low sperm count, an increased number of immature sperm cells, and low sperm cell motility. It is treated with cortisone replacement therapy.

Hypogonadotropic Hypopituitarism
Low pituitary gland output of LH and FSH. This condition arrests sperm development and causes the progressive loss of germ cells from the testes, and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate. It can be treated with the drug Serophene. However, if all germ cells are destroyed before treatment commences, the man may be permanently infertile.