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The most common cause of a low sperm count is a varicocele, an abnormality in the vein in your scrotum that drains the testicles. Varicoceles can cause decreased fertility in the following ways:

 Increasing temperature in the testes

 Decreasing blood flow around the testicles

 Slowing sperm production and motility

Varicoceles are treatable in the following ways:

 Surgery: An outpatient procedure during which an incision is made just above the groin and the swollen vein is “tied off.” Recovery takes seven to ten days and requires minimal activity and no heavy lifting. Risks are minimal and include infection, nerve injury, and the collection of fluid around the testicles.

 Radiographic embolization: Also an outpatient procedure, this requires the insertion of a catheter through the femoral vein in the groin. Dye is injected to show where the problem is located and, when isolated, it’s blocked so blood flow to that vein stops.

Other less common male-fertility issues include the following:

 Hormone imbalances: Medications to adjust hormone levels may improve sperm quantity.

 Chromosomal abnormalities: One such problem is sperm that lack part of the Y chromosome, which is the male chromosome. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), where the best-looking sperm are injected directly into your partner’s egg in the lab, can help overcome abnormal sperm issues. (See the following section for more info.)

 History of cancer: Having treatment for cancer, including lymphoma and testicular cancer, can kill or damage sperm. Many men freeze sperm before undergoing cancer treatment for this reason.

 Various diseases: Diabetes, sickle cell disease, and kidney and liver diseases can cause problems. Treatment depends on your individual issues.

Even if your ejaculate has no sperm at all, a procedure called a sperm aspiration in conjunction with an IVF cycle may be able to remove sperm directly from the testicles.