Sperm Motility

posted in: Male Infertility | 2

Hi,

This is Dr. Shah, Consultant in Male Infertility & Sexual Health. In this post, I am going to tell you everything about sperm motility

But, first, let us understand a little about normal sperm motility.

What is normal sperm motility?

Did you know, that the normal sperm motility as stated by the WHO 2010 Andrology Laboratory Guideline values is 40%. 

Most men fear they will never father a child when their semen analysis or sperm test report shows a sperm motility range less than 40%.

This cannot be farther from the truth! Here is a saying I absolutely love, take a look below…


Sperm motility | normal sperm motility | normal sperm motility for pregnancy


In my long years of clinical experience as an Infertility specialist, I have seen over 286 men who had extremely low sperm motility, in the range of 10  to 20%. All these men were told to go in IVF (In Vitro Fertilization) because the professionals who treated them believed that getting pregnant with low sperm motility is not possible. 

I advised each and every one of them the exact opposite of what they were told. Yes, I agree they all suffered from poor sperm motility, but, that does not ever mean that it is not possible to improve it.

With the right treatment and medications, we were able to increase sperm motility naturally for each and every one of them.

Now here comes the bigger truth,

Remember, I told you the WHO 2010 manual recommends a sperm motility index of 40 %?

This value came from a study performed on over 3000 fertile fathers who were able to get their partners pregnant in the 1st year of marriage. The WHO study assessed data only from European men who gave a semen test. It chose to ignore India and China

The big joke is how can you extend an apply sperm motility data from one geography or study population to another population of Indian men??

It’s like telling the apples and oranges are the same!…Read on…. the interesting stuff has not even begun…


sperm motility varies from place to place | normal sperm motility


The sperm analysis or semen test data that we use to assess Male infertility is not even based on study findings from our Indian population!. The WHO did not include Indian men when doing their study. They simply said that the 40% normal sperm motile range as prescribed is for reference purpose only! and that every clinic or lab should come to a conclusion based on their own data and metrics!

Thus, that is exactly why I strongly believe that with the right treatment it is possible to improve sperm progressive motility

Okay now bearing this in mind..

let’s discuss on our second topic

What is the normal sperm motility for pregnancy?

So how much motility is required for pregnancy?..

Well to be honest, all you need is one sperm to fertilize that egg at the right time. But truth be told, not all men are lucky enough for such a scenario. If that was the truth why would there be male infertility issues in the first place?


male infertility | normal sperm motility for pregnancy


In my clinical experience, what the lowest sperm motile range below which pregnancy chances seriously fall, is about 2% to 5%.

Again the statement I make here is highly relative.

In all my years, I was able to treat only one patient who had severely low sperm motility in the range of 1 to 5%. However, this patient also conceived naturally without any aggressive fertility based therapies.

All said and done, for Indian men, motile sperm percentage of 35% or above is good for pregnancy.

This is especially true, when his sperm count, shape, and semen volume is normal!.

Because we have no other options, we try to use the WHO 2010 reference values. We do not swear by it, In all our treatments for male infertility, it is a combination of our data and clinical experience that help us make the right decision for each couple.

There is and always be will chance of pregnancy with low sperm motility least for a few couples. But we cannot directly predict for whom pregnancies will happen.

Thus to conclude this section, you must understand that there is strictly no normal sperm motility for pregnancy. For all practical purposes, we recommend a range of 30 to 40% sperm motility as normal

Now let us further our understanding, about spermatozoa and its motility

Sperm motility can be broadly classified as follows

  1. Sperm that are progressively motile.
  2. Sperms that are non progressively motile.
  3. Sperms that are immotile.

We will discuss the significance of each type –

Sperm progressive motility : 

A sperm is said to be a progressively motile sperm if it moves linearly from one field to the next. This kind of movement is called progressive in nature. What this in principle means is that, the sperm is able to move from one place to another place. Both the number of sperms (sperm count) and the total number of progressively moving sperm in the semen play a key role in pregnancy.

The concept should be fairly easy to understand, remember only sperm that are able to move can reach and fertilize the egg!.

While a lot of fuss was initially made about the speed of sperm movement, we now know for a fact that speed of sperm movement is not or no longer a clinically useful tool to predict pregnancy. As long as you have at least over 32% of progressively motile sperm in the ejaculate, things should turn out normal.

