Low Sperm Count (Nil Sperm Count)

What Is Low Sperm Count?

Sperm count is the number of sperm in your semen. It is measured in a test called semen analysis. The World Health Organization (WHO) gives lower reference values for a normal sample:

A count below these values is called a low sperm count. Your doctor looks at the whole report, not only the count. Motility and shape matter as well.

These are reference limits, not a pass or fail mark. Many men with a count below the limit still father children, and some with a normal count face difficulty. That is why the full picture and the couple's overall health matter.

Types of Low Sperm Count

Doctors use different terms based on the semen report.

1. Oligozoospermia (low sperm count). Sperm are present, but below the normal level. It is often described as mild, moderate or severe, depending on how low the count is.

2. Cryptozoospermia. Very few sperm are seen, and they are found only after the sample is spun in a lab machine.

3. Azoospermia (nil sperm count). No sperm are found in the semen, even after the lab spins the sample. Doctors confirm it on at least two separate tests. There are two main kinds:

• Obstructive azoospermia. The testicles make sperm, but a blockage stops them from reaching the semen. The blockage can be in the tubes that carry sperm, for example after infection or surgery.
• Non-obstructive azoospermia. The testicles make very few sperm or none. Causes include hormonal problems, genetic conditions and testicular damage.

Knowing the type is very important. It decides which treatments are possible.

Other sperm problems. A report can also show low motility (asthenozoospermia) or many abnormally shaped sperm (teratozoospermia). These can occur with a low count or on their own.

Symptoms of Low Sperm Count

Most men with a low sperm count feel completely normal. Erections, desire and ejaculation are usually not affected. The most common sign is trouble conceiving.

Other signs depend on the cause:

• Not conceiving after a year of regular, unprotected sex
• Pain, swelling or a lump in or around the testicles
• A feeling of heaviness in the scrotum, which can be linked to enlarged veins (varicocele)
• Small or soft testicles
• Less facial or body hair, or breast enlargement, which can point to a hormone problem
• A history of infection, injury, undescended testicle or surgery in the groin

A semen test is the only way to know your sperm count. You cannot judge it by how you feel or by the amount of semen.

What Causes Low or Nil Sperm Count?

Causes fall into a few groups. Often more than one is present.

Testicular and structural causes

• Varicocele, which is enlarged veins in the scrotum. It is one of the most common and treatable causes.
• Undescended testicle in childhood
• Injury or twisting (torsion) of the testicle
• Blockage in the sperm tubes after infection or surgery
• Absence of the sperm-carrying tube (vas deferens) from birth

Infections

• Infection of the epididymis or testicle
• Sexually transmitted infections
• Mumps that affected the testicles after puberty

Hormonal causes

• Low levels of the hormones that control sperm production
• Pituitary or other hormone gland problems
• High prolactin levels

Genetic causes

• Changes in chromosomes, such as Klinefelter syndrome
• Missing parts of the Y chromosome
• Gene changes linked to missing sperm tubes

Genetic tests are advised mainly in men with a very low or nil count.

Medical treatments and medicines

• Testosterone injections or gels, and anabolic steroids used for gym or sport. These can lower sperm production sharply.
• Cancer treatment, such as chemotherapy or radiation
• Some medicines for ulcerative colitis, seizures and other conditions
• Surgery in the groin or pelvis

Ejaculation problems

In retrograde ejaculation, semen flows backward into the bladder. The sample looks very small or dry. This can be mistaken for a nil sperm count.

Lifestyle and environment

• Smoking and tobacco
• Heavy alcohol use
• Recreational drug use
• Obesity
• Long periods of high heat, such as frequent hot baths or saunas
• Contact with pesticides, heavy metals or industrial chemicals
• Ongoing stress and poor sleep

Many of these can be changed, and changing them can improve sperm health over time.

Long-term illness

Diabetes, kidney disease and liver disease can lower sperm quality.

When Should You See a Doctor?

