Sperm Quality in IVF: How Sperm Motility and Morphology Impact Success Rates
When it comes to IVF success, sperm quality plays a far more significant role than many couples realize. While female factors often receive more attention, research shows that sperm health directly impacts every stage of the IVF process - from fertilization to live birth. Here's what the latest clinical data reveals about how specific sperm parameters affect your actual chances of success.
Sperm Motility: The Movement That Matters
Progressive motility (PR) - the percentage of sperm moving forward effectively - shows one of the strongest correlations with IVF outcomes. Below is a rough estimate of percentages based on key studies found in the scientific literature!
• Normal motility (≥32% PR)
Fertilization rate: 75-80% with ICSI
Blastocyst formation: 50-55%
Live birth rate per transfer: 42-45%
• Suboptimal motility (10-31% PR)
Fertilization rate drops to 60-65%
Blastocyst formation declines to 35-40%
Live birth rate per transfer: 30-35%
• Severely low motility (<10% PR)
Fertilization rate: 45-50%
Blastocyst formation: 25-30%
Live birth rate per transfer: 20-25%
DISCLAIMER - Please keep in mind that these are rough estimates that vary globally across many clinics; therefore, these percentages are not guaranteed at your clinic or even in your situation. This is informative information to help give everyone a baseline idea about how motility may impact IVF success.
Key Findings
A 2023 study of total motile sperm count (TMSC) found that increased TMSC correlated with increased pregnancy rates!
Paraskevi Vogiatzi’s study in 2022 found that progressive sperm motility is critical to fertilization rates and embryo quality
Sperm Morphology: The Shape of Success
Using strict Kruger criteria, morphology shows these success rate patterns:
• Normal morphology (≥4%)
Fertilization rate: 70-75%
Blastocyst quality (AA/AB): 60%
Live birth rate: 40-45%
• Borderline morphology (1-3%)
Fertilization rate: 55-60%
Blastocyst quality: 45%
Live birth rate: 30-35%
• Severe teratospermia (<1%)
Fertilization rate: 40-45%
Blastocyst quality: 25-30%
Live birth rate: 15-20%
DISCLAIMER - Please keep in mind that these are rough estimates that vary globally across many clinics; therefore, these percentages are not guaranteed at your clinic or even in your situation. This is informative information to help give everyone a baseline idea about how morphology may impact IVF success.
Key Findings
A study in 2019 by Dong-liang Zhu found that <4% sperm morphology are likely to have poor normal fertilization status compared to ≥4%
A study in 2021 by Wen-Jun Zhou found that teratozoospermia, a condition with a high percentage of abnormally shaped sperm, had a significantly lower good quality embryo development rate compared to normal sperm morphology.
The Hidden Factor: DNA Fragmentation
While not part of standard semen analysis, DNA fragmentation provides crucial predictive value:
• DFI <15% (Excellent)
Miscarriage rate: 8%
Live birth rate: 48%
• DFI 15-30% (Borderline)
Miscarriage rate: 18%
Live birth rate: 32%
• DFI >30% (Poor)
Miscarriage rate: 35%
Live birth rate: 15%
DISCLAIMER - Please keep in mind that these are rough estimates that vary globally across many clinics; therefore, these percentages are not guaranteed at your clinic or even in your situation. This is informative information to help give everyone a baseline idea about how sperm DNA fragmentation may impact IVF success.
Key Findings
A study in 2025 by Zaiqing Qu found that the live birth rate was significantly decreased in cases with high sperm DNA fragmentation!
Modern Solutions That Move the Needle
Advanced Sperm Selection
PICSI improves live birth rates by 22% in motility/morphology cases
MACS reduces miscarriage risk by 40% in high DNA fragmentation cases
Clinical Interventions
Varicocele repair increases motility by 38% in 6 months
Antioxidant protocols (CoQ10 + vitamin E) reduce DNA fragmentation by 29%
Lab Techniques
Testicular sperm retrieval (for severe cases) improves blastocyst quality by 35%
IMSI selection increases live birth rates by 18% in teratospermia
The Bottom Line
These numbers and studies show a clear trend: sperm quality directly translates to IVF success rates. While ICSI helps overcome some male factor issues, it doesn't eliminate the impact of poor sperm parameters. The good news? Most sperm quality issues can be improved with targeted interventions before starting IVF.
Action Steps for Optimal Results:
Request DNA fragmentation testing if motility/morphology is suboptimal
Consider 3 months of pretreatment for significant improvements
Ask your clinic about advanced sperm selection methods
Combine male and female factor optimization for the best outcomes
Remember - in IVF, sperm quality isn't just about fertilization. It's about creating embryos with the best potential for healthy development and successful pregnancy. By addressing sperm health with the same rigor as egg quality, couples can significantly improve their chances of IVF success.
“Turns out, just showing up isn’t enough. The sperm also has to swim… and look presentable. Oof!”
