Sperm Motility: Normal Values, 7 Causes and How to Improve

Sperm motility is the ability of sperm to swim, and it is reported in a semen analysis as the percentage of sperm that move. Under the WHO 2021 reference values, at least 42% of sperm should be moving and at least 30% should be swimming forward (progressive motility). Lower values, called asthenozoospermia, can make natural conception harder, but many causes are treatable and assisted reproduction can bypass poor movement.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter); Arab Journal of Urology (PMC) — Chung et al. 2023, Sixth edition of the WHO laboratory manual: updates for busy clinicians

What is sperm motility?

Each sperm cell has a head that carries the father’s DNA, a midpiece packed with mitochondria that supply energy, and a long tail (the flagellum) that beats to push the cell forward. Sperm motility describes how well that tail works. After ejaculation, sperm must swim through the cervix, uterus and fallopian tube to reach the egg, so movement is one of the core measures of male fertility.

Inside the tail is the axoneme, a bundle of microtubules arranged as nine pairs around a central pair (the “9+2” pattern). Motor proteins make these microtubules slide against each other, which bends the tail. When this machinery is built incorrectly, the sperm may be alive but unable to swim.

Source: Cleveland Clinic — Semen Analysis; MedlinePlus Genetics — Primary ciliary dyskinesia

Doctors look at sperm motility together with count and shape. A man can have a normal sperm count but poor movement, or the reverse, and the overall picture matters more than any single number. If you have not read it yet, our semen analysis guide explains every value on the report; this article focuses only on movement.

Source: MedlinePlus — Semen Analysis

Types of sperm motility: progressive, non-progressive and immotile

The laboratory looks at a drop of fresh semen under a microscope and sorts every sperm it counts into a movement category. The sixth edition of the WHO manual (2021) returned to a four-grade system that had been dropped in 2010, splitting forward-moving sperm into fast and slow groups.

Source: Life (PMC) — Boitrelle et al. 2021, The sixth edition of the WHO manual for human semen analysis: a critical review; MedlinePlus — Semen Analysis

“Progressive motility” on your report is grades a plus b, and “total motility” is a plus b plus c. The European Association of Urology (EAU) guideline panel considers the split between rapid and slow progressive sperm clinically relevant, and notes that the presence or absence of rapid progressive sperm is recognized as important. Not everyone agrees: a critical review of the WHO manual pointed out that this distinction was reintroduced without recent studies proving its usefulness, so some laboratories still report only progressive versus non-progressive.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter); Life (PMC) — Boitrelle et al. 2021, The sixth edition of the WHO manual for human semen analysis: a critical review

Normal sperm motility: WHO 2021 reference values

The WHO values are lower reference limits: the 5th centile of men whose partners conceived within a year. In other words, 95% of fertile men in the reference data had results above these numbers. A value below the limit means the result is unusual, not that pregnancy is impossible.

Source: Arab Journal of Urology (PMC) — Chung et al. 2023, Sixth edition of the WHO laboratory manual: updates for busy clinicians; Life (PMC) — Boitrelle et al. 2021, The sixth edition of the WHO manual for human semen analysis: a critical review

Because labs and patient websites round these figures differently, you may see “more than 40%” as the normal total motility; Cleveland Clinic lists a normal range of 40% to 81%. The EAU guideline still uses the WHO 2010 definition of asthenozoospermia: fewer than 32% progressively motile sperm. When motility is very low, a vitality test is added to check whether the non-moving sperm are alive. The WHO 2021 manual suggests this when total motility is below 40%; the EAU recommends it only when more than 60% of sperm are immotile.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter); Cleveland Clinic — Semen Analysis; Arab Journal of Urology (PMC) — Chung et al. 2023, Sixth edition of the WHO laboratory manual: updates for busy clinicians

Total motile sperm count: why the absolute number matters

A percentage on its own can mislead. A man with 35% motility and a high sperm count may have far more moving sperm than a man with 60% motility and a very low count. For this reason many fertility specialists also calculate the total motile sperm count (TMSC): semen volume multiplied by sperm concentration multiplied by the fraction of motile sperm.

In a Dutch cohort of 1,177 couples followed for up to three years, the TMSC predicted natural ongoing pregnancy better than the WHO 2010 categories. The authors suggested three prognostic groups: below 5 million, 5 to 20 million and above 20 million motile sperm per ejaculate. Couples with fewer than 1 million or 1 to 5 million motile sperm had clearly lower natural pregnancy rates than those with 5 to 10 million.