Book a visit if:

• You have been trying for 12 months without success. If your partner is 35 or older, do not wait more than 6 months.
• A semen report shows a low, very low or nil count
• You have testicular pain, swelling or a lump
• You had a groin injury, undescended testicle, mumps after puberty or testicular infection
• You have taken testosterone or steroids
• You had cancer treatment
• You have a family history of infertility

Seeing a doctor early gives more options. Your partner should also be checked, since fertility depends on both of you.

How Is Low Sperm Count Diagnosed?

A clear diagnosis comes before any treatment. At Dr. P. K. Gupta Super Speciality Clinic, the process usually follows these steps:

• A private discussion. Dr. Gupta asks how long you have been trying, about past infections, injuries, surgeries, medicines and habits.
• Physical examination. This includes checking the size and feel of the testicles, looking for varicocele and checking the sperm tubes.
• Semen analysis. You give a sample after about 2 to 7 days without ejaculation. The lab reports count, motility, shape and volume. The test is repeated, since results change from one sample to another. Sperm take about 2 to 3 months to develop, so repeat tests are often spaced out.
• Hormone blood tests. These may include FSH, LH, testosterone and prolactin.
• Scrotal ultrasound. This checks for varicocele, blockages and testicle problems.
• Special tests when needed. These include a urine test after ejaculation (for retrograde ejaculation) and genetic tests in men with a very low or nil count.

If you have no sperm in the sample, further tests help tell whether the cause is a blockage or low production.

Low Sperm Count Treatment in Delhi

Treatment depends on the cause, the type of count problem, your age and your partner's age and health. Dr. Gupta explains the choices and, where needed, works with a urologist, andrologist or fertility specialist.

For low sperm count (oligozoospermia)

• Treating the cause. If a varicocele is present, repairing it (by surgery or a minor procedure) can improve counts in many men. Infections are treated with the right antibiotics.
• Stopping harmful medicines. If testosterone, steroids or other drugs are lowering your count, stopping them under medical advice can allow recovery in many men. Never stop a prescribed medicine on your own.
• Hormone treatment. Some men with a hormone problem benefit from medicines that raise the body's own sperm-making hormones. This is only done after tests confirm it is suitable.
• Lifestyle changes. Quitting smoking, cutting alcohol, reaching a healthy weight, regular exercise, good sleep and avoiding long heat exposure support sperm health.
• Supplements. Some men are advised to take vitamins or antioxidants. Evidence is mixed, so these should be taken only on a doctor's advice. Avoid "sperm booster" products bought online.
• Assisted conception. When the count stays low, treatment such as IUI, IVF or ICSI can help the couple conceive. In ICSI, one healthy sperm is placed directly into an egg. It can work even with very few sperm.

For nil sperm count (azoospermia)

• Obstructive azoospermia. If a blockage is the cause, surgery may open the path. If surgery is not possible, sperm can often be collected straight from the testicle or epididymis and used with ICSI.
• Non-obstructive azoospermia. Hormone tests and genetic tests guide the plan. In some men, small pockets of sperm production exist inside the testicle. A specialist surgeon can search for them (a procedure such as micro-TESE) and use any sperm found with ICSI. Some men have no sperm production, and an honest talk about other options, such as donor sperm or adoption, is part of good care
• Counselling. The news of a low or nil count can be hard. Support for you and your partner is part of the treatment.

No doctor can promise a guaranteed result. What a good doctor can do is find the cause, tell you the truth about your chances and guide you to the best next step.

Healthy Habits That Support Sperm Health

• Quit smoking and avoid tobacco.
• Limit alcohol, and avoid recreational drugs.
• Do not use steroids or testosterone unless a doctor has prescribed them.
• Stay at a healthy weight with regular exercise, such as walking, jogging or swimming.
• Eat a balanced diet with fruit, vegetables, nuts, pulses, whole grains and lean protein.
• Sleep seven to eight hours each night.
• Avoid long heat exposure, such as frequent hot baths or saunas.
• Reduce stress with breathing exercises, time outdoors and breaks from work.
• Use protection to lower the risk of infections.
• Time sex around your partner's fertile days, which usually fall in the days before and on ovulation.

