We usually highlight the latest research in male fertility and sperm health. But recently, something exciting happened - our own data started telling a story.
With hundreds of men using the Hera App and testing, we’ve now gathered enough real-world data to step back and ask:
What are we seeing in the numbers? And is SmartScore actually helping men understand their fertility better?
Here’s what we found.
A Look Inside the Numbers
We took a sample of patients (~300). Here's what we saw across the five core semen metrics:
1. Semen Concentration
- Mean: 40.9M/ml
- Wide range, strong right skew (many low counts, a few very high)
- Insight: Nearly half the sample had suboptimal counts, reinforcing the need for clear interpretation beyond raw values. Above WHO lower reference range (15M/ml), matches Levine et al. (2017) study's average (~40–60 M/ml)
2. Motility
- Mean: 41.7%
- Distribution: Near-normal
- SmartScore Impact: Above WHO reference range (40%) but lower than Levine. The single strongest predictor of fertility in our model (correlation r = 0.92).
3. Morphology
- Mean: 2.8% (low)
- Zero-inflated: A significant number of men had 0% normal forms
- Clinical relevance: Often misunderstood, but clearly impactful when considered with motility and concentration.
4. Total Motile Count (TMC)
Volume (ml) x Concentration (M/ml) x motility (%)
- Median: 26.60
- Skew: Strong right-skew with long tail with a small number had exceptionally high counts (>200M)
- Clinical Insight: The majority of users fell below WHO reference 39M and much lower than Levine study.
5. Volume
- Mean: 3.11 ml
- Distribution: Slightly right-skew
- Clinical Insight: In line with both WHO and Levine
What does this mean?
1. Hidden Fertility Risks Despite “Normal” Averages
While average metrics appear reassuring, median values tell a different story. The TMC mean is 61.4M — but the median is just 26.6M. That means more than half the sample falls below optimal thresholds, even though the average looks fine.
→ Averages alone are misleading.
2. Morphology Is Commonly Overlooked - and Commonly Abnormal
The average morphology was just 2.8%, with a large portion of men registering 0% normal forms.Though often discounted or misunderstood, morphology continues to emerge as a silent contributor to male subfertility that standard assessments may miss.
3. Motility Holds Strong - But Just Barely
With a mean of 41.7%, motility was the most consistently normal parameter across the dataset.That said, it hovers just above the WHO’s 40% cutoff, suggesting that even small shifts could push many into subfertile territory when combined with other deficits.
Why even have SmartScore?
Total Motile Count (TMC) is widely used as a shorthand for male fertility. It multiplies volume × concentration × motility into a single number - but it treats all three variables equally, which oversimplifies how fertility actually works. That can skew the result when one factor is much stronger (or weaker) than the others. A high TMC might look reassuring, even when the overall chance of conception is low.
We kept seeing this so we built something different - SmartScore. We launched recently (here) with our app after rigorous testing.
We kept seeing this problem. So we built something different. SmartScore doesn’t rely on fixed formulas. It learns from real patient outcomes to:
- It’s trained on a growing dataset of men with known fertility profiles
- It recognizes patterns that signal higher or lower likelihood of conception
- It adapts as more outcome data becomes available
SmartScore reflects real-world success, not just lab math.
What about our SmartScore?
We ran SmartScore across patients with similar Total Motile Counts — men who, by traditional standards, would all be told their sperm numbers "look good." But when we applied SmartScore, a different story emerged.
Despite TMCs being in the normal range (47–53 million), SmartScores ranged from 0.43 to 0.91 - a massive difference in predicted fertility. Why? Because SmartScore accounts for how the variables interact, not just their presence.
Some patients had high motility and well-balanced semen parameters. Others had high TMCs driven by unusually large volume or uneven concentration - giving a false sense of fertility health.
The Big Picture
Patients shouldn’t have to become scientists to understand their fertility.
Between motility, morphology, concentration, and Total Motile Count, most semen analyses are hard to interpret - even for clinicians. That’s not good enough.
At Hera, we believe fertility insights should be clear, consistent, and personal.
SmartScore was built to cut through the complexity, translating raw numbers into something that actually makes sense - a single score grounded in data, not guesswork.
One early user put it best:
That’s why we built SmartScore:
To give every man not just a result — but a real sense of direction.