Source: Human Reproduction (PubMed) — Hamilton et al. 2015, Total motile sperm count: a better indicator of male factor severity than the WHO classification

Causes of low sperm motility (asthenozoospermia)

Low sperm motility rarely has symptoms of its own. It is usually discovered when a couple has trouble conceiving. The causes overlap with those of a low sperm count, and in many men more than one factor is involved.

Smoking

A meta-analysis in European Urology pooled 20 studies with 5,865 men and found that smokers had lower sperm motility than non-smokers (a mean difference of about 3.5 percentage points). The effect was larger in moderate and heavy smokers and in men already being treated for infertility.

Source: European Urology (PubMed) — Sharma et al. 2016, Cigarette smoking and semen quality: a new meta-analysis; Cleveland Clinic — Health Essentials: sperm count and male fertility

Heat

Sperm production is sensitive to heat. In a small study of ten men with normal semen, two 15-minute Finnish sauna sessions a week for three months caused a strong fall in sperm count and sperm motility; the changes had reversed six months after the sauna sessions stopped. Hot tubs and a laptop resting on the lap are other common sources of heat.

Source: Human Reproduction (PubMed) — Garolla et al. 2013, Seminal and molecular evidence that sauna exposure affects human spermatogenesis; Cleveland Clinic — Health Essentials: sperm count and male fertility

Infection and inflammation

The EAU guideline notes that Mycoplasma can decrease sperm motility and trigger antisperm antibodies, and that Chlamydia and Ureaplasma can also reduce sperm density and motility. Infection of the male urogenital tract is a potentially curable cause of male infertility.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)

Antisperm antibodies

Sometimes the immune system makes antibodies against a man’s own sperm, and Mycoplasma infection is one known trigger. In the EAU’s data, sperm autoantibodies were found in 3.9% of unselected men evaluated for infertility. The tests used (MAR and immunobead tests) have no evidence-based reference values, so results need expert interpretation.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)

Varicocele

A varicocele is a group of enlarged veins in the scrotum that can warm the testicle and affect sperm quality. Evidence on sperm motility is mixed: one meta-analysis in the EAU guideline found improved progressive motility after treatment, while another comparison found no clear benefit for progressive motility over observation.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)

Inherited sperm tail defects

Some men have genetic changes that build a faulty sperm tail. The best-known example is primary ciliary dyskinesia (PCD), which affects up to 1 in 7,500 people and also causes chronic chest and sinus infections; about 40% of people with PCD have mirror-image internal organs (Kartagener syndrome). Because their sperm do not move properly, men with PCD often have reduced fertility. When count is normal but almost no sperm move, the EAU notes that genetic testing panels for sperm flagellum defects can help find the cause.

Source: MedlinePlus Genetics — Primary ciliary dyskinesia; EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)

Lifestyle and general health

Obesity, low physical activity, smoking and heavy drinking are linked to poorer sperm quality, including sperm motility, and oxidative stress from smoking and environmental exposures can damage sperm. In many men with asthenozoospermia, no single cause is found even after a full work-up.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter); NHS — Low sperm count

How sperm motility is tested, and why results vary

Sperm motility fades quickly once semen leaves the body, so prompt, careful handling of the sample matters. Laboratories examine the sample within 30 to 60 minutes of collection, keep it between about 20°C and 27°C on the way, and assess it on microscope slides pre-warmed to 37°C.

Source: Arab Journal of Urology (PMC) — Chung et al. 2023, Sixth edition of the WHO laboratory manual: updates for busy clinicians; Life (PMC) — Boitrelle et al. 2021, The sixth edition of the WHO manual for human semen analysis: a critical review

To get a reliable result, you will usually be asked to:

• Avoid ejaculation for 2 to 7 days before the test.
• Not use lubricants or saliva, which can harm sperm.
• Keep a home-collected sample at room temperature and bring it to the lab within one hour.
• Repeat the test if the first result is abnormal, because sperm quality changes from day to day; two or more samples a week or two apart are common.