Common Myths About Low Sperm Count

Myth: Masturbation or nightfall causes a low sperm count. There is no proof of this. Sperm are made all the time.

Myth: Infertility is always the woman's problem. The male partner contributes in about half of couples who have trouble conceiving.

Myth: A low count means you cannot father a child. Many men with low counts conceive, naturally or with help.

Myth: Nil sperm count has no treatment. If the cause is a blockage, treatment is often possible. In other cases, sperm may still be found.

Myth: Supplements and "boosters" fix it. Most have little proof, and some contain harmful hidden drugs.

Myth: A low count affects your masculinity or sex life. Sperm count does not change erections, desire or performance.

What Happens If It Is Left Untreated?

• A treatable cause, such as a varicocele or infection, can get worse
• Time passes, and your partner's fertility can fall with age
• A hidden health or hormone problem may go unnoticed
• Stress and tension can build between you and your partner
• Options such as surgery or sperm retrieval may become harder over time

Early testing gives you the most choices.

What to Expect at Your First Visit

• You are welcomed in a private setting
• You talk one-to-one with Dr. Gupta
• He asks about your health, habits and how long you have been trying
• He examines you and advises tests, such as a semen analysis
• Once reports are ready, he explains what they mean and what your options are
• You decide the next step at your own pace

Bring any earlier semen reports or test results. Your partner can come along, but it is not required. The visit is confidential.

Why Consult Dr. P. K. Gupta Super Speciality Clinic?

• Qualified, experienced doctor: Dr. P. K. Gupta holds MBBS and MD degrees and a PGDS in Sexual Medicine (America). He has more than 25 years of experience in sexual medicine. His Uttar Pradesh Medical Council registration number is 48285.
• Cause-first approach: You get tests and an explanation before any treatment.
• Honest guidance: You are told what is likely and what is not, with no false promises.
• Private consultation: Your visit is confidential, and you are never judged.
• Central Delhi location: The clinic is next to Karol Bagh Metro Station and easy to reach from across Delhi NCR.
• Convenient timings: Open six days a week from 9:00 AM to 8:00 PM, and on Sunday from 10:00 AM to 5:00 PM.

Frequently Asked Questions

What is considered a low sperm count?

By WHO values, a count below about 16 million sperm per mL, or fewer than about 39 million in the whole sample, is low. Doctors also look at motility and shape. A single test is not enough, so the test is repeated.

What is nil sperm count?

Nil sperm count, or azoospermia, means no sperm are found in the semen, even after the lab spins the sample. It must be confirmed on at least two tests. The cause may be a blockage or very low sperm production.

Can low sperm count be treated?

Often, yes. Treatment depends on the cause. Fixing a varicocele, treating an infection, stopping harmful medicines and improving lifestyle can raise the count in many men. Assisted conception can help when the count stays low.

Can a man with nil sperm count father a child?

Sometimes. If the problem is a blockage, surgery or sperm retrieval can work. In some men with low production, small amounts of sperm can still be found in the testicle and used with ICSI. In others, none are found, and your doctor will discuss other options.

What is the main cause of low sperm count?

There is no single cause. Varicocele, infections, hormone problems, genetic conditions, medicines, smoking, alcohol and heat are among the common ones. A proper check finds the likely cause.

Do masturbation and nightfall reduce sperm count?

No. They do not cause a lasting drop in sperm count. Doctors only ask for a few days without ejaculation before a test so the sample is reliable.

How long does it take to improve sperm count?

Sperm take about 2 to 3 months to develop. So, any change from treatment or lifestyle usually shows in a semen test after about three months.

Do steroids and testosterone affect sperm count?

Yes. They can lower sperm production sharply, sometimes to zero. If you use them, tell your doctor. Recovery is possible in many men after stopping, but it can take months.

Do sperm count supplements work?

