Teratozoospermia (Abnormal Sperm Morphology): Causes, Symptoms, Diagnosis, and Treatment

What is Teratozoospermia?

Teratozoospermia is a condition that is characterised by defects of the head, midpiece, or tail of the sperm. Sperm morphology is a term that describes the sperm’s shape and size. It is a disorder in which males produce large amounts of abnormal-looking, crooked, or faulty sperm.

Normal vs Abnormal Sperm Morphology

A normal sperm is composed of an oval head, a midpiece, and a long tail, which is the main reason for proper movement. Some defects that can be found in the affected sperm are:

• A misshapen or double head.
• A coiled or broken tail.
• Irregular midpiece or cytoplasmic droplet.

These changes can make sperm fertilisation difficult, as sperm may lack proper motility or be unable to penetrate the egg.

Relation with Male Infertility

Sperm shape is essential for male fertility. In case sperm count and motility are good, the chance of pregnancy can still go down due to poor morphology. But, it should be noted that the presence of abnormal sperm morphology does not imply infertility in all cases - natural conception or the use of ARTs like IVF or ICSI for pregnancy may still be feasible.

What are the Types of Teratozoospermia?

The percentage of improperly produced sperm in the semen sample is usually used to categorise teratozoospermia.

1. Mild Teratozoospermia

Mild levels of teratozoospermia occur when 86% to 90% of the sperm in the semen that is ejaculated have an abnormality. Male patients in the mild stage are more likely to achieve natural conception.

2. Moderate Teratozoospermia

When the normal sperm forms between 5 and 9 per cent of the semen, it is considered moderate. Assisted procedures may include IVF-ICSI (Intracytoplasmic Sperm Injection), which may be suggested by fertility specialists to help in conception.

3. Severe Teratozoospermia

In severe teratozoospermia, 96 per cent or above of the sperms are involved. In this case, a natural pregnancy is almost impossible. Experts of fertility prescribe more elaborate procedures, including IMSI (Intracytoplasmic Morphologically-selected Sperm Injection).

4. Astheno Teratozoospermia

The morphological abnormality is combined with asthenozoospermia, i.e. low motility. Astheno teratozoospermia is challenging to treat. It is something which can be enhanced with time and in terms of life. Couples can become pregnant with the help of procedures such as ICSI and IMSI.

What are the Symptoms of Teratozoospermia?

This condition does not show any visible signs as a rule; most of the men do not even realise whether they possess such defects or not. The condition is only detected after fertility tests in most men.

Common teratozoospermia symptoms include:

• The major symptom of this disease is difficulty in conceiving despite months or years of unprotected intercourse.
• Coexisting sperm abnormalities, such as low count (oligozoospermia) or poor motility (asthenozoospermia)

Semen analysis is the only reliable method for detecting teratozoospermia, as it is usually asymptomatic.

How is Teratozoospermia Diagnosed?

The condition of teratozoospermia is normally detected via a procedure referred to as semen analysis, which is the common test that is conducted on males suspected of having fertility issues. Primary tests and procedures that are involved in the diagnosis of teratozoospermia are:

1. Semen Analysis Test

A semen analysis is the initial process of teratozoospermia diagnosis, and the quantity, motility, and morphology of sperm are investigated using a microscope. A morphology score of less than 4 per cent normal ones (according to the strict criteria of Kruger) implies teratozoospermia.

2. Sperm Morphology Testing

An additional assessment of sperm morphology could be performed to inform a study of the actual nature of morphological abnormalities in sperm shape and size. In this test, the technician observes the sperm under a microscope and classifies them based on various structural flaws, including the head and tail, as well as minor shape flaws, such as abnormally shaped, oversized, poorly shaped, or too short.

3. Other Supportive Fertility Investigations

Additional tests may include:

• In other instances, the doctors might recommend that the patients undergo hormonal profiling to identify various issues.
• Scrotal examination and Doppler ultrasound to check whether there is a varicocele.
• Genetic assessment may be needed in men with severe teratozoospermia. Genetic testing simplifies the process by which doctors determine whether any genes cause a man.
• When a man has severe teratozoospermia, a genetic evaluation can be necessary. Genetic testing makes it easier for medical professionals to identify any genes that contribute to a man's condition.

Teratozoospermia Treatment Options

There is no particular treatment for teratozoospermia; instead, the doctor may recommend one based on the severity of the condition. Depending on how severe the condition is, several types of therapy may be suggested to induce conception.

1. Lifestyle Modifications and Supplements

Minor modifications are capable of enhancing the quality of the sperm as time goes on:

• Cessation of smoking and alcohol.
• Keep a healthy weight through diet and exercise.
• Avoid exposure to high heat and toxins.
• Consume foods that are rich in antioxidants (fruits, vegetables, nuts and whole grains).
• Some vitamin and mineral supplementation can also help support sperm health.

2. Medications for Underlying Causes

When an infection, hormonal imbalance, or varicocele is a contributing factor to the abnormality, then specific medical intervention can be used to correct normal sperm production.

3. Surgical Interventions

Blockages of the reproductive tract can be repaired (varicocelectomy) or opened up, and this can enhance the sperm morphology and fertility.

4. Assisted Reproductive Techniques (ART)

In case of the lack of natural conception, there are a number of fertility procedures at Indira IVF that can be used to help a couple get pregnant:

• Intrauterine Insemination (IUI): Adequate in mild cases, and in which normal sperms are present to some extent.
• In Vitro Fertilisation (IVF): This is the fertilisation of eggs by sperm in a controlled laboratory setting.
• Intracytoplasmic Sperm Injection (ICSI): One of the most efficient methods to treat severe teratozoospermia is through the direct intracytoplasmic sperm injection of one single healthy and high-quality sperm into an ovum.

Such advanced ART procedures are designed to bypass sperm abnormalities and to raise the conception chances to a considerable level.

Conclusion

Teratozoospermia is painful, and it does not mean that a person is infertile. Through modern reproductive medication, lifestyle modifications, and correct diagnosis, many male patients with aberrant sperm morphology can father biological children.

The fertility experts at Indira IVF, utilising the latest diagnostic techniques and personalised teratozoospermia treatment programs, not only assist couples in overcoming these hurdles but also fulfil their dream of becoming parents.