Can You Get Pregnant Naturally With a Low Sperm Count?
Yes. A low sperm count can reduce the chance of pregnancy, but it does not mean natural conception is impossible.
Some couples conceive naturally despite a sperm count below the laboratory reference range. The likelihood depends on how low the count is, sperm movement and quality, how long you have been trying, and the fertility of both partners.[1–5]
What is considered a low sperm count?
A low sperm count is commonly called oligozoospermia.
The World Health Organization (WHO) currently lists approximately 16 million sperm per millilitre as the lower reference value for sperm concentration.[1,2]
Importantly, 16 million/mL is not a fertility cut-off. The WHO reference values come from men whose partners achieved natural conception. Some fertile men have results below this level, while having a result above it does not guarantee pregnancy.[1,2]
If you have your semen analysis results, you can use the Semen Analysis Interpreter for a plain-English explanation.
How likely is natural pregnancy with a low sperm count?
There is no reliable percentage that can be calculated from sperm concentration alone.
Research comparing fertile and infertile men has shown considerable overlap in sperm count, motility and morphology. No single semen measurement can reliably classify an individual man as fertile or infertile.[2,5]
In general:
Mildly reduced counts: natural conception may still occur, particularly if sperm motility is good and there are no major female fertility factors.
Moderately reduced counts: conception may take longer and the importance of other semen parameters increases.
Very low counts: natural conception may still be possible, but specialist investigation becomes increasingly important.
Read more about low sperm count and oligozoospermia.
One semen test does not tell the whole story
Sperm production naturally varies.
Illness, fever, collection problems and other temporary factors can affect a semen analysis. Current European urological guidelines recommend at least two semen analyses when the initial result is abnormal.[2]
The complete result should also be considered. For example, a reduced sperm concentration combined with poor motility and abnormal morphology may have greater fertility significance than an isolated mildly reduced count.[2,5]
Can the cause of a low sperm count be treated?
Sometimes.
Assessment may identify factors such as:
hormonal abnormalities
previous testicular injury or undescended testes
genetic causes, particularly with very low sperm counts
testosterone or anabolic steroid use
certain medications or medical treatments.[2–4]
Importantly, testosterone replacement therapy can suppress sperm production and should not be considered fertility-neutral in men currently trying to conceive. Learn more about fertility after testosterone.
Treatment depends on the cause. Some couples may continue trying naturally, while selected men may benefit from treatment of an underlying condition. Other couples may ultimately consider assisted reproduction such as IUI, IVF or ICSI.
There is no single treatment pathway based on sperm count alone.
Should we keep trying naturally?
That decision depends on the circumstances of both partners.
Continuing natural conception attempts may be reasonable when the sperm abnormality is mild, there are no major female fertility concerns and there is no significant time pressure.
Earlier assessment becomes more important when:
the sperm count is repeatedly very low
several semen parameters are abnormal
pregnancy has not occurred after an appropriate period of trying
there is a history of testicular problems or testosterone/anabolic steroid use
a varicocele is present
the female partner's age or ovarian reserve means delaying treatment may reduce fertility options.[2–4]
Australian and international guidelines recommend assessing the male and female partners in parallel, rather than waiting until female investigations have been completed.[2–4]
What should I do next?
If a semen analysis has shown a low sperm count, the next step is usually to confirm the result and understand why it is low, rather than immediately assuming IVF or ICSI will be required.
A male fertility assessment may include review of semen analyses, reproductive history, examination, hormone testing and selected genetic investigations depending on the severity of the abnormality.[2–4]
Explore Male Infertility & Reproductive Urology or request a male fertility assessment.
Patients travelling from interstate or overseas can also review the International Patient Information page. Existing semen analyses and fertility investigations may be useful when planning an initial assessment.
Take home message
Low sperm count does not mean zero chance of natural pregnancy.
The actual chance depends on the severity of the sperm abnormality and the fertility circumstances of both partners. Confirming the semen result and investigating significant or persistent abnormalities can help determine whether continued natural conception, treatment of an underlying problem or assisted reproduction should be considered.
References
World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: World Health Organization; 2021.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Male Infertility. Arnhem, The Netherlands: EAU Guidelines Office; 2026.
American Urological Association; American Society for Reproductive Medicine. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. 2020; amended 2024.
Katz DJ, O'Donnell L, McLachlan RI, Moss TJ, Boothroyd CV, Jayadev V, et al. The first Australian evidence-based guidelines on male infertility. Med J Aust. 2025;223(11):653-663. doi:10.5694/mja2.70080.
Guzick DS, Overstreet JW, Factor-Litvak P, Brazil CK, Nakajima ST, Coutifaris C, et al. Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med. 2001;345(19):1388-1393. doi:10.1056/NEJMoa003005.
Medical disclaimer
This information is intended for general education only and does not provide individual medical advice, diagnosis or treatment. Semen-analysis results cannot predict an individual couple's chance of pregnancy in isolation. Fertility assessment and treatment should be individualised after consideration of both partners' reproductive circumstances. If you have concerns about fertility or an abnormal semen analysis, discuss them with an appropriately qualified healthcare professional.
