Poor Sperm Morphology

What is a normal-shaped sperm?

A normal sperm has following characteristics:

  • A smooth, oval-shaped head that is 5-6 micrometers long and 2.5-3.5 micrometers wide.
  • A well-defined cap (acrosome) that covers 40% to 70% of the sperm head .
  • No visible abnormality of neck, midpiece, or tail.
  • No fluid droplets in the sperm head that are bigger than one half of the sperm head size.

Sperm morphology is assessed during routine Semen analysis that examines the sperm cells under a microscope. The semen analysis will also examine the motility and concentration of sperm present.

What do we mean by poor sperm morphology

There are many different examples of poor sperm morphology. Some of them are:

  • Large sperm head
  • Small sperm head
  • Double-headed sperm
  • Crooked sperm tail
  • Short sperm tail
  • Elongated sperm tail
  • Double sperm tail
  • Every male, fertile or infertile, has varying percentages of abnormally-shaped sperm.
  • There are many factors that can lead to abnormally shaped sperm including:-Increased testicular temperature, exposure to toxic chemicals, infection and genetic traits.

The medical term for when a man has a large number of abnormally shaped sperm is Teratozoospermia or Teratospermia.

What are the causes of Teratospermia ?

The causes of teratospermia are not clearly defined and are difficult to determine. However, physiological stress is said to have an effect on the morphology of the sperms. The following factors are suggested to be the most common causes:

  • Genetic traits
  • Vericocele
  • Chronic diseases and infections – Male accessory Gland Infections
  • Smoking & Alcohol intake
  • Unbalanced diet
  • Obesity
  • Drug use and radiation therapies
  • Diabetes
  • Testicular trauma etc

What are the various grades of Teratospermia ?

Teretozoospermia is divided into 3 types:-

  1. Mild teratozoospermia – In this case, there are 10 to 14% of sperms whose shape is normal.
  2. Moderate teratozoospermia – If 5% to 9% of the sperms are in good shape.
  3. Severe teratozoospermia:-When less than 5% of the sperms are in good shape, the person is said to be suffering from severe teratozoospermia.

How is poor sperm morphology treated ?

Conservative therapies for poor sperm morphology may include:

  • Lifestyle changes and quitting smoking, alcohol and other substances
  • Foods rich in anti-oxidants, amino acids and L-Carnitine must be consumed to improve fertility.
  • Intake of Omega 3 rich fatty acids
  • Vitamin E also plays a very important role in sperm production and male fertility.
  • Focussed treatment of infections can be done after finding out their source and cause
  • Lifestyle disorders like diabetes and hypertension can be better controlled

In certain conditions surgical therapies like Varicocele repair can be offered to improve the sperm morphology by reducing oxidative damage.

 Fertility can be augmented by use of assisted reproductive techniques like:

  • Intrauterine Insemination(IUI): This will be the first choice among couples where the man is suffering from teratozoospermia problem. If the man is suffering from mild teratozoospermia and if the woman is perfectly healthy, direct injection of semen near the egg will help in fertilization of the egg.
  • In Vitro Fertilization or Intracytoplasmic Sperm Injection(IVF/ICSI): In cases of moderate to severe teratozoospermia, healthy and normal sperms will be selected by looking at the semen under the microscope. The selected sperm will be injected directly into the egg to achieve fertilization.
  • Intracytoplasmic Morphologically Selected Sperm Injection(IMSI): This is a more advanced technology considered above ICSI. This technique allows the andrologist to look at the sperms in more detail and to pick better sperms that can achieve fertilization

The crux is that we can try to find the probable cause to your poor morphology to see the best results with treatment. There is a solution available for those who choose to seek.

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