Asthenozoospermia, also known as asthenospermia, is an alteration that affects sperm motility. It is commonly known as slow moving sperm or lazy sperm.
Throughout this article, we will explain the causes of poor sperm motility, as well as the methods used to detect it, and the best treatment options.
Below you have an index with the 9 points we are going to deal with in this article.
- 1.
- 2.
- 3.
- 3.1.
- 3.2.
- 4.
- 5.
- 6.
- 6.1.
- 7.
- 7.1.
- 7.2.
- 7.3.
- 7.4.
- 7.5.
- 8.
- 9.
- 10.
Diagnosis
A seminogram is the diagnostic test used for its detection. During sperm analysis, a drop of semen is introduced into the sperm-counting chamber (Makler or Neubauer chamber) under the microscope, and 100 spermatozoids are counted.
The percentage of these that exhibit progressive motility, the percentage of non-progressive motile sperm (those who have movement but do not move) and finally the percentage of immotile sperm are determined.
According to criteria established by the WHO, a man does not suffer from asthenozoospermia, that is to say, their sperm has normal motility when it presents:
- Values equal to or above 40% of motile sperm (progressive and non-progressive).
- Values above 32% of sperm with progressive motility, that is to say, capable of moving forward.
Lower levels are considered abnormal or precursors of asthenozoospermia.
Repeated semen analyses
According to embryologist Laura Mifsud, it is crucial to repeat the semen analysis before rendering a definitive diagnosis of asthenozoospermia to a patient. Diagnosing asthenozoospermia or any other sperm diagnosis with a single sperm analysis is a mistake, since it might be due to a external or environmental factor, or a temporary circumstance of the patient.
For this reason, repeating the sperm test is essential to confirm the diagnosis. Moreover, the time period between semen analyses should be a reasonable one in order to make sure the external factor influencing it has disappeared.
Types or grades of asthenozoospermia
Depending on the specific percent of immotile sperm that are present on the sample examined, we can distinguish several types of asthenozoospermia.
As one shall see below, the different grades of asthenozoospermia are not clearly defined. The final diagnosis can be more or less severe based on the type and speed of motion, as well as on the number of immotile sperm.
Broadly speaking, there exist two grades of severity:
Mild-to-moderate
This level is diagnosed when the percent of immotile sperm, or sperm with poor motility, ranges between 60 to 75%.
As in the previous case, the type of motion should be classified. The rationale for this is as follows: if only a few are able to swim but they more progressively and forward, it can be qualified as mild asthenozoospermia.
Severe
Severe oligospermia is diagnosed when the percent of sperm with poor or absent motility is very high.
Although there exists no specific value, we could determine that it is a severe case of asthenozoospermia if the percent of immotile sperm is close to 75-80% or even higher.
One should pay special attention not only to total motility, but also the type of motion. If the number of sperm with progressive, fast motility is too low, it would be qualified as severe asthenozoospermia as well.
Causes
The causes of asthenozoospermia are not precisely defined. However, it is known that sperm motility may be influenced by the following factors:
- Presence of antisperm antibodies
- Excessive consumption of alcohol or other drugs (snuff, marijuana, etc)
- Advanced age: there's a significant decrease in mobility after 45 years
- Fever
- Exposure to toxic agents (fertilizers, chemical solvents)
- Infections that affect the sperm
- Poor nutrition
- Prolonged exposure to heat
- Testicular problems.
- Teratozoospermia, which refers to alterations in the form of the sperm
- Cancer treatments such as chemotherapy and radiotherapy
- Varicocele
The presence of other sperm disorders such as teratozoospermia or oligospermia can cause asthenozoospermia. All in all, they all refer to poor sperm quality.
The term teratozoospermia refers to abnormalities that affect sperm morphology. On the other hand, oligospermia is used to refer to the presence of a low sperm count in the semen.
Treatment for "lazy sperm"
As for possible treatment options, there exist two possible ways one can improve sperm morphology or even restore normal morphology:
- Natural treatment
- It is important to lead a healthy lifestyle, quitting toxic habits that may damage the overall quality of sperm, including sperm quality. This can help restore fertility in some cases of mild or moderate asthenozoospermia.
- Pharmacological treatment
- There exist some medications that could be used to boost sperm quality and reduce sperm morphology issues. Nonetheless, this only works in mild cases of male infertility due to a sperm disorder.
In cases of severe asthenozoospermia, restoring fertility with any of these treatment options is complicated. The only option left to become a father would be Assisted Reproductive Technology (ART).
Asthenozoospermia & infertility
Asthenozoospermia is a cause of male infertility. The ultimate goal of sperm cells is to fertilize the egg and create a new being. In order to do this, they have to overcome several obstacles until they can reach the Fallopian tubes, where the oocyte is waiting. Since sperm motility is affected with asthenozoospermia, achieving this goal is complicated. For this reason, Intrauterine Insemination (IUI) is not recommended in these cases.
