How many sperm does it take to get pregnant?

Our guest blogger today is Sara Naab from Sandstone Diagnostics, a consumer health & wellness company dedicated to providing innovative tools that allow people to take control of their health. Their lead product, Trak is an FDA approved home testing system and companion app that allows men to measure and improve their reproductive health from the comfort and privacy of home. They have worked with leading urologists & researchers to create dontcookyourballs.com, a website dedicated to helping men and women understand the male side of the fertility equation.

Back when we were in high school, the answer was loud and clear. It only takes one. And while yes, only one lucky sperm fertilizes the egg to make a baby, that sperm is quite literally 1 in 100 million.

Vaginas are pretty tough defenders against the outside world, which is usually great for keeping everything healthy, and infection-free. However, when we are trying to conceive, these defense systems are all pointed directly at sperm, making the job of reaching the egg a difficult one. From formation to fertilization, the sperm cell is in constant danger, so men need millions of them to have even a small chance of conception.

So, what’s a normal sperm count?

Like most things about our bodies, there is a wide range of “normal” when it comes to sperm count. On average, men produce anywhere from 40 million to nearly 1 billion sperm cells each time they have sex.

To understand the relationship between sperm and fertility, scientists have conducted large studies where they’ve measured sperm concentration and count, and how long it took the couple to conceive.  They’ve learned quite a bit about how sperm impact a couple’s time to pregnancy.

More sperm can help you conceive faster

It is hard to say exactly how many sperm you need to get pregnant, but here are a few rules of thumb.

More is better: S analyses and home tests generally show a cut-off of about 15 million per mL of semen as “normal.” The truth is, many studies have shown that fertility improves as sperm count increases. To optimize your chances of conception, sperm count should really be higher than 55M/mL.

Quality can make up for quantity: Men who produce healthier sperm don’t need as many to conceive. Improvements in motility or morphology can also improve chances of conception.

How low can you go? As sperm count goes down, chances of conceiving also go down. When sperm count dips below 10 million / mL, chances of conceiving naturally get pretty low, even when motility and morphology are within the normal range.

Does a low sperm count automatically mean we need IVF?

In-vitro fertilization is a miracle of modern medicine that has enabled millions of people to conceive who otherwise would never have been able to. However, having a low sperm count does not automatically mean that you have to go directly to IVF as a means to conception. Here are some things to do if you discover that your partner has a low count:

Establish a baseline: Sperm count can fluctuate by quite a bit, so it is important to measure sperm count more than once understand your baseline fertility. Taking the average of two tests that are done about a month apart can help you understand what your average sperm count really is.

Talk to a urologist: Find a urologist who has specialty training in male reproduction. Usually this will include a fellowship or other training in fertility. A full male fertility evaluation generally includes a semen analysis, physical exam, hormone measurements and genetic screening. Talking to the right doctor will help you get to the heart of what’s going on, and what your options really are.

Get healthy: There are lots of things men can do to improve their health and their fertility. Some simple ideas include avoiding things that can elevate heat below the belt, such as hot tubs or saunas, laying off on alcohol or cigarette use, losing weight, or starting a multivitamin regimen. For some men, just doing a few of these things has been shown to double or triple their sperm counts.

Know the cut-offs: In the world of assisted reproduction, sperm are typically measured by the total progressively motile sperm present in a sample. Studies have been done to correlate success rates of natural conception, IUI, IVF and IVF using ICSI with various sperm counts. It is important to get educated on the success rates and trade-offs between various procedures before making a decision about how to move forward.

Ultimately, conception is a team sport and a process that medicine cannot fully quantify. There is no “right” way to make it happen, but learning about each of your bodies and taking steps to improve your health can help open more doors.