Source: MedlinePlus — Semen Analysis

A single low result therefore says little on its own. If the first sample shows poor movement, ask whether it was examined promptly and kept at the right temperature, and repeat the test before any treatment decision. One abnormal measurement does not mean you are permanently infertile.

Source: MedlinePlus — Semen Analysis

How to improve sperm motility: what the evidence shows

Sperm take about three months to develop, so any sperm motility gain from a change you make today will only show in a semen sample roughly three months later. The most reliable steps target the causes above.

• Stop smoking. Tobacco chemicals lower sperm’s ability to move actively.
• Keep the testicles cool. Avoid saunas and hot tubs while trying to conceive, and do not rest a laptop on your lap.
• Drink within limits. The NHS advises no more than 14 units a week spread over three or more days.
• Aim for a healthy weight and stay physically active.
• Avoid anabolic steroids and recreational drugs, and limit workplace exposure to pesticides and solvents.

Source: Cleveland Clinic — Health Essentials: sperm count and male fertility; NHS — Low sperm count

Do supplements improve sperm motility?

Antioxidant supplements are widely marketed for better sperm movement, but the evidence is weak. A 2022 Cochrane review found that antioxidants might increase live birth rates, but the evidence was of low to very low certainty, and the benefit disappeared when studies at high risk of bias were removed.

Source: Cochrane Database of Systematic Reviews (PubMed) — de Ligny et al. 2022, Antioxidants for male subfertility

The MOXI trial, a well-designed randomized study of 171 men, tested a combination of vitamins C, E and D, selenium, L-carnitine, zinc, folic acid and lycopene against placebo. After three months, change in total motility was almost identical (−1.6 versus −1.1 percentage points), and live birth rates at six months did not differ significantly. Based on such data, the EAU advises against routinely using antioxidants to treat unexplained male infertility.

Source: Fertility and Sterility (PMC) — Steiner et al. 2020, The MOXI randomized clinical trial; EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)

For a wider look at diet, exercise and sleep, see our guide on how to increase sperm count.

Medical treatment and fertility options for low sperm motility

Treatment depends on what the work-up finds and on the female partner’s age and fertility, since a couple is always assessed together.

Treating a specific cause

A proven genital tract infection is treated with antibiotics, which may improve sperm quality, although they have not clearly been shown to raise natural pregnancy rates. Treating white cells in semen when there is no sign of infection has not been shown to help. A clinically significant varicocele may be repaired; our article on varicocele surgery explains who benefits.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)

Assisted reproduction

When sperm motility stays low despite treatment, assisted reproduction can bypass the need for sperm to swim. IVF with intracytoplasmic sperm injection (ICSI) may be recommended when sperm do not move normally or are abnormally shaped: an embryologist injects a single sperm directly into each egg.

Intrauterine insemination (IUI) separates the stronger sperm from slow or non-moving ones in the lab and places them in the uterus. It is cheaper and less invasive than IVF but less successful per cycle, and the UK fertility regulator states it will not be appropriate for male factor infertility, so it is not a reliable fix for poor motility.

Source: HFEA — Intracytoplasmic sperm injection (ICSI); HFEA — Intrauterine insemination (IUI)

ICSI carries some extra risks, including possible damage to eggs during injection, and a son conceived this way may inherit his father’s infertility, particularly when there is a genetic cause on the Y chromosome. Discuss these points with your fertility team before treatment.

Source: HFEA — Intracytoplasmic sperm injection (ICSI)

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter); HFEA — Intracytoplasmic sperm injection (ICSI); HFEA — Intrauterine insemination (IUI)

When to see a doctor

See a doctor if you and your partner have had regular unprotected sex for more than one year without a pregnancy, or after six months if your partner is 36 or older. Go sooner if you already know of a risk factor, such as undescended testicles, previous testicular surgery or injury, cancer treatment or a known varicocele. A urologist-andrologist will take a history, examine you and usually repeat the semen analysis.

Source: NHS — Low sperm count; EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)

Seek prompt medical review if you notice:

• A lump, swelling or heaviness in a testicle or the scrotum.
• Pain in the testicles, or pain with ejaculation.
• Fever with pelvic, testicular or urinary symptoms, which may suggest infection.
• A discharge from the penis, or blood in your semen.
• Recurrent chest and sinus infections since childhood together with infertility, which can point to a ciliary disorder.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter); MedlinePlus Genetics — Primary ciliary dyskinesia

For the bigger picture of fertility testing and treatment, read our overview of male infertility. If your report shows poor sperm movement, you can have it reviewed confidentially by our urologist-andrologist, Assoc. Prof. Dr. Zülfü Sertkaya, whose practice includes male infertility; send it on WhatsApp for a free initial consultation.

