Treatment of Asthenozoospermia

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Main article: Asthenozoospermia Overview

Updated: 19-October-2024

Treatment of asthenozoospermia (also known as asthenospermia) can vary greatly according to the probable cause. The doctor may recommend you one or several treatments. Treatment options for men with low sperm motility include:

Expectant management
Lifestyle
Supplements
Environment
Surgery
Medication
Assisted Reproductive Technology

Expectant Management

Expectant management means watchful waiting. This can be an option for men diagnosed with asthenospermia, especially if:

the male patient is young and can make significant lifestyle changes.
the female partner is also young and not diagnosed with any female infertility factors.

Experts suggest men diagnosed with low sperm motility can increase their sperm motility and chances of conception by trying at least every 1-2 days during the woman’s fertile window.
_{Source: Keihani S, et al. (2017); Hussein M, et al. (2008); Tur-Kaspa I, et al. (1994)}

It’s also important that popular lubricants (K-Y jelly, Durex) and natural lubricants (i.e., olive oil, saliva) are avoided, as they can impair sperm movement and function.

_{Source: Markram J, et al. (2022); Soriano M J, et al. (2021)}

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Lifestyle

Although there is limited evidence that lifestyle changes can treat asthenospermia, experts suggest the following lifestyle changes to increase sperm motility:

Quit smoking
Limit alcohol consumption (especially ALDH2*2 genotypes)
Lose weight if obese
Regular exercise to stay in good shape
Consume a healthy and balanced diet

For males who cannot quit smoking entirely, melatonin supplementation may be a valid option, almost protecting the sperm entirely from cadmium induced damage in a controlled rat study.

Source: Venditti M, et al. (2021)

Limiting alcohol consumption is also important especially among East Asian men. This is due to changes in the ALDH2 gene (known as ALDH2*2) found in 40%-50% of East Asian men. A recent study revealed ALDH2*2 carriers have significantly lower progressive sperm motility (19% vs. 37%) and total sperm motility (20% vs. 41%) compared to non-carriers after consuming alcohol.

_{Source: Greenberg D R, et al. (2022)}

Surprisingly, just 2 or more alcoholic drinks, on 3 or more occasions per month, was enough to cause a significant reduction in sperm motility.
_{Source: Greenberg D R, et al. (2022)}

In a recent small trial, men with obesity (BMI ≥30 kg/m²) were randomized to 2 different diets to lose weight (with minimal exercise, restricted to resistance training <1.5 hours/week) over a 16 week period. At the end of the trial, the well-balanced low-energy diet of 800 kcal/day achieved the greatest weight loss and significantly improved both total and progressive motility for men with asthenospermia (n=3). Further studies are needed to understand these results.

_{Source: Sharma A, et al. (2023)}