Throughout the female reproductive tract, sperm encounter multiple barriers: only the most agile and quickest will overcome all of them, reaching the final goal, that is to say, meeting the egg cell. For this reason, progressive movement and speed motion are key aspects to keep in mind when it comes to achieving a natural pregnancy.
When sperm are unable to move forward, or they do so but inadequately, getting pregnant naturally becomes very hard. In these cases, ART is the only option left to become parents.
Options to achieve pregnancy
When a man is asthenozoospermic and therefore is unable to get his wife or partner pregnant, the most recommendable treatment option is In Vitro Fertilization (IVF), either conventional or using ICSI (Intracytoplasmic Sperm Injection). Artificial insemination is contraindicated in cases of poor sperm motility. In short, these are the potential assisted reproduction treatment options available:
- Conventional IVF
- In cases of mild asthenozoospermia, this technique is possible, which is the simplest, most physiological version of IVF. With this technique, the sperm meets the egg by itself.
- ICSI
- In the most severe cases of asthenozoospermia, this is the first option. Contrary to the conventional version, in this case it is the embryologist who injects the sperm into the egg, so motility is not required.
- Sperm donation
- If pregnancy is not achieved with any of the two techniques already mentioned, using donor sperm would be the only option to father a child.
If you need to undergo IVF to become a mother, we recommend that you generate your Fertility Report now. In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.
FAQs from users
What are the possible treatments for asthenozoospermia?
Asthenozoospermia is a decrease in sperm motility. According to the World Health Organization (WHO), a progressive motility of more than 32% (31-34%) is considered normal, while total motility (progressive + non-progressive) is 40% (38-42%).
When in two seminograms performed on a patient with a period of 2-3 months between one and the other a lower motility is found, it is considered asthenozoospermia.
The first line of treatment should be aimed at improving habits and quality of life: not smoking, not drinking alcohol, not taking drugs, exercising, not being overweight, eating a balanced diet, etc.
As for the possible pharmacological treatment, it should always be indicated by a urologist. Androgens, human menopausal hCG/gonadotropin, bromocriptine, alpha-blockers, systemic corticosteroids and magnesium supplements have been shown not to be effective in the treatment of asthenozoospermia. In addition, follicle-stimulating hormone and anti-estrogens in combination with testosterone may be beneficial treatments in selected patients (always under strict medical supervision by a specialist).
The treatment of infertility caused by such asthenozoospermia is the use of assisted reproduction techniques that facilitate the arrival or entry of sperm into the oocyte (egg), such as artificial insemination or in vitro fertilization with or without ICSI.
Can a period of abstinence influence sperm motility?
The male factor has become one of the most relevant aspects of assisted reproduction recently. Different genetic diagnostic techniques have been used to analyze the role that the male is playing in achieving a pregnancy.
The period of abstinence is an aspect that has varied over the years, thinking at first that the greater the abstinence, the better the result of both the seminal diagnosis and the embryonic evolution and term pregnancy. Some studies show that a period of frequent ejaculations after a period of abstinence can improve sperm quality.
The period of abstinence differs according to the assisted reproduction unit attended and the standardization of the processes. The recommendations of the World Health Organization is to have sexual abstinence of between 2-7 days. If the abstinence is less than two days, we will find spermatozoa that possibly have less DNA fragmentation, but the count of the number of spermatozoa is lower than in normal conditions. If we have a high abstinence period, it is likely that we will find reduced sperm motility.
In conclusion, it is important to have an optimal period of abstinence according to the recommendations of the assisted reproduction center in order to maximize the chances of success in each case.
Can I conceive naturally with asthenozoospermia?
There are still chances of achieving a natural pregnancy with asthenozoospermia if it is a mild-to-moderate case. However, if sperm motility is severely affected, the only option to become parents would be using a fertility treatment like IVF with ICSI.
What are the symptoms of asthenozoospermia?
Unfortunately, there are no symptoms associated with asthenozoospermia. The only possible way for a patient to suspect that he has this sperm disorder is by doing a semen analysis.
Are teratozoospermia and asthenozoospermia caused by the same factors?
In most of the cases, asthenozoospermia and teratozoospermia have the same causes. Both sperm parameters appear altered in the semen analysis, which is known as asthenoteratozoospermia. Nonetheless, they do not go hand in hand in all cases.
Suggested for you
Throughout this post, we have explained all about asthenozoospermia, which is a sperm disorder that affects sperm motility. But what do you know about this sperm parameter? Do you want to learn more about the way sperm swim? Find it out: How Is Sperm Motility Examined?
Also, several references to the semen analysis test have been made through this article, as it is the only test that allows us to diagnose not only asthenozoospermia, but also other sperm disorders. To learn more about this diagnostic test, read: What Is a Semen Analysis Report? – Purpose, Preparation & Cost.
Last but not least, if you are interested or need to undergo ICSI, the fertility treatment typically used to achieve pregnancy with asthenozoospermia, click here: What Is ICSI Technique? – Process, Success Rates & Cost.
Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.
