A low sperm count can feel like a full stop on your plans to start a family. But it doesn't have to be. For many couples, it's a hurdle — not a dead end.

This article walks you through what low sperm count actually means, what can cause it, and most importantly, what you can do about it. Whether you're just starting to explore your options or you've been trying for a while, there are steps you can take right now.

Can you get pregnant with low sperm count?

Yes — and this is important.

Having a low sperm count can make it harder to conceive naturally, but it may still be possible to conceive naturally, and there are fertility treatments that can help.

The key word is "harder," not "impossible." Many couples where the male partner has a low sperm count do go on to conceive — sometimes naturally, sometimes with a little support.

Problems with sperm, including a low sperm count and problems with sperm quality, are quite common. They affect around one in three couples who are struggling to get pregnant. So if you're dealing with this, you're far from alone.

How common is low sperm count in the UK?

More common than most people realise. Male fertility issues contribute to a significant share of conception difficulties across the country.

Among those experiencing difficulty with conception, a male fertility problem is considered important in around 40 percent of all couples investigated for fertility.

That's nearly half of all couples seeking fertility investigations. It's a real and widespread issue — and one that deserves more open conversation than it typically gets.

Tips for getting pregnant with low sperm count

1. Time sex around ovulation

This is one of the most practical things you can do. The fertile window is roughly five to six days each cycle — the days leading up to and including ovulation. Having sex during this window maximises the chance that sperm and egg meet at the right time.

The NHS recommends having sex every two to three days without using contraception. Regular, well-timed sex keeps sperm fresh and improves the odds.

Using an ovulation test kit can help you identify your most fertile days. These are simple urine tests that detect the LH surge that happens just before ovulation.

2. Make lifestyle changes that support sperm health

Some of the most effective things you can do cost nothing. The NHS advises the following if you have a low sperm count:

• Drink less alcohol — it's recommended to drink no more than 14 units of alcohol a week, spread across three days or more.

• Stop smoking if you smoke.

• Lose weight if you're overweight.

• Wear loose-fitting underwear — tight underwear can increase the temperature of your testicles, which may affect the quality of your sperm.

• Avoid exposure to chemicals at work such as pesticides, solvents, or some heavy metals.

• Do not take recreational drugs such as anabolic steroids or cocaine.

These changes won't produce results overnight, but sperm take around 74 days to mature. So changes you make today can start showing up in your semen analysis results in two to three months.

3. Look into male fertility supplements

Certain nutrients are known to support sperm production and quality. Zinc, selenium, folate, CoQ10, and antioxidants like vitamins C and E are among those most commonly associated with sperm health.

If your diet is lacking in any of these, a targeted male fertility supplement could help fill the gap. TwoPlusFertility's male fertility supplement is formulated specifically with conception in mind — it includes key nutrients that can support sperm health as part of a broader approach to improving your fertility.

It won't override a medical cause, but for many couples, optimising nutrition can be a meaningful part of the picture.

4. Get a semen analysis done

If you haven't already, getting a semen analysis is an important first step. The main test to check for low sperm count is a semen analysis test. This involves a sample of your semen being tested to check the amount of sperm in it. The test also checks how fast the sperm move and the shape of your sperm.

Your GP can refer you for this. See your GP if you have not been able to conceive after one year of trying for a baby. If your partner is 36 or over, that window shortens to six months.

Knowing your actual numbers means you can make more informed decisions about next steps — rather than guessing.

5. Try intracervical insemination (ICI) at home

This is a step many couples aren't aware of but can explore at home, without a clinic visit.

Intracervical insemination (ICI) involves placing sperm closer to the cervix using a soft applicator. The idea is simple: it puts sperm closer to where they need to be, which can be particularly useful when sperm count or motility is a concern.

The TwoPlusFertility Applicator Extra is designed specifically for this. It's a home-use artificial insemination kit that allows you to deposit sperm directly at the cervix during your fertile window. For couples dealing with low sperm count, it can help make the most of what's there — by reducing the distance sperm need to travel and minimising any loss that might occur with conventional intercourse.

It's not a medical procedure. It's a practical tool that you use at home, at a time that works for you, in a way that's private and non-invasive. Used alongside ovulation tracking, it can help you be more strategic about your fertile window.

What are your medical options available in the UK?

If natural conception isn't happening, there are NHS-funded options available.

If you have a low sperm count and you and your partner have not been able to get pregnant after trying for over one year (or six months if your partner is 36 or over), there are treatments on the NHS that may help. 

Treatment may include in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). These treatments are where eggs are removed from your partner's ovaries and fertilised with your sperm in a lab. They are then put back into your partner's womb to grow and develop.

ICSI in particular was developed with male factor infertility in mind. A single healthy sperm is injected directly into an egg — making sperm count far less of a barrier than it would be in natural conception.

There are treatments available on the health service or privately that can help you become a dad if you have a low sperm count. NHS eligibility varies by region, so it's worth speaking to your GP about what's available to you locally.

twoplus Fertility: Improving conception chances for those with low sperm count

Trying to conceive can quickly start to feel like a chore. Timed sex, misaligned schedules, and even performance pressure often adds up. The twoplus Applicator Extra takes that pressure off, so every fertile window becomes an opportunity again, not an obligation.

The twoplus Applicator Extra is a self-assisted artificial insemination that can be used from the comfort of your home. In just 3 simple steps, the Applicator Extra helps deposit sperm close to the cervix, giving nature a helping hand.

• No medical help or clinic visit needed

• Deposits semen close to the cervix, giving sperm a more direct path

• Designed for comfort with soft tip made of 100% medical grade silicone 

• Make your fertile window count

• Affordable alternative to try now: 3 steps. 15 minutes

Finding the right care for your sperm health

Getting pregnant with low sperm count is genuinely possible for many couples. It may take more planning, more patience, and in some cases, medical support — but there are real options at every stage.

The most helpful thing you can do right now is start somewhere. That might be a GP appointment, a semen analysis, a lifestyle change, or simply tracking ovulation more carefully. For some couples, tools like the TwoPlusFertility Applicator Extra can help bridge the gap between where you are and where you want to be — making every fertile window count.

You don't have to wait for a clinic appointment to take your first step.

Sources:

1. NHS. Low sperm count. https://www.nhs.uk/conditions/low-sperm-count/ (Last reviewed: 26 January 2024)

2. NIdirect (Northern Ireland Government). Low sperm count. https://www.nidirect.gov.uk/conditions/low-sperm-count

3. NHS. Causes of infertility. https://www.nhs.uk/conditions/infertility/causes/

4. East Lancashire Hospitals NHS Trust. Semen analysis male fertility patient information leaflet. https://www.elht.nhs.uk/application/files/5015/4480/5288/CP_AF32_Fertility_patient_information_leaflet-_Rev_14.pdf