However, do remember that even if you have sperm progressive motility lesser than 32%, pregnancy is still possible. It is only at very low values of 2 to 5% were the chances of pregnancy become less.

Have a quick look at the image below to understand progressive sperm motility


Sperm progressive motility | sperm motility| normal sperm motility | normal sperm motility for pregnancy


Sperm non-progressive motility : 

Okay, now let’s discuss sperm non-progressive motility. A sperm is said to have non-progressive sperm motility if it moves in circles, or if it simply vibrates around a set point. Non progressively motile sperm may become progressively motile over a later period of time. But we do not know to what extent this phenomenon occurs.

Hence for all practical purposes, the total sperm motility in a given sample = sperm progressive + non-progressive motility. Total sperm motility gives us a good sign of the total number alive sperms in the semen.

Have a look at the image below to understand sperm non-progressive motility.


Sperm non progressive motility | sperm motility | normal sperm motility | normal sperm motility for pregnancy

Immotile sperm : 

Immotile sperm as you can clearly understand from our very definition, simply means that the sperms are not moving or mobile.

A very important distinction has to be made here though, just because a sperm is not moving, it does not mean it is dead!!!. When a semen analysis report shows a higher range of immotile sperm, most people think or tend to assume that the sperms are all DEAD.

But that is absolutely not true!. Which is exactly why in a semen analysis report we have a separate section to assess sperm vitality.

All said and done, immotile sperm do not contribute to the chances of achieving a pregnancy. Having over 80% of immotile sperm in the semen is definitely strongly associated with male infertility.

Also interestingly, some men suffer from sperm flagellar defects, this also results in immotile sperm.

The causes of immotile sperm are summarized below

  1. Oxidative stress from poor lifestyle habits can result in immotile sperms
  2. Smoking and excess alcohol consumption can lead to immotile sperms
  3. Hormonal deficiencies can lead poor sperm count and immotile sperm
  4. Sperm tail defects can also be genetically inherited can also lead to immotile sperms
  5. Cystic fibrosis is a genetically inherited condition is also associate with immotile sperm
  6. Kartageners syndrome is also associated with immotile sperm
  7. Sexually transmitted infection can also increase the percentage of immotile sperm
  8. Excess heat exposure can also increase the proportion of immotile sperms
  9. Numerous other sperm production problems due to genetic mutations in the Y-chromosome can also lead to sperm immotility with extremely low sperm counts.
Sperm motility range chart –

Alright then, let’s take a look at the WHO Semen analysis normal reference values!

Semen Analysis Normal Values

The WHO 2010 Semen Analysis normal reference values.

As you can clearly see, these values are based on studies done on European men. While we still use these reference values in our day to day practice we do not SWEAR by them.

If you have taken a recent semen test, you can compare it with the table above. You can also get in touch with me at my fertility clinic. I will try my best to help you.

That apart, I hope you got some understanding of sperm motility. Now let’s look at ways to improve sperm motility

How to increase sperm motility?

So, how to increase sperm motility fast?, here are some ways that you should definitely try to follow

A. Exercise, exercise and keep exercising to improve sperm motility –

Exercise does not mean hitting the gym and lifting heavy weights and wearing out yourself. Healthy exercise for sperm motility can be a simple act of walking regularly for over 45 mins every day for a period of 8 weeks.


walk to improve sperm motility | normal sperm motility improves by walking


Walking for a period of 8 weeks tremendously improves your bodies free testosterone, testosterone is a key hormone required for normal sperm production. When you regularly walk, this hormone rises in your body exponentially, and definite improvement in sperm motility is seen after a period of 8 weeks.

Walking is one the most common strategies we advise patients when they have problems with their sperm motility percentage.

B. Eat lots of Antioxidant-rich fruits and vegetables –

No two thoughts on that, a healthy diet goes a really long way in drastically improving the results of your semen test, more so the motility of your sperm. Oxidative stress is constantly generated by free radicals production in our body.

