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Question:
My wife and I have been trying to get pregnant for about a year now. We just started going for infertility tests and I was told that my sperm count is just under 20 million. Am I going to be able to impregnate my wife?
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Answer:
by Michael Werner: (05/26/2004)
85% of couples that have unprotected intercourse for a year will achieve a pregnancy. Because you have not yet achieved a pregnancy, you and your wife, as a couple, would be considered sub-fertile. This means that you do not conceive at the rate that we would expect. However, it does not mean that you are infertile (i.e. incapable of conceiving.).
40% of infertility cases are due primarily to a male factor; 40% of the cases are due to a female factor, and 20% of the time, it is a combination of both. Therefore, unless you had zero sperm on your semen analysis, your wife would also need an evaluation to make sure that there she does not have issues which need to be addressed as well.
I tell couples to look at infertility in the following way: imagine that, in order to conceive, it takes 100 points between the husband and the wife. Some points come from the man and some points come from the woman. Obviously, no one has 100 points by themselves. Some couples, however, conceive regularly with a man who has a very poor semen analysis (much worse than the one you are describing). Other couples do not conceive even though all tests have shown that there are no identifiable problems.
In order to understand your sperm count in this context, it is important to understand what numbers are considered “normal.” There are many parameters that go into understanding a full semen analysis.
The one number that you mentioned in your question (“My sperm count is just under 20 million”) describes the concentration. The concentration tells us how many million sperm there are per cc. The average concentration is 60 million/cc. A man is not considered in the infertile range unless his concentration is below 20 million/cc. If you are just under 20 million/cc then this number alone does not represent a very poor semen analysis. There are a number of relevant factors including the volume of the ejaculate (how many cc’s you ejaculate), the motility of the sperm (what percentage of the sperm moving), the quality of this movement (forward progression), and the shape of the sperm (morphology). It is impossible to fully evaluate your semen analysis without knowing these numbers.
In general, the appropriate next step for you would be to see a urologist, preferably one who specializes in male infertility as this is a very technical field. Also, it is important to recognize that a man’s semen analyses do vary significantly and no one can be evaluated based on a single semen analysis.
If you would like further information about infertility and specialists in your area you may want to see Male Infertility Specialists. Another resource you may want to use to discuss the issue further is Resolve, a national organization which helps couples who are sub-fertile. Their help line is 617-623-0744.
Reviewed by Sexual Health Editorial Team
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