Understanding Infertility in men
Sperm motility refers to the movement of spermatozoa, or sperm, and is medically known as ‘asthenozoospermia’. Sperm motility can seriously affect infertility in men. This article will cover the causes of a low sperm count and also how to treat low sperm motility.
Why is sperm motile?
During orgasm, millions and millions of sperm are ejaculated. Some sperm is motile, some immotile, some weak, some exhausted and only twitching and some dead. Initially, when ejaculated, the semen looks like a coagulum, a slimy clotted fluid, and then becomes liquefied into a watery fluid to facilitate the movement of sperm in the female genital tract. Much motile sperm keeps going in spite all these obstacles to reach the egg. Nature is clever and here again, uses ‘survival of the fittest’ principle.
So ultimately a single sperm is able to penetrate the egg. Sperm motility, in particular, progressive motility, is therefore related to pregnancy rates. Understandably it is one of the important biological parameters in semen analysis.
The sperm motility test
There is a simple system of grading sperm motility (WHO, 2010):
- Progressive motility (PM) – sperm can move in all directions.
- Non-progressive motility (NP) only twitching but no progression.
- No motility at all
The sperm motility is expressed in percentage units. For example, a report may show progressive 20-30%; non-progressive 50-60% and immotile 10-30%.Some laboratories give total motility (TM) = PM + NM.
Why does Sperm become non-motile?
To understand the sperm motility rate, it is important to know what factors make the sperm motile. A normal sperm has a head, midpiece, and tail, so it basically looks like a tadpole. The tail propels the head and gives the head, the cell, a vigorous lashing movement. The head contains the nucleus, which has chromosomes (DNA) and a cap-like structure cell acrosome which contains an enzyme (sperm lysin), which helps in the entry of sperm into the egg. The middle piece is essentially a ‘powerhouse’ where the mitochondria are situated. The tail is merely an extension of cytoplasm and helps in propulsion.
What are the factors that affect sperm motility?
Any factor which affects sperm integrity- structural or functionality could affect its motility.
The possible causes of a low sperm count include:
Genetic causes
Genetics can be a factor in a low sperm motility count. It has been discovered that a defect in the male sex (Y) chromosome can result in the inability to produce sperm, otherwise known as azoospermia. Azoospermia is the most common cause of infertility in men, as the condition causes a low sperm production.
Dietary
A poor dietary practice has been proven to affect male infertility. Diets which contain an especially high level of red meat have been proven to affect both sperm quantity and quality. To improve a low sperm count, it is recommended that you increase your intake of fruit and veg, whilst reducing your saturated fat and cholesterol levels.
Environmental:
Studies have shown that men who are more exposed to pesticides, lead, toxic gases, and chemicals are much more likely to have a low sperm count, compared to the men who have not been exposed. Men trying for a baby should try to avoid toxic environmental factors.
Lifestyle
There are several lifestyle factors that can cause a low sperm count. These factors include a sedentary lifestyle, obesity, psychological stress, a lack of physical activity and a lack of sleep. Infertility in men can be reduced through reducing stress levels. And living a healthy lifestyle through a balanced diet and regular exercise.
Habits
Studies have shown that habits like alcohol and smoking can be a factor of infertility in men.
Drinking alcohol and smoking can reduce the number of sperm in semen, making it harder to conceive. Alcohol, smoking, and drugs can also alter the normal shape and affect the movement of sperm. Therefore, men who wish to protect the health of their sperm should avoid or limit their intake of alcohol, smoking, and drugs.
High temperature
Exposure to high temperatures can result in a low sperm count. Varicocele, synthetic underclothing, hot water baths, and exposure to laptops and mobile phone can also cause infertility in men. Although it is impossible to avoid using laptops and mobile phones altogether. It is recommended you avoid placing your mobile phone in your front pocket or sitting with your laptop on your lap. This will reduce any exposure and effect on sperm motility.
Infections particularly in the prostate
Sexually transmitted infections can reduce the level of infertility in men. Although sexually transmitted infections do not cause a low sperm count, they instead affect the transportation of the sperm. STIs can create infections in the testicular tubes, making it difficult for sperm to travel. Often STIs can be difficult to diagnose as most carry no symptoms. Therefore it is important to have a sexual health screening each time you have a new sexual partner.
Body stress
Stress in the body itself can affect sperm motility. For example, a recent bout of flu could temporarily cause a low sperm count in men. Illnesses like the flu affect infertility in men, as they slow down the production of sperm. However, as it takes sperm 75 days to fully mature, this drop in fertility will only be temporary.
Medications
Men who are on medication for other health reasons should make their doctor aware that they are trying to children. The doctor will then be able to change any medications that affect testicular function.
Sperm motility test
The easiest and most reliable way to conduct a sperm motility test is by visiting your GP. It is recommended you visit your GP if, after a year of trying to conceive a baby, you have so far been unsuccessful. Your GP will then be able to carry out a semen analysis to discover if your sperm has any abnormalities.
It is recommended that both you and your partner are tested for infertility problems. As often infertility problems are a combination of both partners or remain undiagnosed.
How to treat low sperm motility
If you’re only just encountering fertility problems and wondering how to treat low sperm motility, it is usually recommended you keep trying to conceive naturally for a little bit longer.
If this fails, you will typically be recommended to try IVF. IVF, or In vitro fertilization, is recommended as a course of treatment when the sperm count is only slightly lower than average, and the couple has been trying to conceive naturally for at least two years.
Hormone treatment is also recommended in some cases if the patient has a low level of gonadotropin hormones. Gonadotropic hormones stimulate the production of sperm, so the patient may be offered a course of treatment with gonadotropin medication to improve fertility.
We hope you found this article useful in understanding infertility in men and how to treat low sperm motility. Click through for more information on infertility in men and treatments available at London Urologist.
Mr Vinod Nargund is a Consultant Urological Surgeon specialising in Urological cancer, male sexual and fertility problems. He was trained in Urology at the City Hospital Belfast, the Royal Infirmary Bradford and the Churchill and John Radcliffe Hospitals in Oxford. You can view all of his qualifications on his biography page.