Healthy Sperm: What It Means and How to Improve It

• What is considered healthy sperm?
• How sperm health affects chances of pregnancy
• What can affect sperm health?
• How to improve sperm health
• What if sperm health is poor?

Healthy sperm are those with the qualities and attributes needed to reach and fertilise an egg. The three main attributes that determine sperm health are:

• Sperm count
• Sperm motility
• Sperm morphology

Sperm count (concentration of sperm cells)

Sperm count refers to the number of sperm cells per millilitre (mL) of semen. It influences the chances that a sperm cell reaches the egg and is also known as sperm concentration. A higher sperm count increases the likelihood of fertilisation. The World Health Organization defines a healthy sperm count as at least 15 million sperm cells per mL of semen.

Learn more about sperm count and its impact on fertility.

Sperm motility (how sperm move)

Sperm motility refers to how efficiently sperm move through the female reproductive tract and toward the egg. The ability to swim efficiently increases the chances of fertilisation. Sperm cells that move in a straight line and at more than 25 micrometres per second are progressively motile. At least 32% of sperm cells in semen must be progressively motile for it to be classified as healthy.

Learn more about sperm motility and its impact on fertility.

Sperm morphology (shape and structure)

Sperm morphology refers to the shape of sperm cells. It is more difficult for abnormally shaped sperm cells to reach, bind with, and penetrate an egg. A healthy sperm cell resembles a tadpole, with a smooth, oval head, a neat midpiece, and a single, straight tail. Sperm morphology also measures the percentage of cells in semen with a good shape. At least 4% of sperm cells must have a normal morphology for the sperm to be considered healthy.

Sperm health is a key indicator of male fertility and has a significant impact on your chances of conceiving. A low sperm count, poor sperm motility or high rates of abnormal morphology can make it more difficult or impossible to conceive. However, it is not the only factor influencing the likelihood of conceiving. Other factors include:

• Partner’s fertility – your partner also needs to be able to conceive for you to fall pregnant.
• Timing – sexual intercourse needs to take place in the fertility window. This is the six-day period every month when sperm can fertilise an egg.
• Frequency of sexual intercourse – couples who have sex two to three times a week are more likely to conceive than those who do so less regularly.

The key male fertility factors that influence sperm health are:

• Age – sperm health decreases steadily after the age of 35. This is not a sharp decline and many older men can still conceive.
• Lifestyle factors – smoking, alcohol consumption, body weight, exposure to toxins, and sustained exposure to heat can all negatively impact sperm health.
• Medical factors – hormone imbalances, infections, obstructions and conditions like varicocele can all affect sperm health.
• Genetic factors – various genetic conditions can cause sperm health issues. These include chromosomal abnormalities (e.g., Klinefelter syndrome), Y-chromosome microdeletions, and single-gene mutations.

You may be able to improve sperm health naturally by:

• Stopping smoking and consuming less alcohol.
• Adopting a healthier Mediterranean diet and managing body weight.
• Limiting exposure to stress, heat and environmental toxins.
• Exercising regularly.

Seek a professional medical diagnosis if you make these changes and still cannot conceive. This will help identify the root cause of your fertility challenges and suitable treatments.

You cannot usually tell whether your sperm is healthy without a semen analysis. In some cases, such as dry ejaculation, there may be visible signs that sperm is not healthy. However, most sperm health problems are symptomless and semen analysis is the most accurate and effective way of diagnosing issues.

Poor sperm health does not mean it is impossible to conceive. Problems can be more or less severe. For instance, men with mild sperm health issues might take longer to conceive. Even if the issue is more severe, men can still make lifestyle changes, seek medical support, pursue fertility treatment and consider donor sperm if they want to become a parent.

You should consider semen analysis and male fertility testing if:

• You and your partner are under 35 and have not conceived after 12 months.
• You or your partner is over 35 and you have not conceived after six months.
• You have a medical condition that may impact fertility.
• You are concerned about your fertility and want reassurance.

You will usually receive the results of semen analysis within a week of delivering a sample. The results will help determine your best course of action going forward.