Sperm quality and motility dropping over time, looking for insights
Hi, I’m posting from my wife’s account since I don’t have one and she’s much more active on Reddit than I am. I’m usually just a lurker, but I’ve been reading this community for a long time.
Right now I’m honestly panicking. If you’re willing, I’d like to share my story.
I’m 30 years old. I had surgery for a left varicocele twice: first in 2010 (microsurgery, vein ligation) and then again in 2020 (scleroembolization).
In 2018, when I was 23, I had my first semen analysis with these results:
- Volume: 3.6 ml
- pH: 7.6
- Sperm concentration: 2.25 million/ml
- Total sperm count: 8.1 million
- Progressive motility: 42%
- Non-progressive motility: 20%
- Immotile: 38%
- Normal morphology: 16%
So the quantity was low, but the quality wasn’t that bad.
The issue is now. In December 2025, after getting married and starting to think about having a family, my semen analysis showed:
- Volume: 4.3 ml
- pH: 8.0
- Concentration: 2.10 million/ml
- Total sperm count: 9.03 million
- Liquefaction after 30 min: incomplete
- Rapid progressive motility: 0%
- Slow progressive motility: 19%
- Non-progressive motility: 29%
- Immotile: 52%
- Normal morphology: 2%
I also did further tests:
Hormones & infections:
- FSH: 10.4 U/L
- LH: 7.8 U/L
- Testosterone: 19.00 nmol/L
- Chlamydia: negative
- Mycoplasma / Ureaplasma: negative
- Bacterial cultures: negative
- No mycobacteria detected
Andrology visit:
Suggested: karyotype, Y chromosome microdeletions, cystic fibrosis screening
Scrotal ultrasound:
Slightly reduced testicular size (right: 3.7 cm, left: 3.3 cm)
Conclusion: mild testicular hypotrophy → advised prolactin test and endocrinology visit
Hormonal follow-up:
- FSH: 7.2 mU/mL
- LH: 5.0 mU/mL
- PRL: 11.4 ng/mL
- Testosterone: 3.62 ng/mL
- SHBG: 24 nmol/L
- TSH: 1.87 microU/mL
Endocrinology conclusion:
Pituitary–gonadal axis preserved → recommended genetic testing
Latest semen analysis (a few days ago):
- Volume: 5.0 ml
- pH: 8.5
- Concentration: <2.0 million/ml
- Rare motile sperm observed
All tests were done after 3 days of abstinence.
I’m now waiting for genetic test results.
My question is: why am I getting worse over time? What is happening to me?
I’m honestly scared. I feel like I’m losing the few good sperm I have left. I’m trying to freeze sperm as soon as possible because I’m afraid of losing everything.
For context, I’ve always had a healthy lifestyle: Mediterranean diet, gym twice a week, never smoked, I stopped alcohol completely 4 months ago (but I barely drank before), and I also cut coffee (I used to have one every 2–3 days).
Also, at the moment I don’t have any varicocele. I specifically checked for this very recently with two different specialists, just a few days apart, to rule out any doubt.
Thank you so much to anyone who reads or replies.