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Morphology and Motility Issues

Sperm motility and morphology problems often relate to specific parts of the “manufacturing process” and to general health. The main structures that make sperm are the Sertoli cells in the testes, and sperm fully mature in the seminiferous tubules, where the sperm cell elongates to form a tail and the acrosome forms at the tip.

As a general rule, abnormal heads relate more to the testes and tails to the tightly coiled tubules. The semen samples article has information on how semen samples can be interpreted, and motility and morphology issues explain the multiple causes of these conditions.

The European Academy of Andrology recommends men with poor sperm motility, morphology and numbers should have: i

Medical Assessment

  • A physical exam for signs of hypogonadism (low testosterone)
  • A scrotal exam to assess the health of the testicles and tubes, and the presence of varicoceles
  • Have two semen analyses to define oligo-astheno-teratozoospermia
  • A sex hormone check
  • A scrotal ultrasound as a routine investigation
  • Karyotype analysis when men have sperm concentrations below 5 × 106/ml
  • If incomplete congenital obstruction of the genital tract is suspected, the cystic fibrosis transmembrane conductance regulator gene should be evaluated

The men should

  • Continue taking physical activity to improve the chance of achieving pregnancy
  • Only have androgen replacement therapy to improve the chance of pregnancy when biochemical/clinical signs of hypogonadism exist
  • Have ART (assisted reproduction techniques) to improve the chance of pregnancy when other treatment options are not available or not efficient

Some causes of poor motility and morphology require surgery and hormone replacement, however, lifestyle changes and herbal medicine are very effective at raising male fertility. A study published in 2018 found that the semen values of men (concentration, motility and morphology) who took medicinal herbs improved by 10.7x in three months, compared to men who made lifestyle changes and took a supplement.

The morefertile® PFPs predict different causes of poor sperm motility and morphology, as well as different paths to successful treatment.

PFP Motility Morphology Other semen issues Other Issues
Energy & Blood Low motility Abnormal heads to sperm Low semen volumes Tired, weak limbs, lack of strength.

Palpitations, shortness of breath, anxiety, poor digestion

Energy & Fluids Low motility Abnormalities mainly in body and tails Low semen volumes, possibly thick semen. Low libido, lassitude, heaviness in the body

Loose stools, weak limbs, lack of strength. Low spirits, woolly-headed

Hot Low motility Heads are mainly affected; small and pointy or malformed Low semen volumes, liquefaction issues, high libido, premature ejaculation Hot and sweaty at night.

Irritability that’s worse when tired. Over-busy mind, anxiety

Cold Low motility Heads are mainly affected; small and pointy or may lack a midsection Thin, watery semen, low libido, liquefaction issues Cold, weak lower back and knees, aversion to cold, apathy. Weak erections, coldness and dampness of the genitals. Frequent urination of pale urine, possible varicocele
Hot & Fluids Low motility Abnormal sperm Thick or cloudy semen. Low sperm count Obesity, metabolic syndrome, inflammation or infections.
Fluids Low motility Abnormal morphology Thick semen, liquefaction issues Sweaty, clammy or lumpy testes, high BMI, heavy limbs and lethargy. Nausea, feeling full in the chest, non-postural dizziness, woolly headedness. Loose stools (that may contain mucus) or mucus in airways
Flow Low motility Many abnormal sperm Low sperm counts Varicocele, history of trauma to testes, distension or pain in the genital region. Possible painful ejaculation, hard and tender lumps on the scrotum or testes.

i Colpi, G.M., Francavilla, S., Haidl, G., Link, K., Behre, H.M., Goulis, D.G., Krausz, C. and Giwercman, A. (2018), European Academy of Andrology guideline Management of oligo-astheno-teratozoospermia. Andrology, 6: 513-524. https://doi.org/10.1111/andr.12502