IVF Procedure with Low Sperm Count: A Hopeful Path to Parenthood

Infertility can feel like a lonely road, but advances in assisted reproductive technology (ART) have opened new doors for couples struggling to conceive. One of the most common issues affecting male fertility is low sperm count, medically known as oligospermia. Fortunately, In Vitro Fertilization (IVF)—especially when combined with advanced techniques like ICSI (Intracytoplasmic Sperm Injection)—offers promising solutions for men with low sperm count to achieve biological parenthood.

In this article, we’ll explain how IVF works in cases of low sperm count, what patients can expect, and how modern fertility treatments are changing lives every day.

What Is a Low Sperm Count?

A man is considered to have a low sperm count when he has fewer than 15 million sperm per milliliter of semen. This can reduce the chances of the sperm reaching and fertilizing the egg naturally. The condition can result from various causes, including:

Hormonal imbalances
Genetic disorders
Testicular injuries or infections
Varicocele (enlarged veins in the scrotum)
Lifestyle factors (e.g., smoking, alcohol, obesity)
Environmental toxins

Even when sperm count is low, some sperm may still be viable and motile—key factors that make IVF a viable option.

How IVF Helps in Low Sperm Count Cases

When natural conception isn’t possible, IVF can bridge the gap by enabling fertilization outside the body. In men with low sperm count, especially when other sperm parameters like motility and morphology are compromised, IVF is often paired with ICSI (Intracytoplasmic Sperm Injection).

IVF + ICSI: A Game-Changer for Male Infertility

With ICSI, a single healthy sperm is directly injected into a mature egg, significantly increasing the chances of fertilization—even if only a few good sperm are available.

Step-by-Step IVF Procedure for Low Sperm Count

Here’s how the IVF process typically works for couples facing male infertility:

1. Initial Consultation and Testing

Both partners undergo a series of tests, including:

Semen analysis (to evaluate sperm count, motility, and morphology)
Hormone testing (FSH, LH, testosterone)
Ultrasound or genetic testing (if needed)

If the sperm count is extremely low or absent, the fertility specialist may recommend sperm retrieval methods such as:

PESA (Percutaneous Epididymal Sperm Aspiration)
TESA (Testicular Sperm Aspiration)
TESE (Testicular Sperm Extraction)

These techniques are particularly useful when sperm are not present in the ejaculate due to blockage or other issues.

2. Ovarian Stimulation in the Female Partner

The female partner receives fertility medications to stimulate the ovaries to produce multiple eggs. Monitoring is done through blood tests and ultrasounds.

3. Egg Retrieval

Once the eggs are mature, they are collected via a minor surgical procedure under mild sedation.

4. Sperm Collection or Retrieval

On the day of egg retrieval, sperm are either collected from a fresh semen sample or retrieved surgically from the testicle or epididymis (if required).

5. ICSI Fertilization

An embryologist uses a microneedle to inject a single healthy sperm into each mature egg under a microscope. This bypasses the need for the sperm to swim to the egg, which is crucial in low sperm count cases.

6. Embryo Culture and Monitoring

The fertilized eggs (now embryos) are cultured in a lab for 3–5 days. They are closely monitored for growth and development.

7. Embryo Transfer

A high-quality embryo is selected and transferred into the woman’s uterus. The remaining embryos can be frozen for future use.

8. Pregnancy Test

About two weeks after embryo transfer, a blood test is performed to check for pregnancy.

Success Rates of IVF with Low Sperm Count

Success rates depend on multiple factors, including:

Female partner’s age
Quality of sperm and eggs
Experience of the fertility clinic
Use of advanced technologies like ICSI

Studies show that IVF with ICSI has similar success rates in men with low sperm count as in those with normal sperm parameters. This gives hope to many couples who thought natural conception might not be possible.

Real-Life Scenario: IVF Success Despite Severe Oligospermia

Let’s consider a hypothetical example:
Ali and Ayesha, a couple from Lahore, had been trying to conceive for over 3 years. Ali’s semen analysis revealed a sperm count of just 3 million/ml—far below the normal range. The fertility specialist recommended IVF with ICSI. Sperm were successfully retrieved and injected into Ayesha’s eggs. Three embryos developed, and one was transferred. Two weeks later, they received the joyful news of a positive pregnancy test.

Tips to Improve Sperm Health Before IVF

While IVF with ICSI can work even with very few sperm, improving sperm quality can still help. Men can try the following:

Quit smoking and reduce alcohol
Eat a balanced diet rich in antioxidants
Exercise regularly but avoid excessive heat (like hot tubs)
Manage stress and sleep well
Take supplements like zinc, CoQ10, and folic acid (if recommended)

Cost Considerations in Pakistan

In Pakistan, especially in cities like Lahore, Karachi, and Islamabad, IVF with ICSI is available at leading fertility centers. The cost of IVF with ICSI typically ranges from PKR 700,000 to 900,000, depending on the clinic, diagnostic services, and additional procedures like PESA/TESA.

Final Thoughts

A low sperm count can feel like a barrier to parenthood—but it doesn’t have to be. With the help of IVF and advanced techniques like ICSI, even men with very limited sperm can father biological children. Early diagnosis, expert medical care, and emotional support are key components of this journey.

If you or your partner have been diagnosed with a low sperm count, don’t lose hope. Book a consultation at a reputable fertility clinic and explore your options. Parenthood may still be closer than you think.