If a semen analysis has shown and you know how to improve low sperm count, the next step is not to buy the strongest fertility supplement you can find. A low count can have many possible causes, and the most useful approach is to confirm the result, look for factors that may be contributing, and choose treatment according to the cause.
Some men may improve sperm parameters through changes in smoking, alcohol, weight, heat exposure, medication or other modifiable factors. Other men have varicocele, hormonal disorders, genetic conditions, obstruction, testicular problems or treatment-related fertility issues that require medical or specialist care.
There is no single natural remedy that reliably raises sperm count in every man. If a semen analysis is abnormal, current fertility guidance recommends confirming the result and investigating possible causes. Lifestyle improvement may help some men, but severe or persistent abnormalities need proper medical fertility assessment rather than repeated supplement trials.
What Does “Low Sperm Count” Mean?
Sperm count is measured through a semen analysis. One important measurement is sperm concentration—the number of sperm in each millilitre of semen.
Current NICE fertility guidance, using World Health Organization reference values, uses a sperm concentration of 16 million spermatozoa per millilitre or more as the lower reference value. It also considers total sperm number, motility, morphology, semen volume and other parameters.
These numbers should not be treated as a simple pass-or-fail fertility test. Men below a reference value may still achieve pregnancy, and men with results above the reference values can still have fertility difficulties.
Important: these are semen-analysis reference values, not guarantees of fertility or infertility. Your result should be interpreted in the context of the whole semen analysis, your medical history and your partner’s fertility factors.
Should a Low Sperm Count Be Tested Again?
Usually, yes.
Sperm counts can vary between samples, and collection problems, recent illness and other temporary factors can affect results. NICE recommends a repeat confirmatory semen analysis when the first result is abnormal.
The repeat is ideally performed around three months later to allow a full sperm-production cycle to be completed. However, when the result shows no sperm or a very severe sperm deficiency, repeat testing should happen sooner so specialist assessment is not delayed.
Do not assume one abnormal result proves permanent infertility.
What Can Cause a Low Sperm Count?
Low sperm count has many possible causes. Sometimes no single cause is found.
Varicocele
A varicocele is enlargement of veins around the testicle. It is a recognised cause of male infertility and may affect sperm production or quality in some men. Whether treatment is appropriate depends on examination, semen results, fertility history and specialist assessment.
Hormonal conditions
Sperm production depends on signals from the hypothalamus and pituitary gland as well as normal testicular function. Hormonal disorders can reduce sperm production, but the correct treatment depends on which part of the hormonal system is affected.
Testicular conditions
Previous undescended testicle, testicular injury, surgery, infection, cancer treatment or other testicular disease can affect sperm production.
Genetic causes
Some men with very low sperm counts or no sperm in semen may have an underlying genetic condition. Specialist fertility or urological assessment may include genetic testing where appropriate.
Blockages
Sperm may be produced but prevented from reaching the ejaculate because of obstruction in the reproductive tract. Previous infection, surgery, vasectomy or congenital conditions may be relevant.
Medication and medical treatment
Some medicines and treatments can affect sperm production. Examples include certain cancer treatments, anabolic steroids and external testosterone.
Never stop prescribed medication independently. Discuss fertility concerns with the prescribing clinician.
Smoking, alcohol and recreational drugs
Smoking, heavy alcohol use and some recreational drugs may negatively affect sperm quantity or quality. Avoiding these exposures supports general reproductive health but does not guarantee normalisation of a severely low count.
Obesity and metabolic health
Obesity may affect male fertility through hormonal, metabolic and inflammatory pathways. Sustainable weight management may help selected men but is not a substitute for fertility investigation.
Heat and environmental exposure
Repeated excessive testicular heat and some environmental toxins may affect sperm production or function. Everyday heat exposure should not be exaggerated into a universal explanation for infertility.
Can Lifestyle Changes Improve Low Sperm Count?
They may help when modifiable factors are relevant, particularly smoking, heavy alcohol use, excess weight, poor general health or some environmental exposures.
Useful health-supporting steps may include:
- stop smoking
- reduce or avoid heavy alcohol use
- avoid anabolic steroids and non-prescribed testosterone
- avoid recreational drugs
- work toward a healthy body weight
- exercise regularly
- eat a balanced, nutrient-sufficient diet
- support consistent sleep
- avoid unnecessary prolonged testicular overheating
- review medication and supplements with an appropriate clinician
These measures are sensible because they support overall reproductive health. They should not be sold as guaranteed “sperm count boosters.”
Does Testosterone Increase Sperm Count?
No. External testosterone is not a treatment for low sperm count.
Testosterone injections, gels, pellets and anabolic steroids can suppress the hormonal signals from the brain that tell the testes to produce sperm. In some men this can markedly reduce sperm production or lead to no sperm being detected in semen.
