Total motile sperm count (TMSC) is the number of moving sperm in one ejaculate: semen volume times sperm concentration times the share of sperm that move. Type the numbers from your report below and this page does the sum in your browser. In a Dutch study of 1,177 couples, TMSC tracked the chance of a natural pregnancy better than the WHO 2010 categories did, with three rough groups: under 5 million, 5 to 20 million, and over 20 million. The WHO publishes no reference limit for TMSC, clinics use different thresholds, and it is one number among several rather than a verdict on your fertility.
Work out your total motile sperm count
Use the numbers from one report, before any washing or preparation. Enter progressive motility, total motility, or both: your report may give either. Decimals are fine.
What total motile sperm count is
It is the number of sperm in the whole ejaculate that are moving. Most of the prognostic work, including the Dutch cohort and the Dutch national guideline, counts only progressive sperm, the ones swimming forward, which the older WHO grading called A and B [1][2][3]:
TMSC = volume (mL) x concentration (million per mL) x progressive motility (%) / 100
Some IUI research uses total motility instead, which also counts sperm that move without getting anywhere [4]. That gives a larger number from the same sample, so this page shows both when you enter both, and each threshold below says which one it came from.
What the number means
Hamilton and colleagues followed 1,177 couples referred to three Dutch hospitals, with three years of follow-up. Every TMSC group had a lower natural pregnancy rate than couples with unexplained infertility, and couples under 1 million, or between 1 and 5 million, did worse than those between 5 and 10 million. The authors concluded that, "roughly, three prognostic groups can be discerned: couples with a TMSC <5, couples with a TMSC between 5 and 20 and couples with a TMSC of more than 20 x 106 spermatozoa" [1]. They also found that the prewash TMSC "shows a better correlation with the spontaneous ongoing pregnancy rate" than the WHO 2010 classification system.
These are averages across couples who were already seeing a specialist. They cannot tell one couple their chances, and your partner's age and fertility matter at least as much as any semen number.
The thresholds clinics use for IUI and IVF
There is no single agreed cut-off, and NICE NG257 does not use TMSC at all [5]. The thresholds you may hear:
- 10 million, total motility, before washing. In a US study of 1,039 couples and 3,479 IUI cycles, pregnancy rates after IUI were very low at an average TMSC of 10 million or less, and "improved and constant" above it. Below that level, IVF with ICSI was more cost-effective than IUI in that clinic [4].
- 1, 3 and 10 million, progressive, before washing. The Dutch guideline calls 3 to 10 million mild, 1 to 3 million moderate and under 1 million extreme, and advises ICSI under 1 million before or after washing [3].
- 5 to 10 million before washing, or 0.8 to 5 million after. These are the cut-offs most frequently studied in the IUI literature, which a systematic review reported alongside "a lack of standardization in semen testing methodology" [6].
How this compares with the WHO limits
The WHO 2021 manual sets no limit for TMSC. Its lower reference limits are 1.4 mL for volume, 16 million per mL for concentration, 42% for total motility and 30% for progressive motility [7][5]. Multiplying them gives about 6.7 million progressive or 9.4 million total, but that is arithmetic rather than a threshold: each limit is the 5th centile of a different measure, and the manual says these distributions "cannot be used as distinct limits between fertile and subfertile men" [7]. Our semen analysis checker shows each of your own values against its limit.
Why the number changes between tests
Semen varies a lot within the same man. In one study the within-man coefficient of variation for sperm count was 54.2% in men seen for infertility and 45.8% in donors, and the author concluded that at least three samples were needed for a reliable picture [8]. Days since the last ejaculation matter too, which is why labs ask for 2 to 7 days [9]. Because sperm take about 74 days to develop [10], NICE advises repeating an abnormal test ideally 3 months later, or as soon as possible if very few sperm or none were found [5].
What to do with the result
- Note which motility your report gives, and use the figures from one report rather than mixing two.
- Read it with the rest of the report: our guide to a semen analysis explains each line, and low sperm count covers what a low result can mean.
- If the number is low, ask for a repeat test before drawing conclusions. The 74-day timeline shows when a retest can reflect changes you make now, and when to retest has the detail.
- Ask your clinic which TMSC it calculates and what threshold it applies, because they differ.
- Work on the habits linked to semen quality: improving motility and every factor ranked.
Common questions
Is a TMSC over 20 million normal?
In the Dutch study it was the best of the three groups, and a later editorial in the same field described over 20 million as a normal TMSC value. It is not a guarantee, and a lower number does not put pregnancy out of reach.
Should I use progressive or total motility?
Progressive, if you want to compare with the Dutch groups and the Dutch guideline, which both count only sperm swimming forward. Total motility, if your clinic uses the US threshold of 10 million. The calculator shows both if you enter both.
My report already gives a total motile count. Why is it different?
Labs differ in which motility they multiply by and how they round. Some home tests report motile sperm concentration per mL instead, which is not multiplied by volume, so it is a different measure.
Can a total motile sperm count go up?
Volume, concentration and motility all vary between samples and are linked to health and habits, so the number can move, but nobody can promise that it will. Any change takes around three months to show, because that is how long new sperm take to form.
Related
Sources
- Hamilton JAM, et al. Total motile sperm count: a better indicator for the severity of male factor infertility than the WHO sperm classification system. Human Reproduction, 2015.
- Borges E Jr. Total motile sperm count: a better way to rate the severity of male factor infertility?. JBRA Assisted Reproduction, 2016.
- Nederlandse Vereniging voor Obstetrie en Gynaecologie. Richtlijn Mannelijke subfertiliteit (Dutch guideline on male subfertility): ART, and the definitions in Algemene inleiding. 2026.
- Van Voorhis BJ, et al. Effect of the total motile sperm count on the efficacy and cost-effectiveness of intrauterine insemination and in vitro fertilization. Fertility and Sterility, 2001.
- National Institute for Health and Care Excellence. Fertility problems: assessment and treatment (NG257). 2026.
- Ombelet W, et al. Semen quality and prediction of IUI success in male subfertility: a systematic review. Reproductive BioMedicine Online, 2014.
- World Health Organization. WHO laboratory manual for the examination and processing of human semen, sixth edition. 2021.
- Keel BA. Within- and between-subject variation in semen parameters in infertile men and normal semen donors. Fertility and Sterility, 2006.
- Bjorndahl L, et al. The sixth edition of the WHO laboratory manual for the examination and processing of human semen: ensuring quality and standardization in basic examination of human ejaculates. Fertility and Sterility, 2022.
- Heller CG, Clermont Y. Kinetics of the germinal epithelium in man. Recent Progress in Hormone Research, 1964.
