What Does "Low Sperm Motility" Actually Mean?

Picture it. The call comes in from the doctor, and the diagnosis is low sperm motility. That’s what’s slowing down all your baby making plans. 

So, what the heck can you do about it? It turns out this relatively common issue doesn’t have to be a giant red stop sign on your fertility roadway. Here’s the lowdown on low sperm motility. 

What’s low sperm motility, anyway?

OK, so you went through health class. You know sperm is the male sex’s contribution to conception. But what about motility? Medical speak for “movement,” motility refers to the sperm’s ability to move or “swim” out of the penis, through the vagina and on through his partner’s reproductive system, finally ending at the Fallopian tubes, where the woman’s egg is (hopefully) waiting to be fertilized. 

Maybe your doctor has called it “asthenozoospermia” instead of low sperm motility. Either way, what they’re saying is an analysis of your sperm in the lab has come up with a bunch of slow swimmers. You’re far from alone—one Journal of Reproductive Systems study found as much as 81 percent of men with fertility issues had motility problems—but, let’s face it: slow speed is a problem when it comes to baby-making sex. 

As Jamin Brahmbhatt, MD, a urologist at Orlando Health puts it, “Sperm are movers and shakers.” The better they are at this, the more likely they’ll make it to their ultimate destination—the egg.

How can doctors tell? 

When a man heads to his urologist’s office to find out if he’s got a fertility issue, they’re likely going to undergo a number of steps to get to the bottom of things, including:

• Questions about family and health history
• Physical examination
• Blood tests
• Semen analysis

It’s that last one that will help detect a motility issue, Dr. Brahmbhatt says. The sperm is examined under the microscope in a lab, where a technician evaluates how much (if any) of the semen sample contains motile sperm. The lower the number—you guessed it, the lower the chances of conception. 

Can we test for sperm motility at home? 

Yes, there are now at-home sperm tests that provide clinical-grade, full sperm analysis including sperm motility. In addition to motility, these sperm tests can look at:

• Volume: Semen plays a crucial role in carrying sperm through the reproductive tract. Producing the right amount means giving sperm the best chance at reaching the ovum for fertilization.
• Concentration: Sperm concentration helps contextualize the relationship between your unique volume and count. The right ratio can be as important an indicator of fertility as a high sperm count.
• Morphology: A sperm’s shape affects its ability to both reach and fertilize an egg—this metric helps you understand what percentage of your sperm have a natural shape and what abnormalities there might be.
• Count: Not only does a healthy sperm count improve your chances of conception, it’s also a great indicator of your overall health.

What can I do about low motility? 

This is where your doctor will have to look at more than just your semen to figure out what to do. 

Low sperm motility can be caused by something called varicoceles, essentially a varicose vein in the testes. If that’s the case, says Marc Goldstein, M.D., director of the Center for Male Reproductive Medicine and Surgery at Weill Cornell Medicine/New York Presbyterian Hospital, they can perform a minor procedure to remove the vein, hopefully allowing sperm to flow freely and allowing for conception the old fashioned way. Studies show this can be successful, although not a cure-all treatment for every man. 

Sometimes lifestyle changes are all it takes to increase sperm motility:

• Reduce your drinking: Scientists have found a link between alcohol usage and sperm quality, including motility. But there’s good news here too. Sperm quality for some men has been found to improve in as little as three months after he quits drinking. 

• Stop steroid use or testosterone use: According to Dr. Brahmbhatt, even testosterone prescribed by a physician for a diagnosed medical condition can shut down sperm production. If you’re on anabolic steroids, your doctor would probably tell you to get off of them, stat. If you’re on prescribed hormones, talk to your doctor about your fertility plans. 

• Lifestyle changes: Sperm health comes down to overall health. The science linking high BMI and lower quality sperm is mixed, with some researchers saying there’s an absolute tie and others questioning the correlation. Either way, it’s worth talking to your doctor to see if some exercise and diet changes might make a difference for your fertility. 

• Avoid the hot tub and tight undies: No, it’s not a myth! The testicles like to be “a little cooler” than the rest of your body, Dr. Brahmbhatt says. When they’re overheated, it really can affect your sperm. 

If lifestyle changes don’t do the trick and there are no apparent varicoceles, there are other treatments available:

• Intrauterine insemination (IUI): When a reproductive endocrinologist transfers sperm into a woman’s uterus to increase the chance of fertilization.
• In vitro fertilization (IVF): When sperm is mixed with an egg in a lab setting to fertilize the egg “naturally” before transferring the resulting embryo into the woman’s uterus.
• Intracytoplasmic sperm injection (ICSI): Another IVF procedure, in which a single sperm cell is injected directly into the egg. 

Bottom line 

Learning you have low sperm motility can feel like a low blow. But the more you talk to your doctor, the more options you might find on the table.