Men typically have low counts because germ cells, which make sperm, have died.
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Infertility: It can be difficult to improve low sperm counts. Dr. John A. Schnorr: Turns out that when men have low sperm counts, most of the times because they have had a death of the germ cells in the testicle that actually make sperm. So to get new germ cells, we would literally need to clone that person to make new germ cells and put the germ cells into the testicle which would then make sperm. So most of the time it's failure of the germ cells which is why we can't improve sperm counts. That's a generalization, you can improve them a little but you don't -- in most patients you can't improve them very much.