Condition & Treatments
/ Motility and morphology
Sperm that don't swim well, or have an unusual shape: what it means, and what can help
Motility is how well sperm swim, and morphology is the proportion with a normal shape. Both are measured on a semen analysis. Low results are common, often have a treatable cause, and on their own rarely mean you can't become a father.
I N S H O R T
Results vary from test to test, so an abnormal result should be repeated in a specialist Andrology lab.
Common causes include varicocele, infection, smoking, heat, excess weight and hormone problems. Less often, the cause is a genetic or structural defect in the sperm.
Treating the cause can improve sperm within about three months. Where it can't, IUI or ICSI can help.
What the numbers mean
The World Health Organization's reference values are at least 30% of sperm swimming forwards (progressive motility), at least 42% moving at all (total motility), and at least 4% with a normal shape [1]. Results below these are common in fertile men too, so they are a guide, not a verdict
Tests
to look for varicocele.
Sperm DNA fragmentation,
as poor motility and morphology often go with DNA damage.
Sperm vitality test,
if no sperm are moving, to check whether they are alive.
Treatment options
Treating the cause: varicocele repair, or antibiotics for infection
Lifestyle changes and targeted antioxidants, with clear, specific advice.
Hormone treatment, where hormone levels are low
Assisted conception: IUI for milder problems, or ICSI, where a single sperm is injected into each egg
Why this matters to your care
A low motility or morphology result is a finding, not a diagnosis. Prof Raheem looks for why it is low before deciding on treatment, so you aren't sent straight to IVF if something simpler could work
Does poor morphology mean my baby could be affected?
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No. Sperm shape on its own does not predict the health of a baby
Can motility improve?
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Often, yes. Sperm takes around three months to be made, so a repeat test is usually done 3 months after starting treatment.
Do we need IVF?
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Not necessarily. Many couples conceive naturally or with IUI once the cause is treated.
References
1. World Health Organization. WHO laboratory manual for the examination and processing of human semen, 6th edition, 2021. Link