Evidence is limited and mixed. Some men benefit from specific vitamins or antioxidants on medical advice, but many "booster" products have no proof and may contain hidden drugs.

Is my visit confidential?

Yes. Your consultation is private, and your details are not shared without your consent.

Book a Private Consultation

If you are trying to conceive and have a low or nil sperm count, or have not conceived after a year, do not wait. A short visit can find the cause and plan the right next step.

Dr. P. K. Gupta Super Speciality Clinic

Metro Plaza, Next to Gate No. 8, Karol Bagh Metro Station, Karol Bagh, Delhi – 110005

Call / WhatsApp: +91 9999938715

Timings: Monday – Saturday: 9:00 AM – 8:00 PM | Sunday: 10:00 AM – 5:00 PM

Related: Sexologist in Delhi · STD Treatment · Book an Appointment

Medically reviewed by Dr. P. K. Gupta, MBBS, MD, PGDS (Sexual Medicine – America) · Last updated: October 2026

Serving Patients from Delhi, NCR and Other Cities for Low Sperm Count (Nil Sperm Count) Treatment

Delhi-NCR, Greater Noida, Patparganj, Nuh, Mahipalpur, Guwahati, Munirka, Jungpura, Rajasthan, Shastri Nagar, Dilshad Garden, Janakpuri, Siwan, Gujranwala Town, Kurukshetra, Bhopal, Karala, Kanhaiya Nagar, Amroha, Sagarpur, Ujjain, Karkardooma, Bhiwani, Badarpur, Surajpur, Noida, Khurja, Uttam Nagar, R K Puram, Haryana, Palam, Kanjhawla, Hari Nagar, Palwal, Patna, Sagar, Rampur, Baghpat, Okhla, Srinagar (J&K), Rohtak, Safdarjung Enclave, Sarai Kale Khan, Modinagar, Ashok Vihar, Panipat, Jind, Khanpur, Paharganj, Sarita Vihar, Central Delhi, Madhya Pradesh, East Delhi, Najafgarh, Sonia Vihar, Bhajanpura, Kanpur, Manesar, Loni, Sikandrabac, Hapur, Sadar Bazar, Pitampura, Alipur, Mukherjee Nagar, Karol Bagh, Indore, Ambala, Pataudi, Shalimar Bagh, West Delhi, Geeta Colony, Rajender Nagar, Sohna, Bawana, Faridabad, Shahdara, Daryaganj, Jhansi, Mangolpuri, North Delhi, Lajpat Nagar, Kailashpuri, Vasant Vihar, Shastri Park, Kirti Nagar, Chhapra, Allahabad, Burari, Tri Nagar, Naraina, Mathura, Sri Ganganagar, Sonipat, Haldwani, Punjabi Bagh, Keshav Puram, Sultanpuri, Rewari, Alwar, Lucknow, Gandhi Nagar, Vivek Vihar, Bawal, Rajouri Garden, Muzaffarnagar, Dadri, Mayur Vihar, Samaypur Badli, Haridwar, Greater Kailash, Karnal, Trilok Puri, Bahadurgarh, Seelampur, Manali, Meerut, Ghaziabad, Tilak Nagar, Kamla Nagar, Uttar Pradesh, Delhi Cantt, Kaithal, Aligarh, Dwarka, Peera Garhi, Ramesh Nagar, Rohini, Agra, Gurgaon, Varanasi, Hisar, Paschim Vihar, Bareilly, East of Kailash, Gwalior, Chandigarh, Tugalkabad, Jhajjar, Narela, Azad Nagar, Vasant Kunj, Panchkula, Shimla, Chandni Chowk, Wazirpur, Neemrana, Lal Kuan Ghaziabad, Govindpuri, Kasturba Nagar, Bulandsahar, Dehradun, Swaroop Nagar, Sant Nagar, Gaya, Kolkata, Ballabhgarh, Malviya Nagar, Bhiwadi, South Delhi, Karawal Nagar, Moti Nagar, New Ashok Nagar, Moradabad, Gurugram