Low Sperm Count but Normal Motility: What It Means for Fertility

Low sperm count, but normal motility?

I recently wanted to try to conceive, so I went for a sperm analysis.
Today I received the report, which shows the following results: pH: 8.0, Total volume: 3 ml, Sperm count: 31 (40-150 x 10^5/ml), Morphology: 90%, Red blood cells: 0, White blood cells: 1, Liquefaction time: 60 minutes, Grade A: 23%, Grade B: 42%, Grade C: 9%, Grade D: 26%, Motility rate: 74%.

I am particularly concerned about the sperm count, as I noticed that the online references use 10^6/ml as the unit, while mine is indicated as 10^5/ml.
Is it possible that there was an error in the testing? Additionally, the report notes that a sperm count of less than 100 million indicates a concerning condition.
Does this mean my situation is critical? Also, this sample was collected after 3 days of abstinence; should I wait longer before retesting?

Cai Lian, 30~39 year old female. Ask Date: 2018/09/13

Dr. Fu Shizhang reply Urology

The normal lower limit for sperm count is 15 million per milliliter.
There is no need to consider whether it's 10^5 or 10^6; a count below this indicates oligospermia.
However, it is advisable to conduct a repeat test to confirm if the sperm count is indeed low.

Reply Date: 2018/09/13

More Info

When it comes to fertility, sperm analysis is a crucial step in understanding male reproductive health. Your recent sperm analysis report indicates a total sperm count of 31 (in units of 10^5/ml), which translates to 3.1 million sperm per milliliter if we consider the standard unit of measurement. This is significantly below the World Health Organization (WHO) reference range, which states that a normal sperm concentration should be at least 15 million sperm per milliliter. Therefore, your sperm count is indeed considered low, which is medically referred to as oligospermia.

The pH level of your semen is 8.0, which is slightly alkaline. Normal semen pH ranges from 7.2 to 8.0, so your result is within the acceptable range. A higher pH can sometimes indicate an infection or other issues, but in your case, it is not alarmingly high.

Regarding motility, your report shows a motility rate of 74%. This is a positive aspect, as motility refers to the ability of sperm to move effectively. The WHO guidelines suggest that a motility rate of over 40% is considered normal. Therefore, while your sperm count is low, the motility is within a healthy range, which means that the sperm that are present are capable of moving, which is essential for fertilization.

You mentioned a concern regarding the notation of sperm count in units of 10^5/ml instead of the more common 10^6/ml. This is simply a difference in reporting and does not necessarily indicate an error in testing. The critical factor is the actual number of sperm, which, as calculated, is low.
The note about having fewer than 100 sperm being dangerous is a bit misleading. While a very low sperm count can significantly reduce the chances of conception, it does not mean that conception is impossible. Many factors contribute to fertility, including the health of the female partner, timing of intercourse, and overall reproductive health.
As for your abstinence period before the test, a 3-day period is generally recommended for sperm analysis. However, some studies suggest that longer abstinence (up to 5 days) may yield a higher sperm count, but this can vary from person to person. If you are concerned about your results, it may be beneficial to repeat the test after a longer abstinence period to see if there is any change in your sperm count.

In conclusion, while your sperm count is low, the motility is normal, which means there is still a possibility of achieving pregnancy. It is advisable to consult with a fertility specialist who can provide a comprehensive evaluation and discuss potential next steps, which may include lifestyle changes, further testing, or assisted reproductive technologies if necessary. Remember, fertility is a complex issue, and many couples with similar challenges have successfully conceived with the right support and interventions.

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