Sperm Motility Test

If you are trying to conceive, or wondering whether you could, sperm motility is one of the first numbers worth knowing. It tells you how many of your sperm are actually swimming forward in a purposeful way, which is the movement pattern required to reach and fertilize an egg. A sperm sample can have a normal count, but if too few of those sperm are moving well, fertility is significantly reduced.

Sperm motility, sometimes reported as progressive motility on a semen analysis, refers specifically to the percentage of sperm that swim in a forward direction. This is distinct from sperm that vibrate in place or drift aimlessly. Progressive motility is what allows sperm to travel through cervical mucus and through the layers surrounding the egg. It is one of the most widely used indicators of sperm quality and a major determinant of male fertility.

When the result comes back low, the clinical term is asthenozoospermia (reduced sperm motility). This is one of the leading causes of male infertility and can stem from genetic factors, environmental exposures, or underlying health conditions. The good news is that motility responds to lifestyle changes more readily than some other semen parameters.

How Motility Is Measured

Most modern labs assess motility using computer-aided sperm analysis, or CASA. Rather than relying on a technician's visual estimate under a microscope, CASA systems track individual sperm and measure their swimming patterns objectively. This reduces the subjectivity that can vary between labs or technicians.

CASA can also identify clinically meaningful subgroups within a single sample, such as sperm with movement patterns that are especially good at penetrating cervical mucus, or sperm showing a vigorous swimming pattern called hyperactivation that is associated with fertilization capacity. If you are pursuing assisted reproduction, these detailed movement profiles can help guide decisions about which techniques to use.

Beyond basic motility, labs can run additional functional tests including sperm DNA fragmentation analysis, tests for antibodies that may impair sperm, and measurements of oxidative stress. These are not routine but can be valuable when motility is unexpectedly low and the cause is unclear.

What Drives Your Motility Result

Sperm do not actually begin swimming in the testes where they are produced. They acquire the ability to move during a maturation journey through a coiled tube called the epididymis. The health of this transit system, along with secretions from the prostate and other accessory glands, directly influences how well sperm swim in the final ejaculate. Studies in population-level samples have found that levels of prostate-specific antigen (PSA) in semen correlate directly with the percentage of motile sperm.

At the cellular level, motility depends heavily on the energy output of mitochondria, the small power generators inside each sperm cell. Sperm selected for the highest motility show significantly higher mitochondrial membrane potential compared to less motile fractions from the same sample. In men with fertility problems and compromised motility, mitochondrial energy output tends to be low. This is one reason that nutrients supporting mitochondrial function, like CoQ10 and L-carnitine, appear in the intervention research.

What Moves This Biomarker

Sperm motility is one of the more modifiable aspects of male fertility. Dietary patterns, targeted supplements, exercise habits, and avoidance of specific exposures all have documented effects.

Diet. The pattern that stands out most consistently is a Mediterranean-style diet rich in fish, vegetables, fruits, whole grains, nuts, and poultry. Men with the highest adherence to a Mediterranean diet were roughly 2.6 times less likely to have abnormal sperm motility compared to those with the lowest adherence. A study of young Danish men found that a prudent dietary pattern (fish, chicken, vegetables, fruits, water) was associated with markedly higher motile sperm counts, while a Western pattern (processed meats, refined grains, high-fat dairy, sweets) was associated with worse results across nearly all semen parameters.

Foods to favor include fish, shellfish, poultry, vegetables, fruits, low-fat dairy, nuts, and whole grains. Foods to minimize include processed meats, full-fat dairy, and sugar-sweetened beverages. Adequate sleep also matters: sufficient sleep duration has been associated with roughly a 5% improvement in progressive motility compared to inadequate sleep.

Supplements. Network meta-analyses of randomized trials have identified several supplements with meaningful effects on motility:

Sources: Chen et al., 2023 (lycopene, omega-3, CoQ10); Zafar et al., 2023 (L-carnitine). All findings from systematic reviews and network meta-analyses of randomized controlled trials.

What this means for you: if your motility is low, a combination approach starting with L-carnitine, CoQ10, or omega-3s is reasonable to discuss with your clinician. Meta-regression analysis has confirmed that improvements in sperm motility from supplementation translate into increased pregnancy rates, so these are not just numbers on a lab report.

Exercise. Moderate-intensity exercise performed 3 to 4 times per week for 30 to 60 minutes per session is the sweet spot. Men with the highest levels of moderate-to-vigorous physical activity showed 17.3% higher progressive motility and 16.4% higher total motility compared to the least active men. A meta-analysis of exercise interventions found that structured exercise programs improved motility and were associated with substantially higher pregnancy rates (roughly 12.6 times higher). However, very high-intensity training can have the opposite effect by disrupting reproductive hormone signaling and increasing oxidative stress.

Weight and smoking. Obesity, particularly at a BMI above 30, negatively affects motility. Weight loss through lifestyle changes is recommended as a non-invasive strategy. Smoking shows a dose-dependent effect: moderate and heavy smokers have significantly worse motility parameters than nonsmokers. Quitting is advised, though the studies supporting this recommendation have notable limitations in design quality.

What to avoid. Heavy alcohol use, recreational drugs (especially cannabis and anabolic steroids), and environmental toxin exposure are all associated with reduced motility. Excessive caffeine should be limited, though low-to-moderate intake does not appear harmful.

Questions This Biomarker Can Answer

• Is the quality of my sperm movement a factor in why we have not conceived?
• Are my diet and exercise habits supporting or undermining my sperm function?
• Has quitting smoking or losing weight actually improved my fertility potential?
• Do I have enough progressively motile sperm to attempt natural conception, or should I consider assisted reproduction?
• Is a targeted supplement regimen making a measurable difference in my sperm quality?