Current NICE fertility guidance specifically states that androgens should not be offered to treat semen abnormalities.
Do not start testosterone or bodybuilding hormones casually. If you are already using testosterone and have fertility concerns, speak with an appropriately qualified medical practitioner, urologist, andrologist or fertility specialist rather than stopping treatment without guidance.
Do Vitamins or Supplements Improve Low Sperm Count?
There is no supplement that reliably corrects every cause of low sperm count.
Some vitamins, minerals and antioxidant products have been studied in male infertility, but study quality, formulations and outcomes vary. A supplement cannot:
- repair an obstructed sperm duct
- correct every genetic cause
- replace treatment for hypogonadotropic hypogonadism
- repair severe testicular damage
- replace varicocele assessment
- replace fertility treatment where indicated
Correcting a genuine nutritional deficiency may support normal physiology, but taking large amounts of zinc, selenium, vitamin D or herbal products without an identified need is not a proven way to normalise sperm count.
Read our broader vitamins for men’s sexual health guide for evidence and supplement-safety considerations.
How Long Does It Take for Sperm Count to Change?
Sperm are produced continuously, but sperm formation takes time. A semen analysis reflects health and exposures over the preceding months rather than only the previous few days.
That is why meaningful lifestyle changes should not be judged by daily changes in semen appearance, and why NICE generally recommends waiting about three months before repeating an abnormal semen analysis unless the initial abnormality is severe.
For a deeper explanation of sperm-production timing, read how sperm production works and how long new sperm take to develop.
Does More Semen Mean a Higher Sperm Count?
No. Semen volume and sperm concentration are different measurements.
Most semen volume comes from reproductive glands. Sperm cells make up only one component of semen.
You cannot accurately estimate sperm count from:
- how much semen comes out
- how thick semen looks
- semen colour
- how forceful ejaculation feels
- how long you abstained
A semen analysis is required.
Does Ejaculating Less Increase Sperm Count?
Abstinence can change measurements in an individual semen sample, but fertility is not simply improved by trying to “store” sperm for as long as possible.
If you are producing a semen sample for laboratory testing, follow the laboratory’s collection instructions because the abstinence interval affects how results are interpreted.
Couples trying to conceive naturally are generally advised to have regular intercourse rather than waiting long periods between ejaculations.
How Is Low Sperm Count Medically Treated?
Treatment depends on the cause. There is no single low-sperm-count medicine suitable for every man.
Treating a specific hormonal disorder
Current NICE guidance recommends gonadotrophin treatment for men with hypogonadotropic hypogonadism. This is specialist medical fertility treatment, not a general testosterone-boosting programme.
Varicocele treatment
Selected men may be considered for varicocele treatment by a urologist or male-fertility specialist depending on clinical findings and fertility circumstances.
Treating infection or obstruction
Some infections require medical treatment. Structural blockages may require urological investigation or surgery. Treating infection does not guarantee that fertility will be restored.
Assisted reproductive treatment
Depending on semen results, female-partner factors and the couple’s overall fertility situation, specialist options may include intrauterine insemination, IVF or intracytoplasmic sperm injection (ICSI).
NICE 2026 states that ICSI can be considered where the male partner has abnormal semen parameters, taking the severity into account.
When Should Low Sperm Count Be Investigated More Closely?
Specialist assessment becomes particularly important when:
- two or more semen analyses are abnormal
- the sperm concentration is severely reduced
- no sperm are detected
- there is a testicular lump, swelling or marked size difference
- there is a history of undescended testicle
- there has been testicular injury or surgery
- chemotherapy or radiation has been used
- there are sexual or ejaculation problems
- there is suspected hormonal or genetic disease
- testosterone or anabolic steroids have been used
- conception has not occurred despite regular unprotected intercourse
If you are unsure where to start, read our guide to what doctor to see for male infertility.
Private Low Sperm Count Self Health Check
This self-check is educational and cannot diagnose infertility or explain an abnormal semen analysis.
- Have you actually had a laboratory semen analysis showing low sperm concentration or total sperm number?
- Was the abnormal result confirmed with another semen analysis?
- Were motility, morphology or semen volume also abnormal?
- Have you used testosterone, anabolic steroids or bodybuilding hormones?
- Have you had an undescended testicle, testicular injury, surgery or cancer treatment?
- Have you noticed a testicular lump, swelling, persistent pain or obvious size difference?
- Are smoking, heavy alcohol use, obesity or recreational drugs relevant?
- Have you recently had a significant fever or serious illness?
- Have you and your partner been trying to conceive without success?
- Are you taking prescription medicines or fertility supplements that have not been reviewed by a qualified clinician?
How to interpret this:
- One mildly abnormal semen analysis: confirm the result according to appropriate fertility guidance.
- Repeated abnormal semen analyses: medical male-fertility assessment is appropriate.
- Severe oligozoospermia or azoospermia: specialist assessment should not be delayed.
