male infertility, assisted reproductive technology (ART), semen analysis, sperm morphology


By Todd Nippoldt, Mayo Clinic, Malpani Infertility Clinic

What is sperm morphology?

Sperm morphology or teratozoospermia is the shape and size of sperm. The head should be oval in shape, have a mid-section, and have a long, straight tail. If sperm have a double tail, no tail, or a head that is crooked, misshapen, has double heads, or too large, it is considered abnormal, and unable to successfully penetrate an egg.

Sperm morphology is routinely tested in the male infertility semen analysis. Most men have a large percentage of abnormal sperm morphology, with only 4-15% of their sperm being considered normal. What is important is that that 4-15% has good vitality and motility as well as the overall volume of semen, sperm concentration, and sperm count.

Men with abnormal sperm are still perfectly capable of fathering children; it just may take longer than normal to do so.

If there is a deficiency in these areas, doctors do not necessarily act immediately, but rather sit back and see if the situation improves on its own, repeating the test four to six weeks later to look for improvements. If the second round of test results still shows abnormalities, additional tests may be required to see if there are underlying issues causing the abnormalities.

Does having abnormal sperm mean he's infertile?

Men with abnormal sperm are still perfectly capable of fathering children; it just may take longer than normal to do so. This diagnosis does not equal infertility. It just means a challenge is ahead of you, and patience is going to be necessary. If natural conception doesn't work, you always have the option of assisted reproductive technology like in vitro fertilization and Intra Cytoplasmic Sperm Injection (ICSI).  

One issue with abnormal sperm morphology is that there is no easy fix. There is no one pill, vitamin, shot, or surgery that will correct this issue. This doesn't mean you shouldn't give these options a try before resorting to assisted reproductive technology, it just means that it is advisable to set a defined period for trying it.

What can we do?

Have a semen analysis after 3 months to see if the treatment is working. The longer you try it, the older your female partner gets, and the lower her fertility gets. If you spend years on these treatments, you lower the chances of success from even the best ART treatments. Intrauterine insemination (IUI) is not recommended for patients with abnormal sperm morphology. In general, ICSI is the most recommended treatment because an embryo can be created with any sperm, regardless of the quality of the sperm being used.  

There is also no clear-cut answer as to what causes this condition. It has nothing to do with your physical health, stature, diet, sexual appetite or behaviors. Do not let this situation get you down because there are options, and there is hope. You just have to be willing to accept the options available to you.

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