References
Aitken RJ, Buckingham DW, Brindle, J, Gomez E, Baker HWG, Irvine DS (1995): Analysis of sperm movement in relation to the oxidative stress created by leukocytes in washed sperm preparations and seminal plasma. Hum Reprod 10:2061–2070.
Blanco AM (1992): El laboratorio en el estudio del factor masculino en infertilidad. In: Guitelman A, Aszpiz SM (Eds). Exploracion Funcional Endocrina. Buenos Aires: Ed. Akadia, 1992.
Bruno Dahlberg (1990) Asthenozoospermia/Teratozoospermia and Infertility, Archives of Andrology, 25:1, 85-87.
Dahlberg B (1988): Sperm motility in fertile men and males in infertile units: In vitro test. Arch Androl 20:31-34.
Reproducción Asistida ORG. Video: Astenozoospermia (Asthenozoospermia), by Laura Mifsud Elena, BSc, MSc, Jul 8, 2015. [See original video in Spanish].
S. M. Curi, J. I. Ariagno, P. H. Chenlo, G. R. Mendeluk, M. N. Pugliese, L. M. Sardi Segovia, H. E. H. Repetto & A. M. Blanco (2003) Asthenozoospermia: analysis of a large population, Archives Of Andrology, 49:5, 343-349.
World Health Organization (1992): WHO Laboratory Manual for the Examination of Human Semen and Sperm–Cervical Mucus Interaction, ed 3. Cambridge,UK: Cambridge University Press.
FAQs from users: 'What are the possible treatments for asthenozoospermia?', 'Can a period of abstinence influence sperm motility?', 'Can I conceive naturally with asthenozoospermia?', 'What are the symptoms of asthenozoospermia?' and 'Are teratozoospermia and asthenozoospermia caused by the same factors?'.
Hi,
We are Married and TTC for 3 Years. Semen Analysis Results are as Follows:
1. Sperm Count: 54Mil/ml
2. Sperm Motility: 42%
3. Sperm Morphology: 5%
Would like to understand the Chances of Natural Conception and should i need to take any suitable medication to improve the parameters?
Dear Senthil,
Usually it is needed a more extended semen analysis to evaluate it properly. There are several important parameters that would be helpful, like volume, vitality and an analysis of the motility that allows to differentiate between the different types (progressive, non-progressive…).
Even so, the sperm count and the motility are normal and would allow a natural conception. In the case of morphology, it can be analysed with different methodologies that have different reference values. For example, if the morphology has been assessed by the WHO method the cut point is 4% of normal forms or more. In this case, the morphology of your semen analysis would be normal. If it has been assessed by the Kruger method the cut point is at 14%, which would mean that, in your case, that parameter is altered. In order to solve this doubt, you should check the semen analysis report and look for the morphology reference values.
Since the rest of parameters are normal, the morphology is the one that will indicate in your case if natural conception is possible. Since you have been 3 years trying to conceive if morphology is normal you should run other tests in order to determine the infertility causes. If it is altered it might be the cause of the infertility and it is advisable to contact a fertility specialist to extend the fertility study and be assessed about which treatment is the most suitable in your case.
Best wishes.
Hi,
I am 31 years old married male and we are attempting for baby from past 3 years with no success. My problem is with Sperm quality which is as follows;
Sperm Count – 20million per cc
Morphology – Normal -90%
Forward Movement – 60%
Non Linear – 40%
No. of Motile Sperms – 3million per cc
Non Motile-85%
Motile – 15% (Active 10%, Weak-5%)
What I should do for above such condition.
Dear Herald,
Motility problems can have several causes. Your doctor will tell you if you can take some vitamins or complements in order to enhance the sperm quality. If he thinks that those kind of treatments cannot improve quality the only alternative is to go to a fertility specialist in order to undergo a fertility treatment such as artificial insemination or in vitro fertilisation. Depending on your partner’s fertility and age the specialist will recommend one treatment or the other.
I hope I have been able to help.
Hi Doctor,
I am 44 years old. Here is my semen analysis:
Appearance Grey
Liquefaction Time 30mins
Viscosity Viscous
Volume 0.5ml
Fructose Positive
Ph 8.0
Sperm Concentration 56
Total Motility(PR+NP) 35
Progressive Motility(PR) 25
Non Progressive Motility(NP) 10
Immotility(IM) 65
Strict Morphology(normal forms,%) 40
PUS Cells 2-3 /hpf
RBC Nil /hpf
Round Cells 3-4
What is the chance of having a baby naturally? Can ICSI / PGD help?
Thanks
Dear Sandeep,
Your semen analysis shows lower volume and motility than what is expected in a normal sample. This might lead into having some trouble to conceive naturally. Having a baby naturally is not impossible but, since it can be complicated to achieve, I recommend that you visit a fertility specialist.
With your analysis result it is possible to perform FIV or ICSI, and PGD might not be necessary. Therefore, a fertility specialist would recommend some more tests, specially to you your wife, and then decide with all the result which is the technique that suits your case the best.
I hope I have been able to help.
Best of lucks.