Low sperm motility or Asthenospermia: Causes and Treatments

Sperm motility is the ability of the sperm to move. It is an important factor along with sperm count and sperm morphology which is looked at in semen analysis test, because sperm needs to travel forward through the woman’s reproductive tract to reach and fertilise an egg. A man with poor sperm motility may be diagnosed with male factor infertility because if the sperms are lazy and have reduced movement, they won’t be able to reach the egg in time and fertilise it. Normally at least 50% of sperms should be motile and should comprise more of the progressive motile ones.

difference-between-normal-sperm-motility-and-abnormal-sperm-motility
Difference between Abnormal Sperm Motility (Asthenospermia) and Normal Sperm Motility (Normospermia)

what is sperm motility?

Sperm motility refers to the movement of the sperm and plays a major role in achieving pregnancy. For conception to occur the sperms need to swim forward towards the egg and fertilise it before it disintegrates. It is not necessary for all the sperms to move. But according to WHO 2010 criteria in a semen analysis test at least 40% of the sperms should be moving in the given sample to be considered as normal and this is referred to as the total motility. Total motility records all the sperms that are moving, be it the ones that move with forward progression, one that moves in circles or the ones that are only fluttering their tails.

However, for fertilisation we need sperms that can move from one place to another with a rapid forward movement, not the ones that are just twitching their tails or moving around in tight circles. Wiggling in the same place will not suffice. Many sperm have limited motility and their movement is restricted to the same spot.The sperms that swim rapidly forward in a straight line are categorised as sperms with progressive motility. A man should have a progressive motility of 32% to be able to make his female partner pregnant. And healthy sperm motility is defined as sperm showing forward progression at the rate of 25μm/s (micrometres per second). Depending on their type of movement the motility of sperm is divided into three different grades.

sperm-motility-grading
Sperm Motility Grading
  • Grade a – These are sperms with progressive motility (should be 32%) that means they are the strongest and swim fast in a straight line or large circles.
  • Grade b – These sperms are with non-progressive motility that means they tend to travel in a curved or crooked motion.
  • Grade c – These are immotile sperms either fluttering their tails or they fail to move at all.

And Total Motility (which is 40%) in a semen analysis report is given as the sum of progressive motility and non-progressive motility (Total motility = Grade a + Grade b).

what is low sperm motility?

We commonly hear about low sperm count and 90% of male infertility issues are caused by it. But poor sperm motility is also an important factor that needs to be considered while achieving pregnancy. When a man has a low sperm count it means there are fewer sperms that are travelling all along the long trail i.e. from the cervix to the fallopian tubes, hence reducing the possibility of that one sperm reaching the egg. And with a low motility the chance of that ‘one’ sperm fertilising the egg becomes even more difficult because with limited motility it won’t be able to reach the egg in time and fertilise it.

Low sperm motility technically known as asthenospermia or asthenoszoospermia is diagnosed when the sperms that can move efficiently are less than 32%. It means the sperms find it difficult to move towards the egg due to its limited motility.Many men with low sperm count (oligospermia) may also have low sperm motility (asthenospermia) and the condition is called Oligoasthenospermia. And some men might have a normal sperm count but very poor motility. In men who have sperm motility defects it has been found that the level of sperm DNA fragmentation is more.

what affects sperm motility?

There are several factors that can affect sperm motility and they are almost similar to the causes of low sperm count because these two male infertility factors often co-exist. A sperm with low count and motility may also have a poor morphology. So, if a sperm is not formed properly it may also not swim properly. There are some medical and environmental reasons and some lifestyle choices that a man makes that eventually diminishes the overall quality of sperm thus affecting its shape, count and movement. If a man can manage a proper lifestyle then there is a chance of improving the quality of sperm.

  • Excessive stress – Stress be it physical or psychological can cause fertility issues.
  • Health conditions – Some health conditions like diabetes, hypothyroidism, obesity, a presence of varicocele, testicular cancer, infection and etc can affect overall sperm quality.
  • Poor diet –Vitamin C and Vitamin B12 deficiencies can lead to fertility problems.
  • Excessive heat – It is said that excessive heat around the genitals can cause fertility issues.
  • Medications – While trying to conceive it is advisable to consult a doctor and give the list of medications that are been taken as some medications can lead to male infertility.
  • Smoking and drinking –Excessive alcohol consumption and use of tobacco are the cause of many health problems, and in a way may lead to poor sperm count and motility as well.
  • Genetic factors – Some genes that make the sperm move such as the proteins in the tail can be mutated that can produce low or non-existent motility.
how low sperm motility affects pregnancy?

Many childless couples are not able to conceive due to issues in male fertility and for a male everything is usually related to the sperm. The overall quality of sperm should be good enough for natural pregnancy to occur provided the female does not have any reproductive issues. If a man has low count, the chances of pregnancy becomes low, if one has an abnormal morphology the sperm wouldn’t be able to fertilise the egg and if the count and morphology are normal, but the motility is low then the sperm wouldn’t be able to reach the egg in time and fertilise it thus inhibiting pregnancy.

