Beyond Count: Motility and DNA in Fertility Testing | Mate Health
For decades, semen analysis has been the starting point for assessing male fertility. Traditionally, people have focused on sperm count, the raw number of sperm in a sample. But modern reproductive science shows that count alone tells only part of the story. To truly understand male fertility, clinicians now emphasize two critical factors: how sperm move and whether their DNA is intact.
Sperm motility, or the ability of sperm to swim efficiently, is one of the strongest predictors of natural conception. According to the World Health Organization’s 6th edition manual, sperm are classified as progressively motile, non-progressively motile, or immotile. Progressively motile sperm move actively in mostly straight lines, and at least 32 percent of sperm should be progressively motile to meet the global standard for healthy semen parameters. Without enough forward-moving sperm, even a high sperm count cannot reliably lead to fertilization.
Clinicians also look at total motile sperm count (TMSC), which combines both the number of sperm and their movement. This measure is often used to guide treatment decisions. For example, research in reproductive medicine shows that intrauterine insemination (IUI) typically requires at least 5 million motile sperm, while in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) may be recommended when counts fall below 1 million. By focusing on TMSC rather than raw count, doctors can match couples with the treatment path most likely to succeed.
But sperm health involves more than movement. Another critical factor is DNA fragmentation, or breaks in the genetic material carried by sperm. High levels of fragmentation have been linked to reduced chances of natural conception, increased risk of miscarriage, and lower IVF and ICSI success rates. A 2022 study published in Fertility and Sterility found that men with less than 5 percent progressive motility had under a 3 percent chance of conceiving naturally within a year, even when sperm counts appeared normal, highlighting the importance of evaluating both motility and DNA integrity together.
This issue is especially relevant for men over 35, couples with unexplained infertility, or those who have experienced repeated IVF failures. Testing DNA fragmentation provides insights that standard semen analysis alone cannot capture, helping clinicians tailor treatment plans and improving outcomes for patients.
Together, motility, TMSC, and DNA fragmentation create a more complete picture of male fertility. They transform semen analysis from a simple headcount into a diagnostic tool that can guide decisions, improve outcomes, and give couples greater clarity in their journey to conceive.
At Mate Health, we make these advanced insights accessible from home. Our Complete Semen Analysis Kit provides sperm count, motility breakdown, morphology, and vitality. For those seeking deeper answers, our Advanced Semen Analysis Kit includes all of these measures plus DNA fragmentation testing. Both kits feature temperature-controlled shipping, discreet overnight return, and analysis in CLIA-certified labs, with results available in just one to two business days.
Male fertility is complex, but testing it does not have to be. By moving beyond count alone, you can uncover the factors that matter most for conception. Science has evolved, and so should your understanding of your own health.