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As expected, halve of infertility problems are attributable to men and halve to women. Low sperm counts are by far the biggest problems in male fertility.

A healthy male has a sperm count between 40 million and 300 million. During an ejaculation a healthy man can ejaculate between 2 ml and 5 ml (a teaspoon). There are some dispute about how fast a man can replenish his sperm supply after an ejaculation. Some researchers say 24 hours, and others say 48 hours. The average of 36 hours are probably a safe bet when you are trying to conceive. If the man has low sperm count, once every 48 hours are better.

New and fresh sperm have the best motility and normality. Because of this sperm should be replaced at least once every 7 days when you are trying to conceive.

A normal sperm count is defined as the following:

• At least 20 million spermatozoa per ml ejaculate
• Total volume of semen should be at least 2ml
• At least 40 million spermatozoa per ejaculate
• At least 75% of the spermatozoa should be alive (it is normal for up to 25 % to be dead)
• At least 30% of the spermatozoa should be of normal shape and form
• At least 25% of the spermatozoa should be swimming with rapid forward movement
• At least 50% of the spermatozoa should be swimming forward, even if only sluggishly

Sperm motility is a measure of how sperm moves forward toward the fallopian tubes, where it has the potential to fertilize an egg. 

These numbers are averages. A sperm count or motility below this does not indicate total infertility and a sperm count above these numbers does not guarantee fertility.

Causes of a low sperm count can include:

• Genetic causes. These can include Cystic Fibrosis patients who often are missing or have obstructed vas deferens (the tube that carries sperm.) Men who have Klinefelter system, in which they carry two X and one Y chromosome, may negatively impact the testicles and cause infertility. Kartagener syndrome, which is a disorder in which the position of the major organs are reversed, can also cause infertility.
• Stress may reduce sperm count by interfering with hormones, just like it will cause an irregular cycle in women.
• Sexual technique
• Sometimes, a problem with sexual intercourse or technique may affect fertility.
• Retrograde and premature ejaculation may cause fertility problems.
• The incorrect use of lubricants or sperm unfriendly lubricants may affect fertility.
• Testicular overheating. Overheating of the testicles, such as occurs with fever or the use of a sauna or hot tub or wearing too tight underwear may impair fertility.
• The use of prescription or illicit drugs may affect fertility.
• Some studies suggest that smoking cigarettes may impair sperm count, reduce sperm lifespan, and lead to lower sex drive.
• Deficiencies in some nutrients, such as selenium, zinc, foliate and Vitamin C may be risk factors for low sperm count.
• Some studies suggest an association between obesity and low sperm count.
• Bicycling may damage blood vessels and nerves that are responsible for erections, and the vibrations and shocks associated with bicycling may increase the risk of injuries to the scrotum.
• Exposure to toxins, chemicals, and heavy metals such as lead or cadmium may cause low sperm count.
• A varicocele, which is a varicose vein in the cord that connects to the testicle, may impact fertility.
• Infections can also affect fertility.

There are several things that may help increase sperm count:

• Exercise. Regular exercise will help reduce stress. Excessive exercise can cause harm, as can certain exercises that may negatively impact the testicles, such as bicycling.
• Ejaculating less often. The more often a man ejaculates, the less dense the semen will be. Maintain a gap of three days between ejaculations.
• Refrain from smoking and drinking alcohol
• Massage body with herbal oil, which may improve blood circulation
• Have sex in the early morning or afternoon. It is believed that sperm levels are often highest in the morning
• Avoid tight underwear, saunas, and whirlpools, all of which may increase the temperature of the testicles
• Use natural supplements and vitamins that may assist with sperm count
• Maintain a high protein, low fat diet, rich in vegetables and whole grains. Avoid bitter and spicy foods.

There are also a variety of vitamin supplements that may assist with low sperm count:

• Vitamin C
• Vitamin E
• Vitamin B12 Selenium
• Zinc Arginine
• Carnitine

There are several dietary measures that a man who has a low sperm count can take to attempt to increase his sperm count:

• A diet that includes whole, unprocessed foods – whole grains, legumes, vegetables, fruits, nuts, and seeds
• Eliminate alcohol intake. In addition to the general nutritional benefits of avoiding alcohol, avoiding alcohol may also assist with sexual performance issues
• Identify and avoid food allergies
• It is recommended that a man with a low sperm count eat 1/4 cup of raw sunflower or pumpkin seeds each day.
• Drink at least 48 ounces of water every day
• Limit caffeine intake
• When possible, try to eat organic foods. Some studies suggest a connection between chemical fertilizers and pesticides with both male and female infertility.

Newer reproductive techniques such as artificial insemination, may help couples in which the man has a low sperm count to become pregnant.