Free radicals can bind to the sperm cell plasma membrane and damage sperm severely leading to low sperm quality in general. This is exactly why you need to gorge on lots of fruits and vegetables to significantly improve the motile sperm fraction in your semen.


eat fruits and vegetables to improve sperm motility | normal sperm motility for pregnancy


Of course, we have an awesome fertility friendly diet we give patients who come to us for a treatment .

C. Take the prescribed antioxidants from the right male infertility specialist –

I am sorry to say this, male infertility doctors are far and few in between, most patients sadly resort to native treatments for years together at a stretch.

Sadly speaking, lost time simply means you are losing the best years of your life as far as your fertility is concerned. With increasing age, and with more time lost with ineffective non-scientific treatments, fertility for both men and women decreases.

Numerous studies have found a strong correlation between decreased sperm quality and increasing male age.

My advice to you…

Take the right treatment with right expert at the right time

Lost time is lost sperm quality and lost fertility | with increasing age sperm motility is also lost


The Male infertility industry currently sells over 1000 different combination of medications, but which is the right one?. Truth is…

“There is no one right combination drug for improving sperm parameters”

Medicines to improve sperm motility that has some effect are mostly CoQ10, Folic Acid, Vit A, E, C, D3, Carnitine and a few other combination of these chemicals. Again, there is no guarantee that these medicines can actually improve sperm motility. Studies find some benefit but these findings are still not robust.

Over long years of treating many fertility patients, we have found a that a few of these drugs may work in combination with dietary and lifestyle modifications. Never ever take sperm motility tablets sold online without a prescription. These medications will do more harm than good

D. Avoid carrying your cell phone in your pant pocket –

Smartphones are not smart, they cannot do everything!. Sometimes they can do more harm than good.

I think the image below should tell the rest!


smart phones and sperm motility


you see, cell phones emit EMR Radiation which is electromagnetic waves and these waves can ultimately destroy the motile sperm fraction in semen!

Remember the aforementioned tips are probably the best way to increase sperm quality in general. Remember it is not enough if your motility is alone is good. Having a sperm concentration of 1 million per ml with 40% motility is still no good for achieving a pregnancy.

In these scenarios, it is best to visit an expert who understands male infertility in and out and then seek ways to improve sperm motility.

In the last section let us look at…

Zero Sperm Motility –

You must bear in mind that men diagnosed with zero sperm motility are genuinely sterile and cannot most of the time father a child naturally. This is truly one of the most extreme forms of male infertility.

In these scenarios, we must repeat the semen analysis at least over 4 to 5 different times in well-certified andrology labs.

A trial attempt can be made with medications to improve motility, but most of the time, these do not work so well.

Zero sperm motility is usually because of severe genetic defect called 9+0 Syndrome. In this conditions, there is a severe problem with the production of a mature sperm tail at the level of the testis.

The only way to treat this condition is by resorting to ICSI (Intracytoplasmic sperm injection)

In this technique were natural barriers, to fertilization are bypassed. A single normal appearing sperm is taken and injected straight into the egg. A picture of the same is depicted below


icsi ivf | male infertility | male fertility | ivf process
icsi – ivf involves the injection of a single sperm directly into the egg. icsi -ivf is used to treat severe forms of male infertility

The embryo thus formed can then be transferred back to the partner’s uterus after 3 or 5 days of culture. IVF-ICSI is probably a patient’s best bet when he is diagnosed with zero motile sperm (also called total asthenozoospermia)

What is again very important to understand here is that ICSI success rates are better when the sperms are immotile but alive. In some scenarios sperms are both immotile and are dead, in such clinical scenarios, doing ICSI itself remains more of a gamble.

So I hope you thoroughly enjoyed reading this article on sperm motility. I am sure you are now empowered to help people around you when anyone asks you something about sperm motility in general. Do share this article with all your freinds and loved ones!. and remember male infertility no matter how bad is treatable.

This is Dr. Shah, Consultant in Male Infertility & Sexual Health, and if you do have more questions, know that I will be more than happy to answer them at the earliest

References

  1. WHO Reference values for human semen characterization
  2. Semen analysis with respect to sperm number and sperm morphology and other factors – Asian Journal Of Andrology

 

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2 Responses

  1. S. Sukumar

    Lovely post.. cleared a lot of misconceptions.. risky useful for couples who are finding it difficult to start a family.

    Keep up the good work Doc

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