I had to do some investigating about this myself because even though my husband s sperm count is very high, the morphology and motility were below normal. In his case, however, the count was high enough that the doctor does not see it as a problem. Ok, in my opinion, if you want to conceive naturally, the most important values are 1) count 2) motility 3) morphology. However, they are all connected, so you can t really say that one is the most important. For instance, if his count was high, say 200 million per ml and he had 2 ml, with 20% morphology, then his total "normal" sperm count would still be (400 million/5 = 80 million), so in this case the low morphology wouldn t really matter because there would still be 80 million sperm capable of fertilising the egg (40 million is typically the minimum number they like to see but many men have impregnated with much less) On the other hand, if the sperm count is low, motility and morphology suddenly become much more important. Motility is the sperm s ability to swim to the egg and morphology is the shape of the sperm s head- it has to be a certain shape in order to burrow into the egg and fertilise it. The reason I put down that I thought motility was more important than morphology is that the first obstacle the sperm must overcome is the ability to swim to the egg. Once there, only 1 sperm is needed to fertilise the egg- it s just that the likelihood of a normal shape sperm reaching the egg is much reduced with low morphology. Have you investigated IUI? They can sort of overcome the motility issue with IUI, as they insert a washed sperm sample directly into the uterus. Your chances of conception may be higher if you go on clomid, as this can sometimes compensate for a lower sperm count.