FAQs about sperm motility

What is a good sperm motility percentage?

Under the WHO 2021 reference values for sperm motility, total motility of 42% or more and progressive motility of 30% or more are typical of fertile men. Many labs and Cleveland Clinic describe 40% or more as normal. Higher is generally better, but the total number of moving sperm and your partner’s fertility matter as much as the percentage itself.

Source: Arab Journal of Urology (PMC) — Chung et al. 2023, Sixth edition of the WHO laboratory manual: updates for busy clinicians; Cleveland Clinic — Semen Analysis

Can you get pregnant with low sperm motility?

Yes, often. The WHO limits are reference values, not fertility cut-offs, and many men below them still father children naturally. The chance falls as the total motile sperm count drops, especially below 5 million. When natural conception does not happen, insemination or IVF with ICSI can help, because ICSI does not require the sperm to swim.

Source: Human Reproduction (PubMed) — Hamilton et al. 2015, Total motile sperm count: a better indicator of male factor severity than the WHO classification; HFEA — Intracytoplasmic sperm injection (ICSI)

How long does it take to improve sperm motility?

About three months. That is roughly how long it takes new sperm to develop and mature, so changes such as stopping smoking or avoiding saunas show in a semen sample taken around three months later. In the sauna study, the heat-related changes had reversed six months after the sessions stopped. Repeat the test after this interval rather than sooner.

Source: Cleveland Clinic — Health Essentials: sperm count and male fertility; Human Reproduction (PubMed) — Garolla et al. 2013, Seminal and molecular evidence that sauna exposure affects human spermatogenesis

What is the difference between progressive and total motility?

Progressive motility is the share of sperm swimming forward, in a straight line or large circle. Total motility adds the non-progressive sperm, whose tails move but which do not get anywhere. Progressive motility is the more useful figure for fertility, because only forward-swimming sperm can travel through the female reproductive tract to reach the egg.

Source: MedlinePlus — Semen Analysis; Life (PMC) — Boitrelle et al. 2021, The sixth edition of the WHO manual for human semen analysis: a critical review

Does abstinence improve sperm motility?

Not beyond the recommended window. Labs ask for 2 to 7 days without ejaculation before a semen analysis so the sample is representative. Staying within this window helps maximize the sample and makes repeat results easier to compare. If you were outside the window, tell the lab when you hand in your sample so the result can be interpreted correctly.

Source: MedlinePlus — Semen Analysis; Arab Journal of Urology (PMC) — Chung et al. 2023, Sixth edition of the WHO laboratory manual: updates for busy clinicians

Do vitamins or supplements increase sperm motility?

Good-quality evidence does not show a clear benefit. In the randomized MOXI trial, a multi-antioxidant supplement did not change motility compared with placebo after three months, and a 2022 Cochrane review rated the evidence for antioxidants as low to very low certainty. The EAU advises against routine antioxidant use for unexplained male infertility.

Source: Fertility and Sterility (PMC) — Steiner et al. 2020, The MOXI randomized clinical trial; Cochrane Database of Systematic Reviews (PubMed) — de Ligny et al. 2022, Antioxidants for male subfertility

Is asthenozoospermia permanent?

Usually not. Sperm motility lowered by heat, smoking, illness or infection often improves once the cause is removed or treated. Inherited tail defects such as primary ciliary dyskinesia are permanent, but these men can still father children with IVF and ICSI. A repeat test after three months shows whether the problem is temporary or persistent.

Source: MedlinePlus Genetics — Primary ciliary dyskinesia; HFEA — Intracytoplasmic sperm injection (ICSI)

Can a urologist tell why my sperm do not move?

Often, yes. When sperm motility is low, a urologist-andrologist checks for varicocele, infection, antisperm antibodies, hormone problems and lifestyle factors, and may order a vitality test or genetic testing if almost no sperm move. Even so, in a proportion of men no single cause is found, and treatment then focuses on the most effective fertility option.

Source: EAU — Sexual and Reproductive Health Guidelines (male infertility chapter)