Asthenozoospermia is when male sperm motility decreases, making fertility difficult because sperm cannot reach and penetrate the egg.
The In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF+ICSI) is the option with the highest success rates for those with asthenozoospermia, as it prevents the sperm from having to swim to fertilize the egg.
What is asthenozoospermia and why does it matter?
Asthenozoospermia is the decrease in sperm motility, making it very difficult for them to swim to the egg and fertilize it. According to the World Health Organization (WHO), it is diagnosed when the percentage of progressively motile sperm is below 50% or when fewer than 25% move at ≥25 µm/sec.
It is the most common semen disorder and significantly reduces the chances of conceiving naturally. Timely detection allows for personalized treatments before reproductive time limits are exceeded.
Factors that can cause asthenozoospermia
Sperm motility can decline for various reasons:
- Teratozoospermia
- Varicocele
- Semen infections
- Testicular disorders
- Anti-sperm antibodies
- Poor nutrition or extreme BMI (e.g. ≥30 kg/m²)
- Smoking and excessive alcohol or caffeine consumption
- Exposure to toxins (solvents, insecticides)
- Aging (especially after age 45)
- Oncological therapies (chemotherapy, radiotherapy)
- Frequent fevers
- Prolonged heat exposure (saunas, hot tubs)
How is it diagnosed?
The first step is a semen analysis. Abstain from ejaculation for 3–5 days (no more than 7). Key parameters are total motility (>50%) and progressive motility (>25% at ≥25 µm/sec).
Additional tests like morphology assessment and DNA fragmentation provide more information to design the ideal treatment.
Assisted reproduction options
Depending on severity and partner factors (age, ovarian reserve), consider:
- Intrauterine insemination (IUI): capacitated sperm are placed in the uterus near ovulation. Ideal if the woman is under 35 and the case is mild to moderate.
- IVF and ICSI: classical in vitro fertilization to unite eggs and sperm in the lab.
- Intracytoplasmic Sperm Injection (ICSI): a single sperm is injected directly into the egg, ideal for very low motility cases.
Complement any protocol with healthy habits —balanced diet, moderate exercise, quitting smoking— to improve sperm parameters. Do not self-medicate: always under professional supervision.
Natural strategies to improve motility
- Foods rich in antioxidants (vitamins C and E, selenium, zinc).
- Avoid tight clothing, saunas, and prolonged heat exposure.
- Manage stress with mindfulness or therapy.
- Regular moderate physical exercise.
Frequently Asked Questions
1. Can lifestyle changes reverse asthenozoospermia?
Yes. Improving diet, reducing toxins, quitting smoking, and managing stress can increase motility in 3–6 months. Supplements like CoQ10, L-carnitine, zinc, and folic acid have shown benefits, but each case is different. Always consult a specialist before taking supplements.
2. When to consider IVF+ICSI?
If progressive motility is below 20%, IVF+ICSI is usually recommended after less invasive methods fail. ICSI bypasses motility by injecting the sperm into the egg, with fertilization rates above 70% per cycle. The decision depends on age, ovarian reserve, and couple’s history.
3. Are there risks with ICSI?
ICSI is safe, though there are minor risks: ovarian hyperstimulation syndrome, multiple pregnancies, and very rarely genetic concerns. If male infertility is linked to chromosomal abnormalities, genetic counseling is recommended.
4. How long until improvement is seen?
Spermatogenesis takes about 74 days. Lifestyle changes and medical treatments usually reflect in 3–4 months. If there’s no improvement after 6 months, additional tests like hormonal profile or testicular biopsy are considered.
References
- World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: WHO Press; 2021.
- Guzick DS, Overstreet JW, Factor-Litvak P, et al. Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med. 2001;345(19):1388-1393. doi:10.1056/NEJMoa003005
- Colpi GM, Francavilla F, Lugaresi A, et al. International Collaborative Study on Sperm DNA Fragmentation: 2010–2012. Hum Reprod Update. 2014;20(4):559–575. doi:10.1093/humupd/dmu018
- MedlinePlus. Semen analysis: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/003413.htm
We are with you on this journey. Talking to a fertility specialist will give you the guidance and support you need to increase your chances of achieving pregnancy.