Low sperm motility: causes, treatment, and pregnancy success

Many things contribute to fertility including sperm motility, which is the sperm’s ability to move quickly and in a straight line. If you have low sperm motility, this means your sperm can’t move properly and may not be able to reach and fertilize an egg. 

Let’s learn more about this aspect of sperm health, including how to find out if you have low sperm motility and what treatments are available if you do.  

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Sperm motility is one way of telling how healthy a person’s sperm is. Motility describes how efficiently sperm move through the reproductive tract to reach an egg. 

If a person has low sperm motility (also called asthenozoospermia), it means that the majority of sperm aren’t swimming properly. This can affect fertility as sperm may not be able to get to an egg and fertilize it.

Note the use of majority: it’s perfectly normal if you have a few slow swimmers. Not all sperm move perfectly all the time, and that’s okay. However, if most of your sperm start to move slowly or poorly, issues with fertility can arise.

Low sperm motility vs. low sperm count

These two terms sound similar but aren’t actually the same thing. Like low sperm motility, having a low sperm count (the concentration of sperm in a person’s semen) is a factor that can impact semen quality and fertility (Leslie, 2022). 

This means you can have a perfectly healthy sperm count and still have issues with sperm motility. You could also have good sperm motility but not a lot of sperm in your semen. The shape of your sperm can also play a role. 

The point is that if you experience fertility issues, there can be many elements at play––sperm motility is just one of them. 

Many things can affect sperm motility including (Gatimel, 2017; Leslie, 2022):

• Exposure to environmental toxins like heavy metals

• Excessive heat from a fever, restrictive clothing, or being in a hot tub or sauna 

• Lifestyle factors like smoking, drinking, and using recreational drugs 

• Having obesity or being overweight 

• Living with lots of stress

• Testicle injury or infection

• Advanced age

• History of undescended testicle (cryptorchidism) 

• Use of anabolic steroid

• Varicoceles (enlarged veins in the scrotum)

• Antisperm antibodies (when the immune system makes antibodies that attack sperm and damage their motility. This is a rare condition that can occur in both men and women)

If you and your partner have been unable to conceive after at least 12 months of trying (the criteria for diagnosing infertility), your healthcare provider may recommend a semen analysis. This is a highly useful, non-invasive test that assesses a man’s fertility, including whether he has low sperm motility.  

For the semen analysis, you’ll masturbate and ejaculate into a special container. Your sample is then sent to a lab and analyzed. Usually, multiple samples over multiple days are needed. The test can assess not only sperm motility, but also sperm count and shape abnormalities, semen pH and volume, and more (Agarwal, 2020).

If there’s a possibility that you or your partner has antisperm antibodies, then an antisperm antibody test can be performed during the semen analysis (Sunder, 2021).

There are several medical treatments, lifestyle changes, and reproductive technologies that can address sperm motility and help you and a partner become pregnant.

Lifestyle changes and supplements

It can be difficult to make lifestyle changes, but fertility is a complex process and is tied to your overall health. Steps for getting healthy and improving fertility include:

• Quit smoking or using recreational drugs

• Drink less alcohol

• Exercise more and maintain a healthy body weight

• Reduce exposure to heavy metals (like lead and cadmium)

• Avoid your testicles overheating (this can be as simple as wearing loose-fitting underwear or avoiding baths or hot tubs before having sex)

There are also ingredients in some male fertility supplements that may improve sperm motility. Antioxidants like L-carnitine, selenium, vitamin A, vitamin E, and coenzyme Q10 appear to help male infertility and are a low risk tool to try (Calogero, 2016; Moslemi, 2011).

Medication

While there are no drugs specifically designed to address sperm motility, some medications may be prescribed off-label. These include (Chehab, 2015):

• Clomiphene citrate: This medication impacts hormone production and is also used to treat infertility in women.

• Pentoxifylline: This drug helps improve blood flow and behaves like an antioxidant.

If you have a medical condition that could be causing poor sperm motility—like an infection—antibiotics might help. 

For example, you may be prescribed antibiotics for epididymitis, an infection of the small, coiled tube connected to testicles that plays a key role in developing and transporting sperm. Sometimes, anti-inflammatory drugs are prescribed to treat epididymitis as well (Calogero, 2016).

Assisted reproductive technologies

These tools can help a person get pregnant by manipulating the sperm and egg. They can be very effective tools for conceiving even if you have low sperm motility. A good example of this is in vitro fertilization (IVF). 

Before turning to IVF, intrauterine insemination (IUI) is often the first step in assisted reproduction technology. Here are a few things to know about IUI or artificial insemination (Leslie, 2022):

• Procedure: A male partner or sperm donor provides a sperm sample at a fertility clinic. This is deposited into a woman’s uterus using a thin, flexible tube. 

• Why it works: IUI is a brief, painless procedure that maximizes the amount of sperm able to get close to the egg and minimizes how far sperm has to swim. 

• How to increase pregnancy chances: You can increase your chances of successfully conceiving if the female partner takes fertility treatments to enhance ovulation.

• Outcomes: Pregnancy rates using IUI can be up to 50%. 

If IUI doesn’t work, IVF is usually then next step. IVF is a more complex process in which eggs are retrieved from the female partner, a sperm sample is collected from the male partner, and the embryos are fertilized in a lab. Healthy embryos are then inserted directly into the female’s uterus. 

While it can be expensive and takes longer, IVF is up to 45% effective in achieving pregnancy. Another technique that can be added to the process called intracytoplasmic sperm injection (ICSI), which can increase the success rate to 60% (Leslie, 2022).

It’s easy and understandable to feel stressed and worried if you’re struggling with male infertility. 

Try to remember that there are many things that affect fertility and that keeping your stress levels low and remaining connected with your partner can make the process a lot easier. 

Talk to a healthcare provider if you’re concerned about fertility problems and see what next steps are right for you.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

March 17, 2022

Written by

Nancy LaChance, BSN, RN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.