How much sex to have with low sperm count

With so much of the focus of baby-making directed to women, the role of male partners is easy to downplay when you’re trying to get pregnant. But male infertility is common: At least half of the cases where a couple is infertile may be chalked up to sperm-related issues, usually low sperm count (1).


If your partner has been diagnosed with a low sperm count, you’ve probably wondered how much sex the two of you should have to increase your chances of getting pregnant. A Google search — unsurprisingly — delivers conflicting advice. Some articles advise you to get busy a couple of times a day, while others encourage sex every two to three days.


We’re here to explain how much sex you should have if your partner has low sperm count, and we’ll offer a few pro tips to help you on your journey to conceive.


What is low sperm count?


According to the most current committee opinion from the American Society for Reproductive Medicine (ASRM), men with sperm concentrations below 13.5 million sperm per milliliter are considered subfertile (2). In contrast, sperm concentration among fertile men is above 48 million per milliliter.


That said, low sperm count is just one factor in male infertility. A lack of healthy, normally shaped swimmers also plays a role (which we’ll get to soon).


Should we abstain from sex before the fertile window to save up sperm?


Fertility experts once backed the practice of abstinence as a way to increase sperm counts, following guidance in a 1999 World Health Organization manual on infertility, which advised couples to refrain from sex for up to 7 days prior to an evaluation of sperm quality (3).


Today, this recommendation is considered outdated. Plus, it ignores another issue with low sperm count — the condition frequently is associated with mediocre sperm quality, including less motility or abnormal shape (3). Since experts now may advise against abstinence for men with low-quality sperm, how often should you have sex if your partner is in this camp?


How much sex is the “right” amount?


When researchers at Tel Aviv University studied a sample of men with low sperm count and poor sperm motility, they found that ejaculating within 1 to 4 hours (and again 24 hours later) increased the total motile sperm count over and above that of the first ejaculate (4).


This was good news, with the paper’s authors noting, “most of these infertile men may significantly increase their fertility potential...by having intercourse every day or even twice a day, at the time of ovulation.” And while the study size was small — fewer than 600 men — it’s logical that having more sex in a short timeframe increased the amount of sperm available to fertilize an egg.


Recent research has echoed these findings, albeit among a tiny sample. A study of 73 men with low sperm count showed that frequent ejaculations (twice in an hour!) produced more normal sperm and better motility in the second ejaculation (5).


Does this mean you must somehow squeeze twice-daily sex into your already jam-packed schedule? Not quite.


The benefits of sex every other day


We’ve talked about smaller studies, but what happened when scientists investigated sperm quality and sperm count in a group of around 6,000 men? The main takeaway: having sex 3 to 4 times a week helped produce a proper amount of motile, normal sperm (3).


But let’s dig into the science a bit further, because the research offered illuminating nuggets of information on the link between abstinence and sperm quality.


About 25% of the men in the study had a low sperm count (less than 20 million sperm per milliliter), and the remainder had a normal sperm count. All participants abstained from sex for at least 2 weeks. When men in the low sperm count group abstained from sex, their sperm showed a steady decrease in motility over the course of a day (one day!), and after just two days of abstinence, the quality of sperm also deteriorated.


As for the men with normal sperm counts, their swimmers showed little change in motility following abstinence and didn’t degrade in quality until much later.


So having sex every day or suggesting some self-love to your partner with low sperm count may help boost his fertility potential.


Side note: While daily sex during the fertile window yields the highest pregnancy rates, per research cited in a committee opinion of the ASRM, this veteran group of docs also noted that having sex every other day provides similar results — and may relieve some pressure on you and your partner (6). What's more, regular sex outside your fertile window (basically, having sex when you're feeling frisky) may affect your immune system in a way that aids conception.(7)


Of course, you’ll want to respect the feelings of the testicle-haver in your partnership. Being made to feel like a sperm factory isn’t going to be a win for anyone and at the end of the day, you should follow the advice of your doctor.



References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3343360/
  2. https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/diagnostic_evaluation_of_the_infertile_male_a_committee_opinion-noprint.pdf
  3. https://www.fertstert.org/article/S0015-0282(05)00540-6/fulltext
  4. https://www.ncbi.nlm.nih.gov/pubmed/8034087
  5. https://www.ncbi.nlm.nih.gov/pubmed/26776821/
  6. https://www.fertstert.org/article/S0015-0282(16)62849-2/fulltext
  7. https://www.sciencedirect.com/science/article/abs/pii/S0031938415301153

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