For pregnancy to occur everything should work in synchronization, right from a woman’s menstrual cycle to ovulation and hormonal balance, followed by timed intercourse and the sperm quality should be good so that it can increase the chances of pregnancy. After ovulation an egg stays in the fallopian tube for 12-24 hours waiting for the sperm to fertilise it. The sperms should be active enough to travel up the vagina, then go past the cervix, into the uterus and then swim to the fallopian tube to fertilise the egg before it disintegrates. It doesn’t matter how the couples are timing their intercourse, or what is a man’s sperm count, if the sperm are unable to travel towards the egg, pregnancy won’t be achieved.

what are the treatment options for low sperm motility?

If a couple is facing an issue of low sperm motility while trying to conceive and have tried all the home remedies, taken vitamin supplements and even managed lifestyle changes without any luck, then the best course of action would be visiting an infertility specialist. During investigations if low motility is found due to some hormonal disorders, then treatment might be possible but if a genetic cause is responsible for low or no motility then assisted reproductive techniques (ART) might be recommended. The available options for ART are discussed below.

Intrauterine insemination (IUI) is a procedure where healthy and active sperms are injected directly into the uterus. This procedure saves the sperm from taking the long journey from the cervix to the fallopian tube thus making it easier to reach the egg. But this procedure is recommended in males whose motility is a little lower 30-40% range.

In vitro fertilisation (IVF) is recommended when IUI fails and when the sperm motility rate is lower than 30%. In this process, the egg is fertilised directly with the sperm in a lab. The embryo that is fertilised is then transferred to the uterus to establish a successful pregnancy.

Intracytoplasmic sperm injection (ICSI) is recommended in men with severe motility issues that is when the motile sperm count is less than 5 million in the ejaculate. This option has a successful fertilisation rate of 70-90% and can be done as long as one normal motile sperm is found in the ejaculate.

Success story- Low sperm motility

It was almost two years that we were trying to conceive without any luck. Our immediate family members told us to visit a doctor and get ourselves checked for any issues that is hindering pregnancy. We visited a nearby clinic where we were told to get some preliminary investigations done. My reports came out fine, but my husband’s semen analysis report was not normal. It showed a total motility count of 10%, where in the normal motility range is 40%. A second semen analysis report after 2 weeks or so showed motility of 12%. This was the reason I was unable to conceive. Therein, 3 failed IUI and 1 failed IVF, we had lost all hopes. After a year had passed by, we decided for a second consultation, that is when we came to know about Medicover through a dear friend. There we met Dr. Sweta Gupta who recommended ICSI in conjunction with IVF as a treatment options for men with severe sperm motility issues.

And here, today I am a mother to a baby boy. Our dream of parenthood has been finally fulfilled. (Rosy 33 years.)

Doctor’s Suggestion on Low Sperm Motility -Dr.Sweta Gupta

For IUI treatment the sperm motility should at least be in the range of 30-40%. As the cost of IUI procedure is low so couples generally prefer it as the first line of treatment not knowing the fact that for very low motility it is not recommended. Even the success rate is not that high. Generally, IUI should not be recommended if 3 cycles have already failed. The next line of treatment ideally should be IVF, but in Rosy’s husband’s case he had a severe sperm motility issue where percentage of motile sperms were very low. In his case the perfect treatment was ICSI. We prefer offering ICSI treatment to all men diagnosed with asthenospermia to avoid the risk of fertilisation failure with traditional IVF.

Fertility solutions at Medicover Fertility

Medicover Fertility clinics are among the top fertility clinics in Europe, now in India. We have a team of highly dedicated, skilled and experienced doctors who have been successfully treating men with fertility issues. We have a high success rate as we use the most advanced technology in Assisted Reproductive Techniques (ART).

Medicover Fertility has many low sperm motility success stories to share. We have been able to treat many severe cases of sperm motility where patients had come to us after many failed IUI’s and IVF’s. With our services we have been able to restore the smiles in many couples who otherwise had lost all hopes after many failures in attempts to parenthood.

Related Questions:

Q) What is normal sperm motility percentage?

A) Sperm motility refers to the movement of the sperms and is one of the parameters looked at in a semen analysis. At least 40% of the sperms in a sample should be moving to be considered as normal.

Q) How to improve sperm motility?

A) Some lifestyle changes like having proper diet, taking vitamin C and zinc supplements have been shown to increase sperm count, sperm motility and even testosterone levels in men thus improving the chances of fertility.

Q) Can low sperm motility cause infertility?

A) Sperm motility is important for male fertility. If a man’s sperm is unable to swim effectively then natural pregnancy would be difficult. The sperm will not be able to reach the egg because of its poor motility.

Q) Can low sperm motility cause miscarriage?

A) Unhealthy lifestyle choices can lead to many factors that can decrease the chances of a successful pregnancy. These factors may include poor sperm motility, lower sperm counts and abnormal morphology. And any damage to sperm quality can cause fertility problems, even if an egg is fertilised it may lead into a miscarriage.

Q) What are the chances of pregnancy with low sperm motility?

A) The chances of pregnancy with low motility is minimal where one must resort to assisted reproductive techniques. IUI is recommended in couples where the motility ranges from 30-40%. If the motility range is less than 30% IVF is recommended and in cases of severe motility problems ICSI is recommended.

References :
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735139/
2. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455014/
4. http://www.worldofmoms.com/articles/all-about-sperm-motility/4745/2
5. https://www.fertility-docs.com/programs-and-services/sperm-evaluation/sperm-and-semen-testing.php

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