InstalabLoading...
InstalabLoading...
The total number of reproductive cells released per ejaculation, reflecting your fertility potential and reproductive health.
If you are trying to conceive, or simply want to understand your reproductive health, total sperm count is one of the most informative numbers you can get. It tells you how many sperm cells your body produced and delivered in a single ejaculation. A higher count means more sperm available to reach and fertilize an egg. A lower count does not mean you cannot conceive, but it does mean the odds per cycle may be reduced.
Total sperm count is different from sperm concentration, which measures how densely packed sperm are in each milliliter of semen. Total count captures the full picture: concentration multiplied by the total volume of the ejaculate. Two men can have the same concentration but very different total counts if one produces more semen volume. That is why total sperm count, reported as total sperm number (TSN), is its own clinically meaningful value.
A standard semen analysis will report this number alongside concentration, motility (how well sperm swim), and morphology (how normally they are shaped). You can order a semen analysis through many direct-access labs without a referral. The result gives you a concrete starting point for evaluating fertility or tracking the effects of lifestyle changes over time.
The current reference threshold, established by the World Health Organization, is 39 million sperm per ejaculate. This represents the fifth percentile among men whose partners conceived naturally, meaning 95% of fertile men had counts at or above this level. If your total count falls below 39 million, it is classified as oligospermia, a clinical term for low sperm count.
But this threshold is not a clean dividing line between fertile and infertile. Research comparing fertile and infertile men found extensive overlap across all sperm count ranges. No single sperm count value is diagnostic of infertility on its own. A count above 39 million does not guarantee conception, and a count below it does not rule it out.
That said, there are meaningful tiers. A classification analysis of fertile versus infertile men identified a threshold of about 48 million total sperm as the level above which fertility was most likely, while counts below 13.5 million were more consistently associated with subfertility. The range between 13.5 and 48 million represents an indeterminate zone where other factors, including your partner's fertility, become especially important.
Studies of young men from the general population show median sperm concentrations of 41 to 55 million per milliliter, suggesting that even men with counts in the technically "normal" range may have room for optimization. Fertility does not follow a simple pass/fail model. It is a gradient, and higher counts generally mean better odds per cycle.
In 30 to 50% of men with low sperm counts, no specific cause is ever identified. For the rest, the causes fall into a few broad categories.
Structural and genetic factors: Some men are born with conditions that impair sperm production. These include chromosomal differences such as Klinefelter syndrome (an extra X chromosome), Y chromosome microdeletions that remove genes essential for sperm development, undescended testicles, and congenital absence of the tubes that carry sperm (linked to mutations in the CFTR gene, the same gene involved in cystic fibrosis).
Acquired medical causes: The most common correctable cause is a varicocele, an enlarged vein in the scrotum that raises testicular temperature and impairs sperm production. Varicoceles are found in about 40% of men evaluated for infertility. Infections of the reproductive tract, prior testicular injury, and exposure to chemotherapy or radiation can also reduce counts.
Medications and hormones: Anabolic steroids are among the most significant offenders. Supplemental testosterone, whether prescribed or taken for bodybuilding, suppresses the hormonal signals that drive sperm production and can reduce counts to zero. Certain blood pressure medications and SSRIs (a common class of antidepressants) can also impair sperm parameters.
Metabolic and systemic conditions: Obesity alters hormone levels in ways that reduce sperm production. Diabetes, metabolic syndrome, and thyroid disorders are also associated with lower counts.
Lifestyle and environment: Smoking has a dose-dependent effect, meaning the more you smoke, the greater the impact. Alcohol, cannabis, and cocaine all impair sperm production. Exposure to pesticides, heavy metals, and industrial chemicals can suppress counts, as can chronic heat exposure to the testicles (from hot tubs, saunas, or prolonged laptop use on the lap). Sleep disorders are another emerging risk factor.
The good news is that sperm production is a continuous process. Your body makes a new batch roughly every 72 days, which means interventions can produce measurable improvements within a few months.
Weight loss: In a randomized controlled trial of obese men, diet-induced weight loss averaging 16.5 kg (about 36 pounds) increased total sperm count by a factor of 1.41. These improvements were maintained with ongoing exercise or treatment with a GLP-1 receptor agonist, a class of medication originally developed for diabetes and now widely used for weight management.
Smoking cessation: In a study of men with infertility who quit smoking, sperm concentration and semen volume increased significantly within three months. If you smoke and are trying to conceive, quitting is one of the most direct steps you can take.
Nutritional supplements: A network meta-analysis of nutritional therapies for male infertility found that L-carnitine combined with micronutrients was the most effective supplement strategy. Men taking this combination were roughly 3.6 times as likely to achieve pregnancy compared to controls (RR 3.60), with significant improvements in both sperm concentration and total count. Coenzyme Q10 at 200 mg daily for three months also significantly increased sperm concentration in men with unexplained infertility. Selenium and zinc have shown variable benefits, though the evidence is less consistent.
Hormonal therapy: For men with unexplained low counts and normal baseline hormones, clomiphene citrate (a medication that blocks estrogen receptors and stimulates the body's own testosterone and sperm production) taken at 25 mg every other day produced the largest improvement in sperm concentration among hormonal therapies studied, with a mean increase of 22.00 million per milliliter compared to placebo. Follicle-stimulating hormone (FSH) injections at 300 IU every other day also improved concentration by an average of 9.34 million per milliliter. These are prescription therapies you would discuss with a reproductive urologist or fertility specialist.
A critical warning about testosterone: If you are taking supplemental testosterone for low energy, muscle building, or any other reason, it is very likely suppressing your sperm production. Exogenous testosterone shuts down the hormonal signals your testes need to make sperm, and can drive your count to zero. This is one of the most important things to know before starting testosterone therapy if you have any interest in future fertility.
Surgery: If you have a clinically detectable varicocele and abnormal semen parameters, surgical repair (varicocelectomy) is a well-established treatment to improve sperm production.
A single semen analysis is a snapshot, not a verdict. Sperm counts naturally fluctuate based on abstinence interval, recent illness, stress, and other factors. Most guidelines recommend at least two analyses, separated by a few weeks, before drawing conclusions.
Your total sperm count also does not exist in isolation. Motility and morphology matter too. A high count with very poor motility may be less favorable than a moderate count with excellent motility. And fertility is always a couple-level question. Your partner's age and reproductive health are at least as important as your sperm count in determining time to conception.
Certain lab conditions can occasionally affect the accuracy of semen analysis results, so following the collection instructions (typically 2 to 5 days of abstinence, prompt delivery to the lab) matters for getting a reliable number.