- Testicular lump, persistent swelling or major pain: arrange prompt medical/urological assessment.
- Testosterone/anabolic steroid exposure: tell the fertility specialist because these products can suppress sperm production.
How Sandton Men’s Clinic Can Complement Fertility Care
Sandton Men’s Clinic is a premium men’s wellness practice led by George Mulaudzi, Naturopath. The clinic is not a fertility clinic and does not diagnose or medically treat oligozoospermia, azoospermia or male infertility.
A naturopathic consultation may complement specialist fertility care by reviewing:
- nutrition
- body composition
- physical activity
- sleep
- stress
- smoking
- alcohol
- supplement use
- general reproductive wellness
Sandton Men’s Clinic does not:
- perform or diagnose semen analysis as a fertility laboratory
- diagnose male infertility
- prescribe gonadotrophin fertility therapy
- prescribe testosterone as fertility treatment
- provide IVF or ICSI
- perform sperm retrieval
- perform varicocele surgery
- perform fertility-related genetic testing
- guarantee an increase in sperm count
- guarantee pregnancy
Where medical testing, urology, andrology or fertility treatment is needed, appropriate referral should not be delayed.
Complementary Men’s Reproductive Wellness Support
If an abnormal semen result has made you review your health, a confidential naturopathic consultation can help you address lifestyle and supplement factors while you pursue the medical fertility assessment your results may require.
Sandton Men’s Clinic
199 Vanessa Street, Buccleuch, Sandton
Phone: +27 10 205 9208
Frequently Asked Questions | How to Improve Low Sperm Count
How can I improve a low sperm count?
The correct approach depends on the cause. Stopping smoking, reducing heavy alcohol use, avoiding anabolic steroids and testosterone, improving weight and general health, and avoiding unnecessary heat exposure may support sperm health in selected men. Persistent or severe low sperm count requires medical fertility assessment.
Can low sperm count improve naturally?
Sometimes, particularly where a temporary or modifiable factor is involved. However, low sperm count caused by genetic, hormonal, structural or significant testicular conditions may need specialist treatment.
What sperm count is considered low?
NICE 2026 uses the current WHO lower reference value of 16 million sperm per millilitre for sperm concentration. This is a reference value, not a simple fertility cut-off, and the whole semen analysis should be interpreted clinically.
Should an abnormal semen analysis be repeated?
Yes. NICE recommends a repeat confirmatory test after an abnormal first semen analysis. This is ideally around three months later, although azoospermia or severe oligozoospermia should be repeated sooner.
Does testosterone increase sperm count?
No. External testosterone can suppress the hormonal signals required for sperm production. NICE advises against using androgens to treat semen abnormalities.
Can zinc or vitamins raise sperm count?
Correcting a genuine nutritional deficiency may support normal reproductive physiology, but supplements do not reliably treat every cause of low sperm count and should not replace fertility investigation.
How long does it take sperm count to improve?
Sperm production takes several weeks and a full cycle is reflected over roughly a few months. That is why lifestyle changes are generally evaluated over months rather than days.
Can a man with low sperm count still father a child?
Yes, some men with low sperm counts can achieve pregnancy naturally. Fertility depends on more than sperm concentration alone, including motility, morphology, female-partner factors and timing.
When should I see a fertility specialist?
Specialist assessment is especially important when semen abnormalities are repeated, very severe, associated with azoospermia, testicular problems, hormonal concerns, genetic risk, prior cancer treatment or ongoing difficulty conceiving.
Does Sandton Men’s Clinic treat low sperm count?
Sandton Men’s Clinic is a naturopath-led men’s wellness practice, not a fertility clinic. It provides complementary lifestyle and wellness support while appropriate medical professionals diagnose and treat low sperm count and male infertility.
The Bottom Line
A low sperm count should not be managed by guessing from semen appearance or cycling through fertility supplements. Confirm the abnormal result, look at the full semen analysis, and investigate possible causes when the problem persists.
Lifestyle improvement can support reproductive health, but medical treatment depends on the cause. Men with repeated, severe or unexplained abnormalities should be assessed by an appropriately qualified male-fertility professional.
Reviewed by George Mulaudzi, Naturopath, Sandton Men’s Clinic.
This article provides general information and does not replace personalised medical advice, semen analysis, fertility diagnosis or specialist treatment. A low sperm count can have genetic, hormonal, structural, testicular, medication-related, lifestyle and other causes. Do not start or stop testosterone, anabolic steroids, fertility medication or prescribed treatment without appropriate medical advice. Severe or repeated semen abnormalities, azoospermia, testicular lumps or swelling, fertility difficulties and suspected hormonal or genetic conditions require proper medical or fertility-specialist assessment. Sandton Men’s Clinic provides naturopathic wellness support in a complementary role and does not diagnose or medically treat male infertility.