What Is Total Motility?

Total motility is the measure of percentage of sperms that are actively swimming or moving in the given semen. This parameter gives us the probability of the sperm that move efficiently. As per WHO, total motility should range between 42% to 90% 1. Total motility is a sum of 2 parameters namely: 

  • Progressive motility  
  • Non-Progressive motility

Sperms And Total Motility 

Sperm are highly motile and streamlined for speed and efficiency. They consist of two separate regions:

1. Tail

This drives the sperm to the egg and assists them in burrowing through the egg coat

2. Head 

Sperm head contains a condensed nucleus with tightly packed DNA 2

 The tail, sometimes also called the “flagellum” allows the sperms to swim through an aqueous medium. It is a 50-micrometer long structure that looks like a thin bundle of filaments. It connects sperm’s head and middle region. The sperm motility is controlled by the tail. It whips and jingles in order to make the sperm reach the egg. Activation of tail movement is repressed after sperm deposit in the female reproductive tract until the sperm is transported within a small distance of the egg. This increases the sperm's chances of reaching the egg before its energy reserves run out.3

Only a fraction of the millions of sperm generated during a human male's reproductive life manage to fertilize an egg. Thus, competition between the produced sperms is quite strong.2

Why Do Sperms Move? 

Sperm motility is vital for the fertilization process. Thus it goes without saying that there is a definite link between sperm motility and the likelihood of successful conception. 

Men's ejaculate comprises tiny sperms that make their way to their final destination: the ovulated egg, resulting in fertilization. For the fertilization to occur, sperm must travel first from seminiferous tubules through the epididymis, along the length of the penis and finally to the female reproductive tract. This process is made feasible by the sperm's capacity to move. 

In short, sperms' ultimate objective is to fertilize the egg and create a new being. Clearly, this process gets hindered and becomes difficult to achieve when the sperm motility is low. 

Progressive And Non Progressive Motility

As per the recommendation of WHO, Total motility can be graded as progressive or non-progressive motility. 

Sperms with Progressive Motility (PR%) move actively, either linearly or in a large circle, regardless of speed. 

Alternatively, sperms with Non Progressive Motility (NP%) move with all other motility patterns with no progression, such as swimming in small circles, flagellar force barely moving the head, or when only a flagellar beat can be seen.4 

The WHO reference range for Progressive and Non Progressive Motility can range between 1

  • Progressive Motility - 30-77%
  • Non Progressive Motility - 1-32%

Factors Affecting Sperm Motility  

  • Age 
  • Sitting for long hours 
  • Smoking
  • Work and life stress factors 
  • Alcohol consumption 
  • Recreational drugs 
  • Stress 
  • Diet 
  • Radiation exposure 
  • Increased Body Mass Index 
  • Diabetes mellitus 
  • Medical conditions (Metabolic syndrome, Seminal Infections) 
  • Hypertension 
  • Adverse lifestyle factors 

Total Motility And Fertility

Asthenozoospermia

Fact:

Asthenozoospermia is a condition in which sperm motility in the ejaculate is decreased or absent. Based on the percentage of immotile sperms, asthenozoospermia can be classified as: 

  • Mild-to-Moderate (<40% sperm motility or less than 32% with progressive motility)
  • Severe or Complete (100% immotile sperms) 5, 6                                                     

Implication:

In terms of various treatment options, it is critical to live a healthy lifestyle, avoiding habits that can harm the general quality of sperm. This can help in certain mild or moderate cases of the condition. There are a few drugs that could be helpful which nonetheless work for moderate/mild grades of asthenozoospermia. Restoring fertility with any of these approaches is difficult in situations with severe asthenozoospermia. In that case, Assisted Reproductive Technology (ART) would be the sole remaining choice which requires proper medical guidance. With regard to the Total Motile Count (TMC) IUI, IVF or ICSI can be considered. It is recommended to consult with their doctor and take suitable measures in case of severe asthenozoospermia.5, 6 

Ways To Improve Your Sperm Health 

1. Avoid Smoking: 

Semen parameters and sperm function test results are lower in smokers than in nonsmokers. Most of these effects are usually dose-dependent.7

2. Reduce Alcohol Consumption And Drug Use:

Drugs (steroids, marijuana) and alcohol can negatively impact sperm health leading to abnormally shaped sperm, decreased sperm motility and/or decreased sperm production.8  

3. Maintain Healthy Weight:

There exists a clear link between obesity and reduced sperm production. Overweight men who want to improve their fertility should maintain a healthy weight.9 

4. Practice Safe Sex:

Sexually transmitted infections (STIs) are a leading cause of infertility. Having safe sex today may increase your chances of conception in the future.8

5. Reduce Heat Exposure: 

Men who are exposed to prolonged high heat (like hot tubs or using laptops on your lap)  can affect your fertility by lowering sperm production. 8, 9

6. Avoid Commercial Lubricants: 

Some commercial lubricants/substances used for lubrication should be avoided during the fertile period. This may reduce sperm movement and their ability to survive.9

7. Choose The Right Clothing:

Men who wear heat retaining clothes experience decreased sperm production 8. As per studies wearing brief underwear may decrease sperm quality.9

8. Manage Your Stress: 

Many stress-reducing techniques like Meditation, Yoga, Music, Therapies etc., can effectively keep stress at bay.10

How Can You Check Total Motility? 

You can get a semen analysis done. Semen analysis evaluates the characteristics of a male's semen and the sperm contained therein. 

As a result of social stigma in some parts of the world, many men refrain from getting their semen tested. While in-clinic semen analysis was the only choice previously, there is now an at-home option that delivers concrete data. With LifeCell’s SpermScore, get clarity on your fertility by testing 11 sperm health parameters and 14 sperm health conditions from the comfort of your home!

References:

  1. https://www.who.int/publications/i/item/9789240030787  
  2. https://www.ncbi.nlm.nih.gov/books/NBK26914/  
  3. https://www.britannica.com/science/sperm  
  4. https://www.who.int/docs/default-source/reproductive-health/srhr-documents/infertility/examination-and-processing-of-human-semen-5ed-eng.pdf  
  5. https://mefj.springeropen.com/articles/10.1186/s43043-022-00094-7  
  6. www.invitra.com/en/asthenozoospermia/  
  7. https://www.reproductivefacts.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/smoking_and_infertility.pdf  
  8. https://www.reproductivefacts.org/globalassets/asrm/asrm-content/learning--resources/patient-resources/protect-your-fertility3/asrm_brochure.pdf  
  9. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/optimizing-male-fertility/  
  10. https://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheets-and-info-booklets/stress_and_infertility_factsheet.pdf 

References